Drug interactions
Prazosin + Ramipril
Severity: Moderate
Prazosin 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
Prazosin can cause a pronounced first-dose postural hypotension, and adding an ACE inhibitor such as ramipril can intensify this effect. Syncope and falls are the main concern, especially in older adults or those who are volume depleted.
What this interaction means in plain words
Prazosin 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.
Prazosin belongs to Genitourinary; Ramipril belongs to Cardiovascular.
Why it happens
Additive hypotensive effects from alpha-1 adrenergic blockade and ACE inhibition.
What to do
Start prazosin at a low dose at bedtime, advise the patient to rise slowly, and monitor blood pressure; consider reducing the dose of one agent 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
Other interactions of Prazosin
- Alfuzosin + Prazosin Major
- Amifostine + Prazosin Major
- Avanafil + Prazosin Major
- Doxazosin + Prazosin Major
- Dutasteride-tamsulosin + Prazosin Major
- Phenoxybenzamine + Prazosin Major
Frequently asked questions
Can I take Prazosin with Ramipril?
MediHelp rates the interaction as moderate. Prazosin 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. Prazosin can cause a pronounced first-dose postural hypotension, and adding an ACE inhibitor such as ramipril can intensify this effect. Syncope and falls are the main concern, especially in older adults or those who are volume depleted.
How serious is the interaction between Prazosin 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: Start prazosin at a low dose at bedtime, advise the patient to rise slowly, and monitor blood pressure; consider reducing the dose of one agent 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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