Ramipril reduces the incidence of stroke in patients at high risk, despite an only modest reduction in blood pressure. Bosch and colleagues (p 699) report that the relative risk of any stroke was reduced by 32% in patients receiving ramipril compared with placebo, and the relative risk of fatal stroke was reduced by 61%. The rates of use of angiotensin-converting-enzyme inhibitors (ACEIs) in the 2 groups (72% ramipril versus 68% placebo) were similar after the end of the trial. During the posttrial follow-up, patients allocated to ramipril had a 19% further lower relative risk (RR) of myocardial infarction (. Community discussion about Ramipril. Part of the heart health category. Symptom, treatment and advice from community members. Ramipril forum content is not moderated or reviewed by doctors. Patients with severe ramipril induced acute liver injury or hypersensitivity should avoid use of other ACE inhibitors, although cross sensitivity to liver injury among the members of this class of agents has not always been shown. Use of Ramipril in combination with thiazide diuretics gives a blood pressure lowering effect greater than that seen with either agent alone. In single-dose studies, doses of 5 mg to 20 mg of Ramipril lowered blood pressure within 1 to 2 hours, with peak reductions achieved 3 to 6 hours after dosing. Ramipril is used to treat a number of different conditions. The first dose may make you feel dizzy, so it is best taken at bedtime. Some painkillers and indigestion remedies interfere with ramipril. Ramipril reduces the incidence of stroke in patients at high risk, despite an only modest reduction in blood pressure. Bosch and colleagues (p 699) report that the relative risk of any stroke was reduced by 32% in patients receiving ramipril compared with placebo, and the relative risk of fatal Ramipril oral capsule is available as both a generic and brand-name drug. Brand-name: Altace. This drug may cause sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines. Patients who are at high risk of stroke should be treated with the drug ramipril, irrespective of their initial blood pressure levels and in addition to other preventive treatments such as blood.