Drug interactions
Everolimus + Ramipril
Severity: Major
Everolimus and Ramipril: major interaction.
Last updated Sources: US FDA label
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 ACE inhibitors and mTOR inhibitors such as everolimus are associated with angioedema, and their combination raises the incidence of this reaction. Swelling of the face, lips, tongue or airway can be serious.
What this interaction means in plain words
Everolimus and Ramipril can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Everolimus belongs to Oncology; Ramipril belongs to Cardiovascular.
Why it happens
Additive angioedema risk, likely through reduced bradykinin degradation by ACE inhibition combined with mTOR inhibitor effects on the same pathway.
What to do
Counsel the patient to seek urgent care for swelling of the face, tongue or throat. Consider an alternative antihypertensive such as a calcium channel blocker if angioedema occurs or risk is high.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine Contraindicated
Frequently asked questions
Can I take Everolimus with Ramipril?
MediHelp rates the interaction as major. Everolimus and Ramipril can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both ACE inhibitors and mTOR inhibitors such as everolimus are associated with angioedema, and their combination raises the incidence of this reaction. Swelling of the face, lips, tongue or airway can be serious.
How serious is the interaction between Everolimus and Ramipril?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel the patient to seek urgent care for swelling of the face, tongue or throat. Consider an alternative antihypertensive such as a calcium channel blocker if angioedema occurs or risk is high.
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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