There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
The FDA Drug Labels for levetiracetam (PO), ramipril (PO) do not address this question.
From the Research
Drug Interactions
- There is limited information available on the interaction between Levetiracetam and Ramipril.
- However, a study 1 investigated the effects of angiotensin-converting enzyme (ACE) inhibitors, such as Ramipril, on the anticonvulsant activity of Levetiracetam in mice.
- The study found that Perindopril arginine, an ACE inhibitor, raised the convulsive threshold for Levetiracetam, suggesting a potential pharmacodynamic interaction.
- However, it is essential to note that this study was conducted in mice, and the results may not be directly applicable to humans.
- Another study 2 assessed the physical Y-site compatibility of intravenous Levetiracetam with commonly used critical care medications, but Ramipril was not included in the list of tested medications.
Mechanism of Action
- Levetiracetam has a unique mechanism of action, involving neuronal binding to synaptic vesicle protein 2A, inhibiting calcium release from intraneuronal stores, and opposing the activity of negative modulators of GABA- and glycin-gated currents 3.
- Ramipril, on the other hand, is an ACE inhibitor, which works by blocking the conversion of angiotensin I to angiotensin II, resulting in vasodilation and decreased blood pressure.
Clinical Implications
- While there is limited information available on the interaction between Levetiracetam and Ramipril, it is crucial to monitor patients taking both medications for potential adverse effects or changes in seizure control.
- Studies 4, 3, 5 have shown that Levetiracetam is generally well-tolerated and effective in controlling seizures, but its use in combination with other medications, including ACE inhibitors like Ramipril, requires careful consideration and monitoring.