When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to ramipril or another ACE inhibitor, or if you are pregnant.

How to Use This Medicine:
Capsule, Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Capsule or tablet: Swallow the capsule or tablet whole. If you cannot swallow the capsule, you may open it and mix the medicine with 4 ounces (½ cup) of applesauce, water, or apple juice. Eat or drink this mixture all at once so you get all of the medicine. You may also store the mixture for 24 hours at room temperature or up to 48 hours in the refrigerator.
• Missed dose:Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with aliskiren if you have diabetes.
• Some medicines can affect how ramipril works. Tell your doctor if you are using any of the following:
  
  • Aliskiren
  • Lithium
  • Telmisartan or other angiotensin receptor blocker medicine
  • Temsirolimus
  • A diuretic (water pill)
  • An NSAID pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
• Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney problems, liver disease, congestive heart failure, heart or blood vessel disease, diabetes, low blood pressure, or a collagen-vascular disease (such lupus or scleroderma).
• This medicine may cause the following problems:
  
  • Intestinal swelling
  • Liver problems
  • Kidney problems
• This medicine could lower your blood pressure too much, especially when you first use it or if you are dehydrated. Stand or sit up slowly if you feel lightheaded or dizzy.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Change in how much or how often you urinate
• Confusion, weakness, uneven heartbeat, trouble breathing, or numbness in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fever, chills, sore throat, and body aches
• Lightheadedness, dizziness, or fainting
• Severe stomach pain

If you notice these less serious side effects, talk with your doctor:

• Dry cough

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088