Ramipril Dosages for Adults: Your GoodRx Guide

Ramipril (Altace) is an angiotensin-converting enzyme (ACE) inhibitor. It treats high blood pressure (hypertension) and other heart-related conditions. Taking the right amount of ramipril can help you get the most from your medication and help limit unwanted side effects. 

Below, we’ll cover the recommended ramipril dosages for adults. Ramipril isn’t approved for children, but it’s sometimes prescribed off-label for certain conditions. In this case, your pediatrician will provide dosing instructions based on your child’s needs and medical history.

What’s the typical ramipril dosage for adults?

Your ramipril dosage depends on what you’re treating and your other medical conditions.

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High blood pressure

For high blood pressure, the usual ramipril dosage is between 2.5 mg and 20 mg daily. In most cases, you’ll start with 2.5 mg of ramipril once daily. Your prescriber will monitor your blood pressure and increase your dosage from there as needed.

If ramipril alone isn’t enough to lower your blood pressure, your prescriber may add on a diuretic medication (“water pill”) to help.

To reduce the risk of heart attack and stroke

If you’re at least 55 years of age and at a high risk for heart-related problems, ramipril can help lower your risk.

To reduce the risk of heart attack and stroke, the recommended ramipril dosage is 10 mg once daily. In most cases, you’ll start with 2.5 mg of ramipril once daily for 1 week. Then, your dosage will likely increase to 5 mg once daily for 3 weeks. From there, your prescriber will increase your dosage as tolerated up to 10 mg per day.

Heart failure after a heart attack

For adults who’ve had a recent heart attack and are showing signs of heart failure, the target ramipril dosage is 5 mg twice a day. In most cases, you’ll start with 2.5 mg twice daily (5 mg per day) then slowly increase to the target dosage about every 3 weeks as tolerated. If this starting dosage causes low blood pressure (hypotension), your prescriber may lower it to 1.25 mg twice daily instead.

In most cases, if you’re taking ramipril for reasons related to heart failure, your prescriber will have you take your first dose under medical supervision. This ensures you’ll have help on hand if your blood pressure drops too low. 

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How to take ramipril

Ramipril comes as an oral capsule in the following doses:

• 1.25 mg

• 2.5 mg

• 5 mg

• 10 mg

If you’re taking ramipril for high blood pressure, you can take it once a day. But some people’s blood pressure may go up toward the end of the day as ramipril’s effects wear off. In this case, your prescriber may have you divide your daily dose into two smaller doses and take it twice a day. This can help manage your blood pressure better around the clock. Talk to your prescriber about which dosing regimen is best for your needs.

If you have trouble swallowing pills, you can open the ramipril capsule and mix the contents with 4 oz of applesauce, water, or apple juice. Be sure to eat or drink the entire amount to ensure you get your full dose. You can also mix your dose ahead of time and store it for up to 24 hours at room temperature or up to 48 hours in the fridge.

Are there any dosage adjustments for medical conditions?

If you're living with kidney problems, you may need a lower ramipril dosage than described above. It’s recommended to start with a ramipril dosage of 1.25 mg once daily. Your prescriber will increase it from there as tolerated to a maximum of 5 mg per day.

What happens if you miss a dose of ramipril?

If you accidentally miss a dose of ramipril, take it as soon as you remember. If it’s close to your next dose, skip the one you missed and continue with your normal dosing schedule. Don’t double up on your ramipril dosage because of a missed dose unless your prescriber tells you to. This can increase your risk of low blood pressure. 

To help avoid missed doses, set an alarm on your phone or try a medication reminder app.

What should you do if you take too much ramipril?

If you take an extra dose of ramipril by accident, it’s not likely to cause a serious problem. You may experience more side effects, such as dizziness or low blood pressure. But these effects should go away as your dose wears off.

But large amounts of ramipril can make your blood pressure fall dangerously low. If you or a loved one takes more ramipril than recommended, talk with your healthcare team or call Poison Control at 1-800-222-1222. If you’re feeling faint or feel your symptoms are life-threatening, call 911 or seek emergency care right away.

How to save on ramipril

Ramipril is available as both a brand-name and generic medication. GoodRx can help you save over 60% off the average retail price of the generic version. Generic ramipril’s price at certain pharmacies is as low as $10.00 per month with a free GoodRx discount.

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Written by:

Jill Barat, PharmD

Jill Barat, PharmD has nearly 10 years of experience as a pharmacist, including serving as the pharmacist in charge at an independent sterile and non-sterile compounding pharmacy. She also worked as the head of medical content for a telemedicine company.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Patricia Weiser, PharmD

Patricia has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

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