Ramistar-M XL 25 Tablet 10's

Written By Bayyarapu Mahesh Kumar , M Pharmacy

Reviewed By Santoshini Reddy G , M Pharmacy

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MRP ₹209.5

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Whats That

About Ramistar-M XL 25 Tablet

Ramistar-M XL 25 Tablet belongs to the 'anti-hypertensive drugs' class, primarily used to treat hypertension (high blood pressure). Hypertension is a medical condition in which the blood exerts high pressure (force exerted by circulating blood) against blood vessel walls. This condition makes the heart work harder in pumping blood to the whole body. Hypertension can cause severe health complications, including stroke, heart failure, heart attack and kidney failure.

Ramistar-M XL 25 Tablet is composed of Metoprolol and Ramipril. Metoprolol is a beta-blocker, which helps in slowing down the heart rate, making it easier for the heart to pump blood throughout the body. Ramipril is an angiotensin-converting enzyme inhibitor, which relaxes and widens the blood vessels making it easier for the heart to pump blood to all body parts. Hence, it reduces the chance of having a heart attack, stroke, heart-related chest pain (angina) or other cardiovascular diseases.

You can take Ramistar-M XL 25 Tablet with food or without food. Swallow it as a whole with a glass of water. Do not chew, bite, or break it. Your doctor will advise you on how often you need to take Ramistar-M XL 25 Tablet based on your medical condition. In some cases, you may experience certain common side-effects like tiredness, dizziness, shortness of breath, bradycardia, hypotension, diarrhoea, headache, and rash. Most of these side effects do not require medical attention and will resolve gradually over time. Talk to your doctor if you experience these side effects persistently.

Try not to stop taking this medicine on your own even if your blood pressure is normal as it may worsen your condition. Let your doctor know if you have any liver, kidney or heart problems, are pregnant or breastfeeding. Do not take Ramistar-M XL 25 Tablet if you are hypersensitive to metoprolol, ramipril, any beta-blocker, any other ACE inhibitor, or any of the excipients of Ramistar-M XL 25 Tablet . Ramistar-M XL 25 Tablet may cause dizziness, so drive with caution. Avoid alcohol consumption along with Ramistar-M XL 25 Tablet as it might lead to increased dizziness or unpleasant side effects.

Uses of Ramistar-M XL 25 Tablet

Hypertension (high blood pressure)

Directions for Use

Swallow it as a whole with water; do not crush, break or chew it

Medicinal Benefits

Ramistar-M XL 25 Tablet is a combination of two blood pressure-lowering medications, metoprolol and ramipril. Metoprolol is a beta-blocker that works by decreasing the heart rate and increasing the heart's efficiency in pumping blood throughout the body. Ramipril is an ACE inhibitor that relaxes blood vessels and decreases stress on the heart, allowing blood to flow more easily. Thereby, Ramistar-M XL 25 Tablet helps treat hypertension and thus reduces the chance of having a heart attack, stroke, heart-related chest pain (angina) or other cardiovascular diseases.

Storage

Keep Ramistar-M XL 25 Tablet out of reach and sight of children.

Side effects of Ramistar M Xl 25 Tab

Headache

Dealing with Medication-Induced Headache:

Hydrate your body: Drink enough water to prevent dehydration and headaches.
Calm Your Mind: Deep breathing and meditation can help you relax and relieve stress.
Rest and Recharge: Sleep for 7-8 hours to reduce headache triggers.
Take rest: lie down in a quiet, dark environment.
Cold or warm compresses can help reduce tension.
Stay Upright: Maintain good posture to keep symptoms from getting worse.
To treat headaches naturally, try acupuncture or massage therapy.
Over-the-counter pain relievers include acetaminophen and ibuprofen.
Prescription Assistance: Speak with your doctor about more substantial drug alternatives.
Severe Headaches: Seek emergency medical assistance for sudden, severe headaches.
Frequent Headaches: If you get reoccurring headaches, consult your doctor.
Headaches with Symptoms: Seek medical attention if your headaches include fever, disorientation, or weakness.

