Drug interactions
Ramipril + Xipamide
Severity: Moderate
Ramipril and Xipamide: 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
Xipamide is a thiazide-like diuretic that adds to the blood-pressure-lowering effect of ramipril. Volume depletion can cause marked first-dose hypotension and renal function deterioration.
What this interaction means in plain words
Ramipril and Xipamide 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.
Why it happens
Additive antihypertensive effect from diuretic-induced volume and sodium depletion and ACE inhibition of the renin-angiotensin system.
What to do
Consider reducing or temporarily withholding the diuretic before starting ramipril, and start ramipril at a low dose. Monitor blood pressure, renal function and electrolytes.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ramipril and Xipamide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Xipamide?
MediHelp rates the interaction as moderate. Ramipril and Xipamide 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. Xipamide is a thiazide-like diuretic that adds to the blood-pressure-lowering effect of ramipril. Volume depletion can cause marked first-dose hypotension and renal function deterioration.
How serious is the interaction between Ramipril and Xipamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider reducing or temporarily withholding the diuretic before starting ramipril, and start ramipril at a low dose. Monitor blood pressure, renal function and electrolytes.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
