Drug interactions
Bretylium + Ramipril
Severity: Moderate
Bretylium 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
Both drugs can lower blood pressure, and bretylium commonly causes orthostatic hypotension through adrenergic neuron blockade. Combined use can produce additive hypotension, especially on standing.
What this interaction means in plain words
Bretylium 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
Additive pharmacodynamic hypotension from ACE inhibition and adrenergic neuron blockade.
What to do
Monitor supine and standing blood pressure when starting or adjusting either drug, and reduce the ramipril dose if symptomatic hypotension occurs.
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 Bretylium with Ramipril?
MediHelp rates the interaction as moderate. Bretylium 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. Both drugs can lower blood pressure, and bretylium commonly causes orthostatic hypotension through adrenergic neuron blockade. Combined use can produce additive hypotension, especially on standing.
How serious is the interaction between Bretylium 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: Monitor supine and standing blood pressure when starting or adjusting either drug, and reduce the ramipril dose if symptomatic hypotension occurs.
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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