Difference between Lisinopril and Ramipril

[Dillinger]

Hi,

I'm on Lisinopril for kidney protective reasons; I'm happy to do that. A year or two ago I asked to try an ARB drug to do the same thing to see if it improved my kidney function; it didn't in fact it made it worse. So I went back onto 10mg of Lisinopril.

I see that lots of people seem to be on Ramipril which I assume is the same type of drug as Lisinopril - I can't find much detail on what the difference is; the only stuff that came up was the below and that seems to deal solely with blood pressure reduction and not kidney protection.

Does anyone know what the differences are? Should we be on one or the other or is there no real difference?

Best

Dillinger

http://adisonline.com/druginvestigation ... to.13.aspx

 

[Paul1976]

Hi Al!

I currently take a daily dose of Ramipril (10mg) as although my blood pressure is fine now,my consultant endo still wants me to take them for kidney protection as my EGFR result was on the lower side.Is lisinoprol an ACE inhibitor too?

Regards

Paul

 

[catherinecherub]

An explanation of ACE Inhibitors
http://www.bpassoc.org.uk/BloodPressure ... Inhibitors

There is only one difference between the two that I can find and that is the cost. Ramipril is more expensive.

 

[xyzzy]

My GP told me this is the primary study they use as to why ACE Inhibitors are good for diabetics. Called the HOPE and MICROHOPE studies.

http://bjdvd.com/content/1/1/44.full.pdf

Combined primary outcome of myocardial infarction, stroke
or cardiovascular death reduced by 25%, (ramipril 15.3%
versus 19.8% placebo).

Myocardial infarction reduced 22%, (ramipril 10.2% versus
12.9% placebo).

Stroke reduced 33%, (ramipril 4.2% versus 6.1% placebo).

Cardiovascular death reduced 37%, (ramipril 6.2% versus
placebo 9.7%).

Secondary outcomes
 Total mortality reduced 24%
 Revascularisation reduced 17%
 Overt nephropathy reduced 24%
 Overt nephropathy, laser, therapy or dialysis reduced 16%.

Other outcomes
 Any heart failure reduced 20%.
Transient ischaemic attacks reduced 26%.
Worsening angina reduced 13%, (p=0.057).

The benefit of ramipril was noted irrespective of whether
subjects had a history of previous cardiovascular events,
hypertension or microalbuminuria, or whether the patients
had type 1 or 2 diabetes. At the end of the study there is no
significant difference in HbA1C% values.

Blood pressure difference was 2.47/1.00 in favour of ramipril.
After adjustment and changes in blood pressure, ramipril had
the same effect on primary outcomes as before adjustment.

Vitamin E had no significant effect.

Treatment of 1,000 patients with ramipril for four years will
prevent about 150 events in approximately 70 patients.