Drug interactions
Ramipril + Telmisartan
Severity: Major
Ramipril and Telmisartan: major 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
Dual blockade of the renin-angiotensin system with an ACE inhibitor and an ARB increased renal dysfunction, hyperkalemia and hypotension in outcome trials without added cardiovascular benefit. The combination is therefore generally discouraged.
What this interaction means in plain words
Ramipril and Telmisartan 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.
Ramipril belongs to Cardiovascular; Telmisartan belongs to Cardiovascular.
Why it happens
Additive inhibition of the renin-angiotensin-aldosterone system, reducing glomerular filtration pressure and aldosterone-mediated potassium excretion.
What to do
Avoid combined use and treat with a single RAS blocker, adding another drug class if needed. If it is used, monitor creatinine, potassium 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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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 Telmisartan
- Aliskiren + Telmisartan Contraindicated
- Sparsentan + Telmisartan Contraindicated
- Amifostine + Telmisartan Major
- Amiloride + Telmisartan Major
- Amlodipine-benazepril + Telmisartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Telmisartan Major
Frequently asked questions
Can I take Ramipril with Telmisartan?
MediHelp rates the interaction as major. Ramipril and Telmisartan 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. Dual blockade of the renin-angiotensin system with an ACE inhibitor and an ARB increased renal dysfunction, hyperkalemia and hypotension in outcome trials without added cardiovascular benefit. The combination is therefore generally discouraged.
How serious is the interaction between Ramipril and Telmisartan?
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 combined use and treat with a single RAS blocker, adding another drug class if needed. If it is used, monitor creatinine, potassium 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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