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Ramipril for high blood pressure
Ramipril for high blood pressure
This leaflet is about the use of ramipril for high blood pressure (this is also called hypertension).
This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Name of drug
Brand name: Tritace®
Why is it important for my child to take this medicine?
High blood pressure 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 to reduce their blood pressure, your doctor may suggest that they take different medicines at different times of the day. Your doctor will help you plan this.
- Give the medicine at about the same time 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 the medicine at a low dose then gradually increase it until your child’s blood pressure is at the right level.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet. You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing.
Capsules should be swallowed with a glass of water, milk or juice. 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.
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, you do not need to give them another dose. Wait until the next normal dose.
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 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 an extra dose of 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, as they may want to check your child’s blood pressure.
If your child feels faint or dizzy, cold and sweaty, or has a weak or rapid heart rate (they may feel as though their heart is racing or fluttering), or they begin to breathe quickly, contact your doctor or take your child to hospital straight away.
Have the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the medicine packet with you if you telephone for advice.
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, they may be allergic to ramipril. Take your child to hospital or call an ambulance straight away.
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, as it may be too low.
- 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.
- 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.
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 that you get on prescription. Tell your doctor and pharmacist about any other medicines that your child is taking before starting ramipril.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
Is there anything else I need to know about ramipril?
- 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 do blood tests to make sure that your child’s kidneys are working correctly, as sometimes ramipril affects kidney function.
- 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 the medicine at about the same times each day, to help you remember.
- If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
- 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.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- 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 medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where I should 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 doctor, pharmacist or nurse will be able to give you more information about ramipril and about other medicines used to treat high blood pressure.
You can also get useful information from:
Version 1.2, September 2011 (November 2011). © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: September 2013.
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.