Altace - Side Effects & Drug Interactions

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Miscellaneous:

As with other ACE inhibitors, a symptom complex has been reported which may include a positive ANA, an elevated erythrocyte sedimentation rate, arthralgia/ arthritis, myalgia, fever, vasculitis, eosinophilia, photosensitivity, rash and other dermatologic manifestations. Additionally, as with other ACE inhibitors, eosinophilic pneumonitis has been reported.

Fetal/ Neonatal Morbidity and Mortality. See WARNINGS: Fetal/ Neonatal Morbidity and Mortality.

Other:

arthralgia, arthritis, dyspnea, edema, epistaxis, hypoglycemia (see PRECAUTIONS, Drug Interactions), impotence, increased sweating, malaise, myalgia, and weight gain.

Clinical Laboratory Test Findings:

Creatinine and Blood Urea Nitrogen:

Increases in creatinine levels occurred in 1.2% of patients receiving ALTACE alone, and in 1.5% of patients receiving ALTACE and a diuretic. Increases in blood urea nitrogen lev-els occurred in 0.5% of patients receiving ALTACE alone and in 3% of patients receiving ALTACE with a diuret-ic. None of these increases required discontinuation of treatment. Increases in these laboratory values are more likely to occur in patients with renal insufficiency or those pretreated with a diuretic and, based on expe-rience with other ACE inhibitors, would be expected to be especially likely in patients with renal artery steno-sis. (See WARNINGS and PRECAUTIONS.)

Since ramipril decreases aldosterone secretion, elevation of serum potassium can occur. Potassium supplements and potassium-sparing diuretics should be given with caution, and the patient's serum potassium should be monitored frequently. (See WARNINGS and PRECAUTIONS.)

Hemoglobin and Hematocrit:

Decreases in hemoglobin or hematocrit (a low value and a decrease of 5 g/ dl or 5% respectively) were rare, occurring in 0.4% of patients receiving ALTACE alone and in 1.5% of patients receiving ALTACE plus a diuretic. No US patients discontinued treatment because of decreases in hemoglobin or hematocrit. Other (causal relationships unknown): Clinically important changes in standard laboratory tests were rarely associated with ALTACE administration. Elevations of liver enzymes, serum bilirubin, uric acid, and blood glucose have been reported, as have cases of hyponatremia and scattered incidents of leukopenia, eosinophil-ia, and proteinuria. In US trials, less than 0.2% of patients discontinued treatment for laboratory abnormalities; all of these were cases of proteinuria or abnormal liver-function tests.