Dizziness

Here are the 7 steps to manage Dizziness caused by medication:

Inform your doctor about dizziness symptoms. They may adjust your medication regimen or prescribe additional medications to manage symptoms.
Follow your doctor's instructions for taking medication, and take it at the same time every day to minimize dizziness.
When standing up, do so slowly and carefully to avoid sudden dizziness.
Avoid making sudden movements, such as turning or bending quickly, which can exacerbate dizziness.
Drink plenty of water throughout the day to stay hydrated and help alleviate dizziness symptoms.
If you're feeling dizzy, sit or lie down and rest until the dizziness passes.
Track when dizziness occurs and any factors that may trigger it, and share this information with your doctor to help manage symptoms.

Inflammation Of Air Passages In Lungs

Managing Medication-Triggered Bronchitis (Inflammation of the bronchial tubes): A Step-by-Step Guide:

If you experience symptoms like coughing, wheezing, chest tightness, or difficulty breathing after taking medication, seek medical attention immediately.
Your healthcare provider will work with you to stop the medication causing the reaction, start alternative treatments, and provide supportive therapy.
To manage symptoms and prevent complications, follow your doctor's advice to use inhalers or nebulizers as prescribed, practice good hygiene, avoid irritants, stay hydrated, and get plenty of rest.
Regularly track your symptoms and report any changes or concerns to your healthcare provider.

Inflammation Of Sinuses

Here are the steps to manage the medication-triggered Sinusitis (Sinus infection or Inflammation Of Sinuses):

Consult your doctor if you experience symptoms of sinusitis, such as nasal congestion, facial pain, or headaches, which may be triggered by your medication.
Your doctor may adjust your treatment plan by changing your medication, adding new medications, or providing guidance on managing your sinusitis symptoms.
Practice good hygiene, including frequent handwashing, avoiding close contact with others, and avoiding sharing utensils or personal items.
If your doctor advises, you can use nasal decongestants or saline nasal sprays to help relieve nasal congestion and sinus pressure.
To help your body recover, get plenty of rest, stay hydrated, and engage in stress-reducing activities. If your symptoms persist or worsen, consult your doctor for further guidance.

Shortness Of Breath

Here are the seven steps to manage medication-triggered Dyspnea (Difficulty Breathing or Shortness of Breath):

Tell your doctor immediately if you experience shortness of breath after taking medication.
Your doctor may adjust the medication regimen or dosage or give alternative medical procedures to minimize the symptoms of shortness of breath.
Monitor your oxygen levels and breathing rate regularly to track changes and potential side effects.
For controlling stress and anxiety, try relaxation techniques like deep breathing exercises, meditation, or yoga.
Make lifestyle changes, such as quitting smoking, exercising regularly, and maintaining a healthy weight.
Seek emergency medical attention if you experience severe shortness of breath, chest pain, or difficulty speaking.
Follow up regularly with your doctor to monitor progress, adjust treatment plans, and address any concerns or questions.

Stomach Inflammation

If you are having unusual stomach issues after taking the medicine, consult your doctor to determine the underlying cause and further management.
In mild to moderate cases, your doctor may start by recommending anti-inflammatory medications (corticosteroids) to help reduce stomach inflammation and suggest lifestyle changes.
Eating smaller meals (5-6 times daily) instead of big meals can help improve your digestion.
Make sure to drink plenty of water, but stay away from caffeine, alcohol, and carbonated drinks, as they can make your symptoms worse.
Smoking and stress can worsen your stomach inflammation, so try to quit smoking and manage stress with exercise and relaxation techniques.

Stomach Ache

Drink water or other clear fluids.
To prevent worsening of pain, limit intake of tea, coffee, or alcohol.
Include bland foods like rice, toast, crackers, and rice in your diet.
Avoid lying down immediately after eating as it may cause indigestion or heartburn.
Avoid acidic and spicy food as it may cause indigestion.

