Altace is used for:

Treating high blood pressure and decreasing the risk of heart attack, stroke, and death in certain patients. Altace may also be used to treat congestive heart disease following a heart attack or for other conditions as determined by your doctor.

Altace is an angiotensin-converting enzyme (ACE) inhibitor. Altace works by causing blood vessels to relax so that blood flows more freely and at a lower pressure. Altace also increases the heart's ability to pump blood in some types of heart failure.

Do NOT use Altace if:

• you are allergic to any ingredient in Ramipril or similar medicines (ACE inhibitors), or if you have a history of angioedema (swelling of the face, lips, tongue, or throat) caused by an ACE inhibitor
• you are in your second or third trimester of pregnancy
• you have a history of kidney artery narrowing

Contact your doctor or health care provider right away if any of these apply to you.

Before using Altace:

Some medical conditions may interact with Altace. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have heart or blood vessel problems, liver problems, or kidney problems (eg, kidney artery narrowing, dialysis, kidney transplant)
• if you have high blood potassium levels or low blood sodium levels, or are on a low sodium diet
• if you have a severe autoimmune disease, lupus, scleroderma (a skin disease), or bone marrow depression
• if you will be having surgery

Some MEDICINES MAY INTERACT with Altace. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Dextran sulfate because side effects, such as low blood pressure and serious allergic-type reactions, may occur
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, indomethacin), potassium supplements, salicylates (eg, aspirin), or water pills (eg, triamterene, hydrochlorothiazide, or furosemide) because side effects, such as worsening kidney problems or excessive lowering of blood pressure, may occur
• Certain medicines for diabetes (eg, glyburide, glipizide), lithium, or azathioprine because the actions and side effects of these medicines may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Ramipril may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Altace:

Use Altace as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Altace by mouth with or without food.
• If you have difficulty swallowing the capsule, it can be opened and the contents sprinkled on a small amount (about 4 oz) of applesauce or mixed in half a glass (4 oz/120 mL) of water or apple juice. It is best to eat or drink the entire mixture immediately after mixing. These mixtures may be stored in the refrigerator for up to 48 hours.
• If you miss a dose of Altace, take it as soon as possible. If it is almost time for you next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Altace.

Important safety information:

• Ramipril may cause dizziness, lightheadedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use Ramipril with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• A persistent, dry cough may occur. Tell your doctor if this occurs. Recovery is rapid when the medicine is stopped.
• Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these occur.
• Ramipril may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
• Report any lightheadedness, especially during the first few days of taking Ramipril , to your doctor. If you experience fainting, you should talk with your doctor.
• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
• Check with your doctor before you use a salt substitute or a product that has potassium in it.
• Altace may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Ramipril. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• LAB TESTS, including blood tests, may be performed while you use Altace. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Ramipril should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY AND BREAST-FEEDING: Do not take Ramipril after the third month of pregnancy. It may cause injury or death to the fetus. If you become pregnant, contact your doctor right away. It is not known if Altace is found in breast milk. Do not breast-feed while taking Altace.

Possible side effects of Altace:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness or lightheadedness when sitting up or standing; feeling of a whirling motion; headache; nausea; persistent dry cough; tiredness; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bruising or bleeding more easily; chest pain; difficulty swallowing; fainting; fever or sore throat; hoarseness; irregular or slow heartbeat; shortness of breath; stomach pain or tenderness; unusual tiredness or weakness; yellowing of the skin or eyes.

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