Drug & supplement interaction

Capsicum + Ramipril

Ramipril brand name: Altace.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Capsicum has a minor interaction with Ramipril. Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Capsicum and Ramipril

Here is the interaction we found between these two, with the evidence behind it.

Minor

ACE INHIBITORS (ACEIs)

Why this applies to Ramipril

Ramipril falls under ACE INHIBITORS (ACEIs) — the group Capsicum interacts with.

Theoretically, using topical capsaicin may increase the risk of ACE inhibitor-induced cough.
There is one case report of a topically applied capsaicin cream contributing to the cough reflex in a patient using an ACEI. However, it is unclear if this interaction is clinically significant.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: one of the well-known quirks of ramipril (and other ACE inhibitors) is a persistent, annoying dry cough. The thought here is that capsaicin from chili peppers acts on the same nerve pathways that drive that cough reflex, so in theory it could make an ACE inhibitor cough a little more likely or a bit more bothersome.

I want to be honest about how thin this evidence is. It comes from a single case report involving a topical capsaicin cream, and we genuinely don't know if it matters in real life. Eating chili in food is very unlikely to be an issue. If you're using a concentrated capsaicin product and notice a new or worsening dry cough, just mention it to your pharmacist or doctor before changing anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy 1990;65:322-3.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Capsicum Also Interacts With Other Medications

Capsicum has 215 moderate, 23 minor known drug interactions in our database — the Ramipril one above is one of them. If you take anything else, check it against the full list below.

Moderate 215 Minor 23 No known interaction 2,592 (incl. Ramipril)
Taking anything else?

Check Another of Your Medications Against Capsicum

Covers the 2,830 medications we’ve checked against Capsicum. Pick one to open its full report.

From our Q&A

Questions About Capsicum or Ramipril

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Capsicum or Ramipril, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ramipril

This page covers Capsicum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ramipril page lists 149 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Siberian Cocklebur (major).

By severity: 6 major · 119 moderate · 24 minor.

From our pharmacist’s overview on the Ramipril page

“Ramipril (Altace) is an ACE inhibitor for high blood pressure and heart protection, and its supplement list is one I would treat with real seriousness. Most interacting ingredients either deepen its pressure-lowering effect or push back against it, so readings can drift too low or creep back up.”

Reviewed by 2 · Jul 18, 2026

Open the Ramipril interaction page

One more smart check

Taking Capsicum as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,130 real supplement products containing Capsicum, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Capsicum. Your product may carry other ingredients that interact with Ramipril too, on top of Capsicum — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Capsicum and Ramipril Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Capsicum
Top 5%

#50 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ramipril
Top half

#901 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Capsicum

What is Capsicum?

  • Nerve pain (neuropathy)
  • Muscle and joint pain (arthritis)
  • Back pain
  • Digestive support
  • Cluster headache (intranasal)

Capsicum (chili pepper) contains capsaicin, which is best known and best studied as a topical treatment for certain types of pain. Topical capsaicin products are supported by reasonable evidence for some nerve and joint pain, but oral supplements are far less proven. Use it carefully, follow product directions, and talk to your pharmacist or doctor before starting.

Read the full Capsicum monograph & all interactions
Medication

About Ramipril

What Is Ramipril Used For?

Brand name: Altace

Ramipril capsules are used to treat high blood pressure (hypertension), either alone or combined with a thiazide diuretic (water pill). Lowering blood pressure reduces the risk of heart attack and stroke.

In adults 55 and older at high cardiovascular risk, ramipril capsules are used to reduce the risk of heart attack, stroke, or death from cardiovascular causes. Ramipril capsules are also used in stable patients who develop signs of heart failure within the first days after a heart attack, to lower the risk of death and hospitalization related to heart failure.

See full Ramipril drug information
Keep checking

Other Drugs & Capsicum

Browse every other medication we’ve checked against Capsicum — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
215Moderate
23Minor
2,591No known interaction
215 Moderate 23 Minor 2,591 No interaction
Moderate

215 interactions

Showing 60 of 215 moderate interactions — see all 215 on the Capsicum page.

Minor

23 interactions

No interaction 2,591 drugs checked — show the list

We also checked Capsicum against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,591 medications checked with no known interaction — see the full Capsicum list.

See the full Capsicum interactions page
See every supplement checked against Ramipril, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Capsicum monograph › Uses, safety, and every drug interaction in one place Ramipril supplement interactions › Every supplement checked against Ramipril, ranked by severity Ramipril drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Capsicum and Ramipril Together: Common Questions

Can you take Capsicum with Ramipril?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Capsicum and Ramipril interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ramipril and Capsicum?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.