Drug interactions
Ramipril + Tolazamide
Severity: Moderate
Ramipril and Tolazamide: 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
ACE inhibitors can enhance insulin sensitivity and the glucose-lowering action of sulfonylureas, occasionally causing hypoglycemia. The risk is greatest when ACE inhibitor therapy is started or in patients with renal impairment.
What this interaction means in plain words
Ramipril and Tolazamide 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; Tolazamide belongs to Endocrine.
Why it happens
ACE inhibition may improve insulin sensitivity and glucose uptake, producing a pharmacodynamic additive hypoglycemic effect.
What to do
Monitor blood glucose when starting or adjusting ramipril and reduce the sulfonylurea dose if hypoglycemia occurs. Teach patients hypoglycemia symptoms.
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 Tolazamide
- Disopyramide + Tolazamide Major
- Insulin degludec-liraglutide + Tolazamide Major
- Aceclofenac + Tolazamide Moderate
- Acemetacin + Tolazamide Moderate
- Acetylsalicylic acid + Tolazamide Moderate
- Albiglutide + Tolazamide Moderate
Frequently asked questions
Can I take Ramipril with Tolazamide?
MediHelp rates the interaction as moderate. Ramipril and Tolazamide 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. ACE inhibitors can enhance insulin sensitivity and the glucose-lowering action of sulfonylureas, occasionally causing hypoglycemia. The risk is greatest when ACE inhibitor therapy is started or in patients with renal impairment.
How serious is the interaction between Ramipril and Tolazamide?
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 glucose when starting or adjusting ramipril and reduce the sulfonylurea dose if hypoglycemia occurs. Teach patients hypoglycemia symptoms.
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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