Which condition is a contraindication when prescribing Ramipril?

Ramipril is an ACE inhibitor commonly used to treat hypertension and heart failure, but it comes with specific contraindications due to its pharmacological effects. Dehydration represents a significant concern when prescribing Ramipril. When a patient is dehydrated, there's an increased risk of hypotension upon initiation of the drug because ramipril can cause further decreases in blood pressure by blocking the angiotensin-converting enzyme. This can potentially lead to acute kidney injury, particularly in patients with diminished fluid status, since effective renal perfusion may already be compromised.

In contrast, hypertension is the primary indication for using Ramipril, while chronic obstructive pulmonary disease (COPD) and asthma may require caution but are not outright contraindications. These respiratory conditions can lead to concerns regarding potential cough, a common side effect of ACE inhibitors, which may exacerbate existing respiratory issues. However, they do not preclude the use of Ramipril in treatment. Hence, the contraindication linked to dehydration is crucial for safe management and avoiding harmful effects when starting therapy with this medication.