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What is Altace?

Altace, or Ramipril, is an ACE inhibitor that works by inhibiting the angiotensin-converting enzyme, which plays a vital role in regulating blood pressure. By blocking this enzyme, Altace helps in relaxing and widening the blood vessels, allowing blood to flow more easily, which lowers blood pressure and improves the heart’s efficiency in pumping blood.

The Class of Drugs it Belongs To (ACE Inhibitors)

ACE inhibitors, like Altace, are a group of medications used primarily to treat high blood pressure and heart failure. They work by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, thereby reducing blood pressure and easing the heart’s workload.

How it Works in the Body

In the body, Altace is converted to its active form, Ramiprilat, which exerts its effects by inhibiting the angiotensin-converting enzyme. This inhibition leads to decreased levels of angiotensin II and an increase in the levels of bradykinin, contributing to the dilation of blood vessels. The overall effect is a reduction in blood pressure and an improvement in heart function.

Key Information about Altace

Indications and Usage

Altace is indicated for the treatment of hypertension, to lower blood pressure and reduce the risk of cardiovascular events like strokes and heart attacks. It is also used in patients who have shown signs of congestive heart failure post-myocardial infarction, reducing the risk of cardiovascular death and heart failure-related hospitalizations.

Notable Benefits and Limitations

The primary benefit of Altace is its effectiveness in lowering blood pressure and reducing the risks associated with heart failure and post-heart attack conditions. However, it may not be suitable for patients with a history of angioedema related to previous ACE inhibitor therapy or those with certain kidney conditions. It is also contraindicated in pregnancy.

Age Restrictions, if Any

Altace is generally not recommended for use in children under 18 years of age due to a lack of sufficient studies on its safety and effectiveness in this age group.

How to Use Altace

Administration and Dosage

Altace (Ramipril) is typically taken orally, with or without food, as directed by a healthcare provider. The usual starting dose for those not on diuretics is 2.5 mg once daily, with the dose gradually increasing based on the patient’s response and medical condition. The maximum daily dose is 20 mg. For those on diuretics, a lower starting dose or a temporary discontinuation of the diuretic may be recommended. The medication can be taken either as a whole capsule or, for those with difficulty swallowing, the capsule can be opened and its contents mixed with applesauce, water, or apple juice.

Regular Use and Missed Doses

It’s important to take Altace regularly at the same time each day to get the most benefit. Even if patients feel well, they should continue taking the medication, as high blood pressure often has no symptoms. If a dose is missed, it should be skipped, and the regular dosing schedule should be resumed. Doubling up on doses is not advised.

Storage Information

Proper Storage Conditions

Altace should be stored at room temperature, away from moisture and heat. The medication should be kept in a tightly closed container when not in use.

Handling and Disposal

Unused or expired Altace should not be disposed of in wastewater or household garbage. Patients should consult their pharmacist for proper disposal methods to ensure safety and environmental protection.

Potential Risks and Benefits

Benefits of Altace

The primary benefit of Altace is its effectiveness in lowering blood pressure, thereby reducing the risk of strokes, heart attacks, and kidney problems. It is also beneficial in improving survival rates post-heart attack and in treating heart failure by making the heart pump more efficiently.

Risks and Precautions

While Altace is beneficial for many patients, it comes with potential risks. It can cause a serious allergic reaction called angioedema, which can be fatal if not treated promptly. Other risks include low blood pressure, especially after the first dose or when the dose is increased, and effects on kidney and liver function. Patients with a history of certain medical conditions, such as kidney disease, liver disease, or electrolyte imbalances, should use Altace with caution and under close medical supervision.


Altace is contraindicated in patients who are pregnant, as it can cause harm to the unborn baby. It should also not be used by those who have had a severe allergic reaction to any ACE inhibitor or those with a history of angioedema. Patients with low blood pressure, certain types of kidney problems, or those taking specific medications like sacubitril-valsartan should avoid Altace.

In summary, Altace is a valuable medication for managing hypertension and heart failure, but it requires careful use and monitoring due to its potential risks and side effects. Patients should follow their healthcare provider’s instructions closely and report any unusual symptoms or side effects immediately.

Side Effects of Altace

Common Side Effects

Altace, like any medication, can cause side effects. Common side effects experienced by patients include headache, cough, tiredness, dizziness, a spinning sensation, malaise, nausea, vomiting, and stomach discomfort. These side effects are generally mild and transient. The cough, a known side effect of ACE inhibitors like Altace, is typically dry and persistent.

