Drug interactions
Aspirin / citric acid / sodium bicarbonate + Ramipril
Severity: Moderate
Aspirin / citric acid / sodium bicarbonate and Ramipril: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Analgesic-dose aspirin can blunt the blood pressure lowering effect of ramipril. Together they can also impair renal function, especially in elderly or volume-depleted patients. The sodium bicarbonate content adds a sodium load.
What this interaction means in plain words
Aspirin / citric acid / sodium bicarbonate and Ramipril can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Aspirin inhibits synthesis of vasodilatory renal prostaglandins, opposing ACE inhibitor effects and reducing glomerular perfusion.
What to do
Avoid regular use of the analgesic-dose effervescent product in patients taking ramipril; if unavoidable, ensure hydration and monitor blood pressure, serum creatinine and potassium. Low-dose aspirin for cardiovascular prevention is generally acceptable.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Aspirin / citric acid / sodium bicarbonate with Ramipril?
MediHelp rates the interaction as moderate. Aspirin / citric acid / sodium bicarbonate and Ramipril can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Analgesic-dose aspirin can blunt the blood pressure lowering effect of ramipril. Together they can also impair renal function, especially in elderly or volume-depleted patients. The sodium bicarbonate content adds a sodium load.
How serious is the interaction between Aspirin / citric acid / sodium bicarbonate and Ramipril?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid regular use of the analgesic-dose effervescent product in patients taking ramipril; if unavoidable, ensure hydration and monitor blood pressure, serum creatinine and potassium. Low-dose aspirin for cardiovascular prevention is generally acceptable.
What other medicines interact with Ramipril?
MediHelp also lists interactions of Ramipril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Ramipril page.
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