Drug Warnings

Try not to stop taking this medicine on your own even if your blood pressure is normal as it may worsen your condition. Do not take Ramistar-M XL 25 Tablet if you are hypersensitive to metoprolol, ramipril, any beta-blocker, any other ACE inhibitor, or any of the excipients of Ramistar-M XL 25 Tablet . Inform your doctor if you have angioedema (swelling under the skin), diabetes, moderate to severe renal impairment, diabetic nephropathy, severe bradycardia, second or third-degree heart block, cardiogenic shock, cardiac failure, sick sinus syndrome, or liver problems. Ramistar-M XL 25 Tablet is not advised to be used during pregnancy or breastfeeding. Ramistar-M XL 25 Tablet is not recommended for children because its safety and efficacy have not been proven. Ramistar-M XL 25 Tablet may cause dizziness, so drive carefully. Inform your doctor if you take any other prescription or non-prescription medications or herbal supplements to rule out any potential side effects or drug interactions.

Drug-Drug Interactions

RamiprilAliskiren

Critical

RamiprilIrbesartan

Severe

Drug-Drug Interactions

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RamiprilAliskiren

Critical

How does the drug interact with Ramistar M Xl 25 Tab:
Taking aliskiren together with Ramistar M Xl 25 Tab may increase the risk of serious side effects such as kidney problems, low blood pressure, and high potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney problems, muscle paralysis and irregular heart rhythm.

How to manage the interaction:
Taking Ramistar M Xl 25 Tab with Aliskiren is not recommended, but can be taken if prescribed by a doctor. However, consult your doctor if you feel nausea, vomiting, weakness, confusion, tingling in the hands and feet, a sensation of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat. You must drink enough fluids while taking these medications. It is advised to reduce the intake of foods high in potassium, including tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes. Do not discontinue any medications without a doctor's advice.

RamiprilIrbesartan

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking Ramistar M Xl 25 Tab together with Irbesartan may increase the risk of side effects such as low blood pressure, kidney function impairment, and a condition called hyperkalemia (high blood potassium).

How to manage the interaction:
Although taking Irbesartan with Ramistar M Xl 25 Tab together can possibly result in an interaction, it can be taken if a doctor has prescribed it. However, consult a doctor if you experience nausea, vomiting, weakness, disorientation, tingling in your hands and feet, feelings of heaviness in your legs, or a slow or irregular heartbeat. Do not discontinue any medications without a doctor's advice.

RamiprilTizanidine

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking Ramistar M Xl 25 Tab with Tizanidine may have additive effects in lowering your blood pressure

How to manage the interaction:
Although taking Ramistar M Xl 25 Tab together with Tizanidine can possibly result in an interaction, they can be taken together if prescribed by your doctor. However, consult your doctor if you feel headache, dizziness, lightheadedness, fainting, and changes in pulse or heart rate. If you have the above symptoms, avoid tasks requiring attentiveness, such as driving or using dangerous machinery. Be careful when you stand up from a sitting or lying position. Do not stop taking any medication without consulting your doctor.

RamiprilTrimethoprim

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking Ramistar M Xl 25 Tab with Trimethoprim can increase the potassium levels in the blood, increasing the risk of kidney problems.

How to manage the interaction:
Although there is an interaction between Ramistar M Xl 25 Tab and trimethoprim, they can be taken together if prescribed by a doctor. However, consult a doctor if you experience weakness, confusion, numbness or tingling, and uneven heartbeats. Do not stop taking any medication without consulting your doctor.

RamiprilAzilsartan medoxomil

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking Azilsartan medoxomil with Ramistar M Xl 25 Tab may cause low blood pressure, kidney function impairment, and increased potassium levels in the blood.

How to manage the interaction:
Although taking Ramistar M Xl 25 Tab together with Azilsartan medoxomil can result in an interaction, they can be taken together if prescribed by a doctor. However, consult a doctor if you experience vomiting, weakness, confusion, tingling in the hands and feet, or palpitations. Do not discontinue any medications without a doctor's advice.

RamiprilLeflunomide

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking leflunomide with Ramistar M Xl 25 Tab can increase the risk of liver problems.

