Like all medicines, ramipril can cause side effects in some people, but many people have no side effects or only minor ones.
Side effects often improve as your body gets used to the medicine.
Common side effects
These common side effects of ramipril happen in more than 1 in 100 people. There are things you can do to help cope with them:
A dry, tickly cough that does not get better
Cough medicines do not usually help for coughs caused by ramipril. Sometimes the cough gets better on its own. Talk to your doctor if it carries on, bothers you or stops you sleeping, as another medicine may be better. Even if you stop taking ramipril, the cough may take a few days to a month to go away.
Feeling dizzy or lightheaded, especially when you stand up or sit up quickly
This is more likely to happen when you start taking ramipril or move on to a higher dose. If ramipril makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you do not faint, then sit until you feel better. Do not drive, ride a bike or use tools or machinery until the dizziness passes.
Headaches
Make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.
Diarrhoea
Drink plenty of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor first.
If you take the combined contraceptive pill or progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
If you get diarrhoea from a stomach bug or illness, tell your doctor. You may need to stop taking ramipril for a while until you feel better.
Being sick (vomiting)
Take small, frequent sips of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor first.
If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
If you get vomiting from a stomach bug or illness, tell your doctor. You may need to stop taking ramipril for a while until you feel better.
A mild skin rash
It may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.
Blurred vision
Do not drive, ride a bike or use tools or machinery while this is happening. GOV.UK has more information on the law on drugs and driving. If it lasts for more than a day or two, speak to your doctor as they may need to change your treatment.
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Serious side effects
It happens rarely, but some people have serious side effects after taking ramipril.
Call a doctor or call 111 straight away if:
- the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems
- you're paler than usual, you feel tired, faint or dizzy, you have any sign of bleeding (like bleeding from the gums and bruising more easily than usual), a sore throat, a high temperature, or you get infections more easily – these can be signs of a blood or bone marrow disorder
- you have severe stomach pain – this can be a sign of an inflamed pancreas (acute pancreatitis)
- you have swollen ankles or blood in your pee or you're not peeing at all – these can be signs of kidney problems
Immediate action required: Call 999 or go to A&E now if:
- you have weakness on one side of your body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke
- you have a faster heart rate, chest pain and tightness in your chest – these can be signs of heart problems
- you have shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.
Bring all the medicines you take with you.
Serious allergic reaction
In rare cases, ramipril may cause a serious allergic reaction (anaphylaxis).
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
Do not drive yourself to A&E.
The person you speak to at 999 will give you advice about what to do.
Long term side effects
Taking ramipril for a long time can sometimes cause your kidneys to not work as well as they should. Your doctor will check how well your kidneys are working with regular blood tests.
Other side effects
These are not all the side effects of ramipril. For a full list, see the leaflet inside your medicine packet.
Reporting side effects
You can report any suspected side effect using the Yellow Card safety scheme.
Visit the Yellow Card website for more information about reporting side effects.