Can I take Allopurinol and Ramipril together?

Why this happens

Both medicines can affect the immune system and how the kidneys filter waste. When used together, they can cause the body to overreact (hypersensitivity) or slow down the production of blood cells. Additionally, allopurinol may slightly increase the levels of ramipril in the blood.

What you should do

You can take these together, but your doctor should monitor you closely, especially when starting the treatment or changing doses. Seek medical help immediately if you develop a skin rash, hives, swelling of the face or throat, or a fever. Your doctor may perform regular blood tests to check your kidney function and blood cell counts.

Important precautions

Pregnancy

You must not take ramipril if you are pregnant or planning to become pregnant. It can cause serious harm, including kidney damage and skull deformities, to a developing baby, especially during the second and third trimesters.

Severe Skin Rash

Stop taking allopurinol and seek urgent medical help if you develop a skin rash, peeling skin, or mouth sores. This can be a sign of a rare but life-threatening allergic reaction. The risk is higher in people of Han Chinese, Thai, or Korean descent.

Angioedema (Swelling) - ramipril

Seek immediate medical attention if you experience swelling of the face, lips, tongue, or throat. This is a serious allergic reaction called angioedema which can block your airway.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking allopurinol. Alcohol increases the levels of uric acid in your blood, which can trigger a gout attack and make the medicine less effective. Additionally, combining alcohol with allopurinol can increase the risk of liver damage.

Alcohol can increase the blood pressure-lowering effect of ramipril, which may make you feel dizzy, lightheaded, or faint, especially when you first start taking the medicine or when your dose is increased. It is best to avoid or strictly limit alcohol.

Salt substitutes (Potassium-based)

Ramipril can increase the levels of potassium in your blood. Many salt substitutes (such as Lo-Salt) contain potassium chloride. Using these while taking ramipril can lead to dangerously high potassium levels (hyperkalaemia). You should avoid using potassium-based salt substitutes.

Water / Fluids

It is important to drink plenty of fluids (at least 2 to 3 litres a day) while taking allopurinol. This helps to prevent the formation of kidney stones and ensures the medicine works correctly to flush uric acid from your system.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.