Can I take Bisoprolol and Ramipril together?

Why this happens

Both medicines work to lower blood pressure but in different ways. Bisoprolol is a beta-blocker that slows the heart rate, while ramipril is an ACE inhibitor that relaxes blood vessels. Because they both target the cardiovascular system, their effects add together (an additive effect).

What you should do

It is very common for doctors to prescribe these two medicines together, especially for heart failure or after a heart attack. When you start taking them, be careful when standing up quickly from a sitting or lying position. Ensure you attend your scheduled blood tests to check your kidney function and potassium levels. If you feel severely dizzy or faint, contact your doctor.

Important precautions

Asthma or chronic obstructive pulmonary disease (COPD)

Bisoprolol can cause your airways to narrow, making it much harder to breathe or triggering a severe asthma attack. It is usually avoided if you have a history of wheezing or asthma.

Diabetes

Bisoprolol can mask the warning signs of low blood sugar (hypoglycaemia), such as a fast heartbeat or tremors. You will need to monitor your blood sugar more closely.

Pregnancy

Ramipril must not be taken if you are pregnant. It can cause serious injury or death to an unborn baby, particularly if used in the second and third trimesters.

Angioedema (Severe Swelling)

Seek emergency medical help if you experience swelling of the face, lips, tongue, or throat. This is a rare but life-threatening allergic reaction more common with ACE inhibitors like ramipril.

Food and drink warnings

Alcohol

Alcohol can increase the blood pressure-lowering effect of bisoprolol, which may make you feel dizzy, lightheaded, or faint, especially when you first start taking it or when your dose is increased. It is best to keep your alcohol intake within recommended limits and see how the medicine affects you before drinking.

Salt substitutes (Potassium-based)

Ramipril can increase the levels of potassium in your blood. Many salt substitutes (such as Lo-Salt) contain potassium chloride instead of sodium. Using these while taking ramipril can cause your potassium levels to become dangerously high. Check with your pharmacist before using salt substitutes.

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.