Both ramipril and metoprolol are antihypertensives, meaning they lower blood pressure. While both achieving the same goal, they do it by different mechanisms and have different side effects. Beta-blockers (metoprolol) block receptors on blood vessels and the heart that are affected by adrenaline. Ramipril is in a class of medications called ace inhibitors. ACE inhibitors affect an enzyme produced by the kidneys that affects blood pressure.
Sice the medications are different they have different side effects. Some of the beta blockers side effects include decreased energy and libido. ACE inhibitors can cause renal problems in some and sometimes a persistant cough.
There are also people that one drug is favored over another. Beta blockers are good for people after MI and with angina, ace inhibitors are beneficial in diabetics. Truthfully, both have alot of overlap and are often prescribed together to maximize the benefits of both agents such as in people with congestive heart failure.
There are no long term bad effects of ramipril. In fact, there may be some other beneficial effects of the medication outside of its blood pressure effects.
Aspirin and plavix together can be synergistic in people with coronary heart disease. Certainly in people with coronary heart disease, I give them both consideration -- especiall in those that undergo revascularization or have recuurent events.
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