To be sure that ramipril is not lost when such mixture is used, the mixture should be consumed in its entirety. In isolated cases, agranulocytosis, pancytopenia, and bone marrow depression may occur. In such patients renal function should be monitored during the first few weeks of therapy. In patients with impaired liver function, the metabolism of ramipril to ramiprilat appears to be slowed, possibly because of diminished activity of hepatic esterases, and plasma ramipril levels in these patients are linea de transporte maritimo durante la noche ramipril increased about 3-fold. Hyperkalemia: In clinical trials, hyperkalemia serum potassium greater than. Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.