How to manage the interaction:
Although taking Ramistar M Xl 25 Tab with Leflunomide can result in an interaction, they can be taken together if prescribed by a doctor. However, if you experience fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, less desire to eat, fatigue, nausea, vomiting, abdominal pain, or yellowing of the skin or eyes, contact a doctor immediately. Do not discontinue any medications without consulting a doctor.

RamiprilPotassium iodide

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking Potassium Iodide with Ramistar M Xl 25 Tab may significantly increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney problems, muscle paralysis and irregular heart rhythm.

How to manage the interaction:
Although there is a interaction between Potassium iodide and Ramistar M Xl 25 Tab, you can take these medicines together if prescribed by a doctor. However, if you notice any nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, or irregular heartbeat, you should contact a doctor immediately. Avoid taking a potassium-rich diet (tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes) while taking these medications. Do not stop using any medications without talking to a doctor.

RamiprilSpironolactone

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Using Ramistar M Xl 25 Tab together with spironolactone may cause hyperkalemia (increase the levels of potassium in your blood).

How to manage the interaction:
Although taking spironolactone and captopril together can possibly result in an interaction, it can be taken if your doctor has prescribed it. However, consult the doctor immediately if you experience symptoms such as weakness, confusion, numbness or tingling, and uneven heartbeat. Do not stop using any medications without consulting doctor.

RamiprilAmiloride

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Taking Ramistar M Xl 25 Tab and amiloride together may increase the levels of potassium in your blood.

How to manage the interaction:
Although taking amiloride along with Ramistar M Xl 25 Tab can result in an interaction, they can be taken together if prescribed by a doctor. However, consult the doctor if you feel weakness, confusion, numbness or tingling, and uneven heartbeats. Do not stop taking any medication without consulting a doctor.

RamiprilEprosartan

Severe

How does the drug interact with Ramistar M Xl 25 Tab:
Coadministration of Ramistar M Xl 25 Tab together with eprosartan may increase the risk of side effects such as low blood pressure, kidney function impairment, and a condition called hyperkalemia (high blood potassium).

How to manage the interaction:
Although taking Ramistar M Xl 25 Tab together with Eprosartan can possibly result in an interaction, they can be taken together if prescribed by your doctor. However, consult your doctor if you feel nausea, vomiting, weakness, confusion, tingling in the hands and feet, a sensation of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat. You must drink enough fluids while taking these medications. Do not stop taking any medication without consulting your doctor.

Drug-Food Interactions

Potassium rich foods

Moderate

Drug-Food Interactions

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Potassium rich foods

Moderate

Common Foods to Avoid:
Lentils, Orange Juice, Oranges, Raisins, Potatoes, Salmon Dried, Spinach, Sweet Potatoes, Tomatoes, Coconut Water, Beans, Beetroot, Broccoli, Bananas, Apricots, Avocado, Yogurt

How to manage the interaction:
When Ramistar M Xl 25 Tab is taken along with moderately high or high potassium dietary intake it may lead to high potassium levels in blood. Avoid taking moderately high or high potassium dietary intake along with Ramistar M Xl 25 Tab as this can lead to high potassium levels in blood. However, if you experience weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs, consult a doctor.

Diet & Lifestyle Advise

Eating a healthy and balanced diet can help if you have high blood pressure or a heart problem.
Do regular physical activity or exercise.
Opt for a diet rich in whole grains, fruits, vegetables, and low-fat dairy products.
Limit intake of sodium chloride (table salt) in your daily diet.
Quitting smoking is the best strategy to lower the risk of heart disease.
Avoid chronic stress as it can raise your blood pressure. Try to enjoy and spend time with your loved ones to cope with stress and practice mindfulness techniques.
Try to include heart-healthy omega 3 fatty acid containing food/drinks in your daily diet. You can also use low-fat cooking oil like olive oil, soybean oil, canola oil, and coconut oil.

