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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do Fluctuating BP Levels While On Ramipril Indicate?

I have been taking Ramipril 2.5 and my bp was going down as low as 107/69 and it made me feel wired. I stopped taking it 10 days ago and my Bp initially came up to anywhere between 117/130 over 79/85. It has been slowly rising and is now about 130/89. My question is, when stopping the medication, why would it slowly rise instead of going straight up? I am a 68 year old, fit, active healthy female. Many thanks, I don t want to start taking it again if possibe, when my np dropped right down I felt quite unstable.
Fri, 18 Aug 2017
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Addiction Medicine Specialist 's  Response
If the blood pressure is not at least 140/90 there is not a HIGH BLOOD PRESSURE reason to take it. Diabetics should be on it in any case because of it's ability to prevent kidney disease.
On the slowly rise, this is at least a 24 hr drug and probably stays in you a bit longer.
As a PhD in pharmacology I want to say "it has first order kinetics" but that won't mean anything to you.
Here's what happens: the drug is removed as the blood goes through the liver but only some of the blood is going through the liver at any one time, so only that bit gets cleared. BUT the blood doesn't go in only one path like cars through a toll. It goes alike ALL cars in New Jersey (ok, the blood has Far fewer crashes). But the point is that only SOME of the blood is cleared of drug and then it gets mixed and THEN only some of the blood is cleared of drug, so it can only gradually get drug out over time.
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What Do Fluctuating BP Levels While On Ramipril Indicate?

If the blood pressure is not at least 140/90 there is not a HIGH BLOOD PRESSURE reason to take it. Diabetics should be on it in any case because of it s ability to prevent kidney disease. On the slowly rise, this is at least a 24 hr drug and probably stays in you a bit longer. As a PhD in pharmacology I want to say it has first order kinetics but that won t mean anything to you. Here s what happens: the drug is removed as the blood goes through the liver but only some of the blood is going through the liver at any one time, so only that bit gets cleared. BUT the blood doesn t go in only one path like cars through a toll. It goes alike ALL cars in New Jersey (ok, the blood has Far fewer crashes). But the point is that only SOME of the blood is cleared of drug and then it gets mixed and THEN only some of the blood is cleared of drug, so it can only gradually get drug out over time.