Drug interactions
Ramipril + Torsemide
Severity: Moderate
Ramipril and Torsemide: 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 a loop diuretic can cause pronounced hypotension, especially at the first dose or in volume-depleted patients. Renal function may deteriorate, occasionally to acute kidney injury.
What this interaction means in plain words
Ramipril and Torsemide 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; Torsemide belongs to Cardiovascular.
Why it happens
Additive hemodynamic effects: diuretic-induced volume depletion increases dependence on angiotensin II, which ACE inhibition removes.
What to do
Begin ramipril at a low dose, consider reducing the torsemide dose beforehand, and monitor blood pressure, creatinine and potassium after initiation and dose changes.
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 Torsemide
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 Ramipril with Torsemide?
MediHelp rates the interaction as moderate. Ramipril and Torsemide 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 a loop diuretic can cause pronounced hypotension, especially at the first dose or in volume-depleted patients. Renal function may deteriorate, occasionally to acute kidney injury.
How serious is the interaction between Ramipril and Torsemide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Begin ramipril at a low dose, consider reducing the torsemide dose beforehand, and monitor blood pressure, creatinine and potassium after initiation and dose changes.
What other medicines interact with Torsemide?
MediHelp also lists interactions of Torsemide with, for example, Amikacin, Amiodarone, Carbenoxolone. The full list is on the Torsemide page.
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