Drug interactions
Losartan + Ramipril
Severity: Major
Losartan 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
Combining an ACE inhibitor with an angiotensin receptor blocker gives dual renin-angiotensin system blockade. This raises the risk of hyperkalemia, hypotension and renal impairment without a proven added outcome benefit.
What this interaction means in plain words
Losartan 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.
Losartan belongs to Cardiovascular; Ramipril belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic inhibition of the renin-angiotensin-aldosterone system at two points, reducing aldosterone and glomerular efferent tone.
What to do
Avoid routine combination and use a single RAS blocker. If the combination is unavoidable, monitor serum potassium, creatinine and blood pressure closely.
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 Losartan
- Aliskiren + Losartan Contraindicated
- Losartan + Sparsentan Contraindicated
- Amifostine + Losartan Major
- Amiloride + Losartan Major
- Amlodipine-benazepril + Losartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Losartan Major
Frequently asked questions
Can I take Losartan with Ramipril?
MediHelp rates the interaction as major. Losartan 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. Combining an ACE inhibitor with an angiotensin receptor blocker gives dual renin-angiotensin system blockade. This raises the risk of hyperkalemia, hypotension and renal impairment without a proven added outcome benefit.
How serious is the interaction between Losartan 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: Avoid routine combination and use a single RAS blocker. If the combination is unavoidable, monitor serum potassium, creatinine and blood pressure closely.
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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