Ramipril


Ramipril
Systematic (IUPAC) name
(1S,5S,7S)-8-[(2S)-2-[[(1S)-1-ethoxycarbonyl-3-phenyl- propyl]amino]propanoyl]-8-azabicyclo[3.3.0]octane-7- carboxylic acid
Identifiers
CAS number	87333-19-5
ATC code	C09 AA05
PubChem	5362129
DrugBank	APRD00009
Chemical data
Formula	C₂₃H₃₂N₂O₅
Mol. weight	416.511 g/mol
Pharmacokinetic data
Bioavailability	28%
Protein binding	73% (ramipril) 56% (ramiprilat)
Metabolism	Hepatic, to ramiprilat
Half life	2 to 4 hours
Excretion	Renal (60%) and fecal (40%)
Therapeutic considerations
Pregnancy cat.	D
Legal status	POM(UK) ℞-only(US)
Routes	Oral

Ramipril (marketed as Tritace® or Altace®) is an angiotensin-converting enzyme (ACE) inhibitor, used to treat hypertension and congestive heart failure. ACE inhibitors lower the production of angiotensin II, therefore relaxing arterial muscles while at the same time enlarging the arteries, allowing the heart to pump blood more easily, and increasing blood flow due to more blood being pumped into and through bigger passageways.

Ramipril is a prodrug and is converted to the active metabolite ramiprilat by liver esterase enzymes. Ramiprilat is mostly excreted by the kidneys. The half-life of ramiprilat is variable (3-16 hours), and is prolonged by heart and liver failure, as well as kidney failure.

[edit] Indications

Indications for its use include:

Mild to moderate hypertension;
Congestive heart failure;
Following myocardial infarction in patients with clinical evidence of heart failure;
Susceptible patients over 55 years: prevention of myocardial infartion, stroke, cardiovascular death or need of revascularization procedures.