Side Effects of Ramistar-M XL 25 Tablet

Headache
Dizziness or light-headedness
Cough
Digestive disturbances
Abdominal discomfort
Dyspepsia
Diarrhoea
Nausea
Vomiting

Habit Forming

No

Therapeutic Class

ANTI- HYPERTENSIVES

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Author Details

Written By

Bayyarapu Mahesh Kumar

M Pharmacy

Reviewed By

Santoshini Reddy G

M Pharmacy

Last Updated

Jul 8, 2025 | 9:43 AM IST

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Drug-Diseases Interactions

No Drug - Disease interactions found in our database. Some may be unknown. Consult your doctor for what to avoid during medication.

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FAQs

How does Ramistar-M XL 25 Tablet work?

Ramistar-M XL 25 Tablet contains metoprolol and ramipril. Metoprolol is a beta-blocker that slows the heart rate and increases the heart's efficiency in pumping blood throughout the body. Ramipril is an ACE inhibitor that relaxes blood vessels and reduces stress on the heart, allowing blood to flow more freely. Thus, Ramistar-M XL 25 Tablet effectively treats or manages hypertension.

Is Ramistar-M XL 25 Tablet safe to take for an extended period of time?

Ramistar-M XL 25 Tablet is generally safe to use for an extended period of time if prescribed by the doctor.

Does Ramistar-M XL 25 Tablet cause dizziness?

Ramistar-M XL 25 Tablet may cause dizziness or light-headedness. It does not require medical attention and will resolve gradually over time in most cases. Talk to your doctor if you experience this condition persistently. If you experience dizziness, do not drive until you are alert.

What if I miss a dose of Ramistar-M XL 25 Tablet ?

If you forget to take Ramistar-M XL 25 Tablet , take it as soon as you remember. However, if it is almost time for the scheduled dose, skip the missed dose and revert to the original dosing schedule. Do not take a double dose to make up for a forgotten dose.

Will I have to stop taking Ramistar-M XL 25 Tablet before surgery?

Inform your doctor that you are taking Ramistar-M XL 25 Tablet if you are due to undergo any surgery. Metoprolol in Ramistar-M XL 25 Tablet can lower your blood pressure too much when it is combined with some anaesthetics.

Can I stop taking Ramistar-M XL 25 Tablet on my own when my blood pressure is under control or normal?

It is advised to continue your medicine even after your blood pressure is under control or becomes normal, as blood pressure can shoot up at any time. If you have any discomfort, please consult your doctor immediately.

Which are the parameters that need to be closely monitored while using Ramistar-M XL 25 Tablet ?

It is recommended that serum potassium and sodium levels be checked regularly. In patients with impaired renal function, serum potassium levels must be checked more frequently.

Drug-Drug Interactions Checker List

IBUPROFEN
EPHEDRINE
NORADRENALINE
ADRENALINE
ALISKIREN
CICLOSPORIN
TACROLIMUS
FUROSEMIDE
PREDNISOLONE
ALLOPURINOL
INSULIN
LITHIUM
BACLOFEN
TAMSULOSIN
LEVODOPA

Special Advise

It is recommended that serum potassium and sodium levels be checked on a regular basis. In patients with impaired renal function, serum potassium levels must be checked more frequently.
You should monitor your blood pressure regularly to be sure that Ramistar-M XL 25 Tablet is working efficiently. And also, a healthy diet, regular exercise is necessary to keep blood pressure under control.

Disease/Condition Glossary

Hypertension (High blood pressure): It is a chronic condition when blood pressure is too high. Blood pressure is defined as the amount of blood pumped by the heart and the amount of resistance exerted by the arteries against the blood flow. If the heart pumps more blood, then arteries become narrower and in turn, blood pressure becomes high. If blood pressure becomes uncontrolled, it may lead to serious heart diseases, including stroke and heart attack. Additionally, high blood pressure can also cause brain damage (stroke) and kidney failure. Conditions like diabetes, stress, sedentary lifestyle, smoking, respiratory diseases (asthma or COPD), obesity, pregnancy, overactive thyroid (hyperthyroidism), and kidney diseases can lead to high blood pressure.