After one week, your doctor may increase your dose as tolerated up to 5 mg taken twice per day. Your doctor may continue to increase your dose once every 3 weeks if needed. The maximum dose is 20 mg. Your doctor may watch you for at least 2 hours after you take the first dose to make sure that you can safely take this drug.

Your doctor may increase your dose up to 1. The maximum dose is 2. Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages.

This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you. Advertisement Take as directed Take as directed Ramipril oral capsule is used for long-term treatment. It comes with risks if you don't take it as prescribed. If you don't take it at all: Ramipril reduces high blood pressure. If you stop taking it suddenly: Stopping this drug suddenly can cause your blood pressure to spike. This may increase your chance for a heart attack or stroke.

If you don't take it on schedule: Your blood pressure may not improve or may get worse. You may have a higher chance of a heart attack or stroke. What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. Never try to catch up by taking two doses at once. What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at Overdose symptoms may include nausea, weakness, dizziness, dry mouth, thirst, muscle pain or weakness, or feeling like you might pass out. What should I avoid while taking hydrochlorothiazide and lisinopril? Avoid becoming overheated or dehydrated during exercise and in hot weather.

Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Drinking alcohol can increase certain side effects of hydrochlorothiazide and lisinopril.

Avoid the regular use of salt substitutes in your diet, and do not take potassium supplements while taking hydrochlorothiazide and lisinopril, unless your doctor has told you to. What are the possible side effects of hydrochlorothiazide and lisinopril? Get emergency medical help if you have any of these signs of an allergic reaction: Call your doctor at once if you have any of these serious side effects: Less serious side effects may include: This is not a complete list of side effects and others may occur.

Call your doctor for medical advice about side effects. What other drugs will affect hydrochlorothiazide and lisinopril? Cold or allergy medicine, sedatives, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety can add to the side effects of hydrochlorothiazide and lisinopril.

Tell your doctor if you regularly use any of these medicines, or any other blood pressure medications. Tell your doctor about all other medicines you use, especially: This list is not complete and other drugs may interact with hydrochlorothiazide and lisinopril.

Depending on the patient's tolerability to the active substance, the dose is subsequently increased. Doubling the once daily dose to 2. In patients with diabetes and at least one cardiovascular risk Starting dose: The recommended initial dose is 2. Doubling the daily dose to 5mg ramipril after one or two weeks and then to 10mg ramipril after a further two or three weeks is recommended. The target daily dose is 10mg. Symptomatic heart failure Starting dose: In patients stabilized on diuretic therapy, the recommended initial dose is 1.

Ramipril should be titrated by doubling the dose every one to two weeks up to a maximum daily dose of 10mg. Two administrations per day are preferable. Secondary prevention after acute myocardial infarction and with heart failure Starting dose: After 48 hours, following myocardial infarction in a clinically and haemodynamically stable patient, the starting dose is 2.

If the initial 2. If the dose cannot be increased to 2. The daily dose is subsequently increased by doubling the dose at intervals of one to three days up to the target maintenance dose of 5mg twice daily.

The maintenance dose is divided in 2 administrations per day where possible. Sufficient experience is still lacking in the treatment of patients with severe NYHA IV heart failure immediately after myocardial infarction. Should the decision be taken to treat these patients, it is recommended that therapy be started at 1.

Special populations Patients with renal impairment Daily dose in patients with renal impairment should be based on creatinine clearance see section 5. Patients with hepatic impairment see section 5. Elderly Initial doses should be lower and subsequent dose titration should be more gradual because of greater chance of undesirable effects especially in very old and frail patients.

A reduced initial dose of 1. Paediatric population The safety and efficacy of Ramipril in children aged 2 — 16 years has not yet been established. Currently available data are described in sections 4. Method of administration For oral administration. Patients at particular risk of hypotension - Patients with strongly activated renin-angiotensin-aldosterone system Patients with strongly activated renin-angiotensin-aldosterone system are at risk of an acute pronounced fall in blood pressure and deterioration of renal function due to ACE inhibition, especially when an ACE inhibitor or a concomitant diuretic is given for the first time or at first dose increase.

Significant activation of renin-angiotensin-aldosterone system is to be anticipated and medical supervision including blood pressure monitoring is necessary, for example in: Generally, it is recommended to correct dehydration, hypovolaemia or salt depletion before initiating treatment in patients with heart failure, however, such corrective action must be carefully weighed out against the risk of volume overload.

Elderly patients See section 4. Surgery It is recommended that treatment with angiotensin converting enzyme inhibitors such as ramipril should be discontinued where possible one day before surgery.

Monitoring of renal function Renal function should be assessed before and during treatment and dosage adjusted especially in the initial weeks of treatment.

Particularly careful monitoring is required in patients with renal impairment see section 4. There is a risk of impairment of renal function, particularly in patients with congestive heart failure or after a renal transplant.

Angioedema Angioedema has been reported in patients treated with ACE inhibitors including ramipril see section 4.

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In some cases, idroclorotiazide too much liquid can be as unsafe as not drinking enough. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. A side effect is an unwanted response to a medication when it is taken in normal doses. These patients should be asked to report pregnancies to their physicians as soon as possible. If you need surgery, tell ramipril surgeon ahead of time that you are using hydrochlorothiazide. It is not known whether ramipril passes into breast milk or if it could harm a nursing baby. The most common reasons for discontinuation were: Your blood and urine may also be tested if you have been vomiting or are dehydrated. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice, ramipril 5mg idroclorotiazide 25mg. If the initial 2. 25mg on diuretics, especially those 5mg whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with ALTACE.

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