Drug interactions
Ramipril + Sirolimus
Severity: Moderate
Ramipril and Sirolimus: 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 an ACE inhibitor with an mTOR inhibitor such as sirolimus raises the likelihood of angioedema, which can involve the face, lips, tongue or airway. Onset may occur at any time during therapy.
What this interaction means in plain words
Ramipril and Sirolimus 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.
Ramipril belongs to Cardiovascular; Sirolimus belongs to Miscellaneous.
Why it happens
Both drugs reduce bradykinin breakdown (ACE inhibition and mTOR inhibitor-related effects on DPP-IV), so bradykinin accumulates and promotes angioedema.
What to do
Counsel patients to report swelling of the face, lips, tongue or throat immediately. Stop the ACE inhibitor and switch to another antihypertensive class if angioedema develops.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Ramipril with Sirolimus?
MediHelp rates the interaction as moderate. Ramipril and Sirolimus 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 an ACE inhibitor with an mTOR inhibitor such as sirolimus raises the likelihood of angioedema, which can involve the face, lips, tongue or airway. Onset may occur at any time during therapy.
How serious is the interaction between Ramipril and Sirolimus?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel patients to report swelling of the face, lips, tongue or throat immediately. Stop the ACE inhibitor and switch to another antihypertensive class if angioedema develops.
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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