Drug interactions
Furosemide + Ramipril
Severity: Moderate
Furosemide 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
Combining ramipril with a loop diuretic can lead to marked hypotension and acute worsening of renal function, especially at initiation, during volume depletion or in renal artery stenosis. This pairing is widely used in heart failure but requires careful start-up.
What this interaction means in plain words
Furosemide 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.
Furosemide belongs to Cardiovascular; Ramipril belongs to Cardiovascular.
Why it happens
Diuretic volume depletion plus ACE inhibition lowers efferent arteriolar tone, giving additive hypotension and reduced glomerular filtration.
What to do
Consider lowering or briefly holding furosemide before starting ramipril, and begin at a low dose. Monitor blood pressure, creatinine and potassium within one to two 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 Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide Major
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 Furosemide with Ramipril?
MediHelp rates the interaction as moderate. Furosemide 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. Combining ramipril with a loop diuretic can lead to marked hypotension and acute worsening of renal function, especially at initiation, during volume depletion or in renal artery stenosis. This pairing is widely used in heart failure but requires careful start-up.
How serious is the interaction between Furosemide 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 briefly holding furosemide before starting ramipril, and begin at a low dose. Monitor blood pressure, creatinine and potassium within one to two weeks.
What other medicines interact with Furosemide?
MediHelp also lists interactions of Furosemide with, for example, Amifostine, Amikacin, Carbenoxolone. The full list is on the Furosemide page.
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