Serious Side Effects

More serious side effects, although less common, should be addressed immediately. These include severe eye symptoms like sudden vision loss or blurred vision, heart symptoms such as irregular heartbeats or shortness of breath, severe headache, confusion, slurred speech, weakness in arms or legs, loss of coordination, stiff muscles, high fever, profuse sweating, or tremors. In such cases, immediate medical attention is required.

Long-term Side Effects

In clinical trials, some patients experienced increased cough, which in some cases led to discontinuation of the medication. Other long-term effects can include changes in kidney or liver function, and these should be monitored regularly by a healthcare provider.

Drug Interactions

Interactions with Other Medications

Altace can interact with various medications, which can affect how it works or increase the risk of side effects. These include diuretics (water pills), lithium, potassium supplements, salt substitutes that contain potassium, and NSAIDs (nonsteroidal anti-inflammatory drugs). Patients should inform their healthcare provider of all medications, supplements, and over-the-counter drugs they are taking.

Managing Drug Interactions

To manage these interactions, healthcare providers may adjust dosages, change medications, or closely monitor the patient. It’s important for patients to follow their doctor’s instructions and not to start or stop any medication without consulting their healthcare provider.

Warnings and Precautions

Precautions for Specific Populations

Altace should be used with caution in patients with certain medical conditions. These include those with kidney or liver problems, electrolyte imbalances, or a history of angioedema. Patients with these conditions may require closer monitoring or dosage adjustments.


Altace is contraindicated in patients who are pregnant, as it can harm the unborn baby. It should also not be used by patients who have had a severe allergic reaction to any ACE inhibitor or those with a history of angioedema.

Monitoring and Regular Check-ups

Patients on Altace should have regular check-ups with their healthcare provider to monitor blood pressure, kidney function, and for any signs of side effects. Any unusual symptoms should be reported to the healthcare provider immediately.

While Altace is an effective medication for managing hypertension and heart failure, it is important for patients to be aware of its potential side effects, drug interactions, and the precautions necessary for its safe use. Regular monitoring and open communication with a healthcare provider are key to managing these risks.

Patient Information and Instructions

Understanding the Medication

Altace HCT is a combination medication containing ramipril and hydrochlorothiazide. Ramipril, an ACE inhibitor, relaxes blood vessels and improves heart efficiency, while hydrochlorothiazide, a diuretic or “water pill,” helps control blood pressure by eliminating excess salt and water. This combination is used for treating high blood pressure and is typically prescribed when both medications have been taken separately without issues.

Instructions for Use

Patients should take Altace HCT exactly as prescribed by their doctor. The usual recommended dose is one tablet once a day, preferably in the morning, with or without food. The tablet should be swallowed whole and not crushed or chewed. The dose depends on individual response and kidney function. It’s important to take the medication at the same time each day for maximum effectiveness.

Missed Doses and Storage

If a dose is missed, patients should skip it and continue with their regular dosing schedule. They should not take a double dose to make up for a missed one. Altace HCT should be stored at room temperature, away from moisture and heat, and out of reach of children.

Frequently Asked Questions

Altace, or ramipril, is classified as an ACE (Angiotensin-Converting Enzyme) inhibitor. It’s primarily used to manage hypertension (high blood pressure) and treat congestive heart failure. By relaxing blood vessels, Altace helps in lowering blood pressure, which significantly reduces the risk of serious cardiovascular events like strokes and heart attacks. Additionally, Altace is beneficial for patients recovering from a heart attack, as it aids in preventing further heart damage and improving survival rates.

Altace functions by inhibiting the angiotensin-converting enzyme, a key component in the body’s renin-angiotensin system that regulates blood pressure. By blocking this enzyme, Altace causes blood vessels to relax and widen, which lowers blood pressure and reduces the heart’s workload. This mechanism not only helps in managing hypertension but also improves heart efficiency, particularly beneficial for patients with heart failure or those recovering from heart attacks.

Altace is not suitable for individuals with a history of allergic reactions to ramipril or other ACE inhibitors, or those who have experienced angioedema. Patients who have recently used sacubitril, a heart medication, should also avoid Altace. It’s contraindicated during pregnancy due to potential harm to the unborn baby. Additionally, patients with certain kidney or liver conditions, or those on specific medications, should consult their doctor before starting Altace.

Common side effects of Altace include headaches, dizziness, fatigue, cough, nausea, and vomiting. While these are generally mild, they can be bothersome. More serious side effects, though less common, include severe allergic reactions, difficulty breathing, and significant changes in kidney function. Patients experiencing severe side effects should seek immediate medical attention. It’s important to discuss potential side effects with a healthcare provider before starting Altace.

