Ramipril Foods

Drug/Food interactions Food significantly reduces the bioavailability of captopril by 30% to 40%. Administer captopril 1 hour before meals. The rate and extent of quinapril absorption are diminished moderately (25% to 30%) when administered during a high-fat meal. The rate, but not extent, of ramipril and fosinopril absorption is reduced by food. Food does not reduce the Gl absorption of benazepril, enalapril, and lisinopril. 

Ramipril (altace) Cleavage of the ester moiety by hepatic esterases transforms ramipiil into ramiprilat, an ACE inhibitor that is about as potent as benazeprilat and quinaprilat. Ramipril is absorbed rapidly (peak concentrations of ramipril achieved in 1 hour), and the rate but not extent of its oral absorption (50-60%) is reduced by food. Ramipril is metabolized to ramiprilat and to inactive metabolites (glucuronides of ramipril and ramiprilat and the diketopiperazine ester and acid) that predominantly are excreted by the kidneys. Peak concentrations of ramiprilat in plasma are achieved in about 3 hours. Ramiprilat displays triphasic ehmination kinetics with tj of 2-4 hours,... 

Food has little or no effect on the absorption of cilazapril, enal-april, fosinopril, lisinopril, quinapril, ramipril, spirapril, and trandolapril. Although food may reduce the absorption of capto-pril, this does not appear to be clinically important. Food reduced the absorption of imidapril and moexipril, and reduced the conversion of perindopril to perindoprilat, but the clinical relevance of these effects has not been assessed. 

Other single-dose studies have shown that food had no statistically significant effect on the pharmacokinetics of lisinopril, or enalapril, and its active metabolite, enalaprilat. Similarly, food had minimal effects on the pharmacokinetics of cilazapril (AUC decreased by only 14%). Food caused small, but statistically significant increases in the time to reach maximum plasma levels of quinapril and its active metabolite. However, as the increase was less than 30 minutes this is not expected to alter the therapeutic effect. Likewise, the manufacturers of spirapril briefly mention in a review that food delayed its absorption by 1 hour, it did not affect the bioavailability of spirapril or spiraprilat, its active metabolite. Other manufacturers state that food had no effect on the absorption of fosinopril 11,12 ramipril, or trandolapril. ... 

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