Drug interactions
Nitroglycerin rectal + Ramipril
Severity: Moderate
Nitroglycerin rectal 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
Rectal nitroglycerin, used for anal fissures, is absorbed systemically and can cause headache and hypotension. Together with ramipril, additive blood pressure lowering may cause dizziness or fainting.
What this interaction means in plain words
Nitroglycerin rectal 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 vasodilation and blood pressure lowering through pharmacodynamic synergism.
What to do
Monitor blood pressure and advise the patient to rise slowly after applying the preparation. Lower the nitroglycerin dose or review the antihypertensive 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 Nitroglycerin rectal with Ramipril?
MediHelp rates the interaction as moderate. Nitroglycerin rectal 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. Rectal nitroglycerin, used for anal fissures, is absorbed systemically and can cause headache and hypotension. Together with ramipril, additive blood pressure lowering may cause dizziness or fainting.
How serious is the interaction between Nitroglycerin rectal 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 blood pressure and advise the patient to rise slowly after applying the preparation. Lower the nitroglycerin dose or review the antihypertensive 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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