Altace can interact with various medications, potentially altering its effectiveness or increasing the risk of side effects. Notable interactions include diuretics, lithium, potassium supplements, and NSAIDs. Patients should provide their healthcare provider with a comprehensive list of all medications, supplements, and over-the-counter drugs they are taking to ensure safe and effective use of Altace.

Altace should be taken exactly as prescribed by a healthcare provider. It can be taken with or without food, and the tablet should be swallowed whole. The dosage and frequency depend on the individual’s medical condition and response to treatment. Consistent medication adherence is crucial for managing hypertension and heart failure effectively. Patients should follow their prescribed regimen closely and consult their doctor for any adjustments.

If a dose of Altace is missed, it should be taken as soon as remembered. However, if it’s close to the time for the next dose, skip the missed dose and resume the regular dosing schedule. Doubling up on doses to make up for a missed one is not recommended. Maintaining a consistent schedule for medication intake is important for optimal blood pressure management.

Altace is not safe during pregnancy, particularly in the second and third trimesters. It can cause harm or even death to the unborn baby. Women who are pregnant or planning to become pregnant should not take Altace. If pregnancy occurs while on Altace, the medication should be discontinued immediately, and alternative treatment options should be discussed with a healthcare provider.

Altace can impact kidney function, especially in individuals with existing kidney issues or those taking certain medications that affect kidney function. Regular monitoring of kidney function through blood tests is recommended for patients on Altace. This helps in early detection and management of any potential adverse effects on the kidneys.

The safety of Altace during breastfeeding is not well established. It may pass into breast milk and could potentially affect a nursing infant. Women who are breastfeeding or planning to breastfeed should discuss the risks and benefits with their healthcare provider to determine the most appropriate course of action.

Altace can cause allergic reactions, including angioedema, characterized by swelling of the face, lips, tongue, or throat, and difficulty breathing. These reactions can be severe and require immediate medical attention. Patients with a history of allergic reactions to ACE inhibitors should exercise caution and discuss alternative treatments with their healthcare provider.

Altace can interact with diuretics, leading to an excessive reduction in blood pressure. This interaction is particularly significant in patients who are volume-depleted or have renal artery stenosis. It’s important to monitor blood pressure and adjust medication dosages accordingly. In some cases, the diuretic may need to be discontinued or its dosage reduced.

While taking Altace, patients should avoid activities that could lead to falls or injuries due to dizziness or lightheadedness, especially when getting up from a sitting or lying position. Additionally, patients should avoid using potassium supplements or salt substitutes containing potassium unless advised by their doctor, as Altace can increase potassium levels in the blood.

Altace can cause changes in several blood tests, including increased potassium levels, creatinine, and blood urea nitrogen. These changes can indicate alterations in kidney function, electrolyte imbalances, or other issues. Regular blood tests are essential to monitor these parameters and ensure safe use of Altace.

Signs of an Altace overdose can include severe dizziness, fainting, or lightheadedness, indicating extremely low blood pressure. In case of suspected overdose, immediate medical attention is necessary. Contacting a poison control center or seeking emergency medical care can provide the necessary guidance and treatment.

The safety and effectiveness of Altace in children have not been established. Therefore, it is not typically recommended for use in individuals under 18 years of age. If considering Altace for a pediatric patient, it should be done under strict medical supervision and with a thorough understanding of the potential risks and benefits.

Altace should be stored at room temperature, away from excess heat and moisture. The medication should be kept in its original container, tightly closed, and out of reach of children. Proper storage ensures the medication’s effectiveness and safety.

A dry, persistent cough is a common side effect of Altace and other ACE inhibitors. This cough is usually non-productive and can persist as long as the medication is taken. If the cough becomes bothersome or severe, patients should consult their healthcare provider for potential alternatives or management strategies.

Altace can affect the body’s electrolyte balance, particularly potassium levels. It can lead to hyperkalemia (high potassium levels), which can be dangerous if not monitored and managed. Regular blood tests to check electrolyte levels are important for patients taking Altace, especially those with kidney issues or those taking potassium supplements or potassium-sparing diuretics.

Lifestyle changes can significantly enhance the effectiveness of Altace in managing hypertension. These include adopting a heart-healthy diet low in salt and saturated fats, maintaining a healthy weight, engaging in regular physical activity, quitting smoking, and limiting alcohol intake. Such changes can improve overall cardiovascular health and complement the blood pressure-lowering effects of Altace. Patients should discuss with their healthcare provider the best lifestyle practices to adopt alongside their medication.