Drug interactions
Ethacrynic acid + Ramipril
Severity: Moderate
Ethacrynic acid 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
Loop diuretics such as ethacrynic acid can cause volume depletion, which makes a first dose of an ACE inhibitor more likely to cause marked hypotension. Renal function can also deteriorate, particularly in patients with heart failure, renal impairment or low sodium.
What this interaction means in plain words
Ethacrynic acid 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.
Ethacrynic acid belongs to Cardiovascular; Ramipril belongs to Cardiovascular.
Why it happens
Diuretic-induced volume and sodium depletion activates the renin-angiotensin system, so ACE inhibition produces exaggerated hypotension and reduced glomerular filtration.
What to do
Consider lowering or temporarily holding the diuretic before starting ramipril, and begin with a low ramipril dose. Monitor blood pressure, serum creatinine and electrolytes over the first weeks.
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
Other interactions of Ethacrynic acid
Frequently asked questions
Can I take Ethacrynic acid with Ramipril?
MediHelp rates the interaction as moderate. Ethacrynic acid 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. Loop diuretics such as ethacrynic acid can cause volume depletion, which makes a first dose of an ACE inhibitor more likely to cause marked hypotension. Renal function can also deteriorate, particularly in patients with heart failure, renal impairment or low sodium.
How serious is the interaction between Ethacrynic acid 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: Consider lowering or temporarily holding the diuretic before starting ramipril, and begin with a low ramipril dose. Monitor blood pressure, serum creatinine and electrolytes over the first weeks.
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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