Medicines

Ramipril for high blood pressure

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of medicine

  • Ramipril
  • Brand name: Tritace

Why is it important for my child to take Ramipril?

High blood pressure (hypertension) can lead to damage to internal organs. Ramipril is a medicine called an ACE inhibitor which helps to lower blood pressure.

What is Ramipril available as?

  • Tablets: 1.25 mg, 2.5 mg, 5 mg, 10 mg
  • Capsules: 1.25 mg, 2.5 mg, 5 mg, 10 mg

When should I give Ramipril

Ramipril is usually given once each day. This is usually in the morning.

If your child is taking more than one medicine, your doctor may suggest that they are given at different times of the day. Your doctor will help you plan this.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of Ramipril (the dose) that is right for your child. The dose will be shown on the medicine label.

Your doctor will start your child on a low dose of Ramipril. They will check your child’s blood pressure regularly and may increase the dose if your child’s blood pressure is still too high.

It is important that you follow your doctor’s instructions about how much to give.

How should I give Ramipril?

Tablets

  • Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
  • You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

Capsules

  • Capsules should be swallowed with a glass of water, juice, or squash. Your child should not chew the capsule. You can open the capsule and mix the contents with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing.

Liquid Medicine

  • Shake the medicine well. Measure out the right amount using an oral syringe or a medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

Your child’s blood pressure will start to come down after a few days, although you will not see any difference in your child.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of Ramipril, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of Ramipril, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose of Ramipril is due.

You do not need to wake up a sleeping child to give a missed dose.

Never give a double dose of Ramipril.

What if I give too much?

It may be dangerous to give too much Ramipril because it may make your child’s blood pressure too low.

If you think you may have given your child too much Ramipril, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

If your child feels faint or dizzy, cold and sweaty, or has a weak or rapid heart rate (their heart feels like it is racing or fluttering), or they begin to breathe quickly, contact your doctor or take your child to hospital straight away.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side effects).

Side effects you must do something about

If your child’s face, lips or tongue start to swell, or they develop a rash, take your child to hospital or call an ambulance straight away, as your child may be developing angioedema, which needs to be treated.

Other side-effects you need to know about

  • Your child may feel dizzy or light-headed when they stand up, or may faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or light-headed. If this happens often, contact your doctor to check your child’s blood pressure and blood sugar level, as it may be too low.

  • Your child may develop a dry cough that doesn’t go away. If it becomes a problem, contact your doctor for advice, but continue to give Ramipril as normal.

  • Your child may feel sick (nausea) or be sick (vomit) or get diarrhoea when they first start taking Ramipril. Giving the medicine with some food may help. If this is still a problem after a week, contact your doctor for advice.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Ramipril?

  • You can give your child medicines that contain paracetamol, unless your doctor has told you not to.
  • Ramipril should not be taken with some medicines. Tell your doctor or pharmacist about any other medicines your child is taking before giving Ramipril.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

  • If your child has an illness that stops them drinking for more than 12 hours, contact your doctor for advice. Your child may become dehydrated, which could harm their kidneys while they are taking Ramipril. The early signs of dehydration are thirst, headache, dry tongue and lips, and sunken eyes; in an infant the soft spot on the skull (fontanelle) may be sunken.
  • Your doctor will check your child’s blood pressure and pulse rate regularly while taking Ramipril.
  • Your doctor will test your child’s blood regularly to check that Ramipril has not affected their kidneys.
  • Ramipril may affect a pregnancy and could harm an unborn baby. The oral contraceptive pill may also be less effective. If your daughter is sexually active, ask your doctor for advice. If your daughter thinks she may be pregnant it is important that she sees your family doctor as soon as possible.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

Where should I keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight.
  • It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Ramipril and about other medicines used to treat high blood pressure.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by October 2017.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.