A TikTok pharmacist has issued a warning about a potentially life-threatening side effect of ramipril, a common blood pressure medication, that can occur even after years of treatment. Raj Patel, known online as the Straight-Talking Pharmacist, has urged patients to recognise the warning signs and act quickly if they develop swelling around their mouth or face.
Risk of Angioedema
Ramipril belongs to a group of medicines called ACE inhibitors, prescribed to treat high blood pressure and certain heart conditions. Mr Patel told his more than 100,000 followers that the reaction can happen even when someone has taken their medication for years without problems.
"A blood pressure tablet could cause a life-threatening reaction long after you thought the risk had gone," he said in one of his videos. "If you take Ramipril, Lisinopril or any other ACE inhibitors, this really matters and you may want to watch this video till the end."
MHRA Safety Update
The Medicines and Healthcare products Regulatory Agency (MHRA) issued a safety update in June 2026 highlighting the risk of angioedema associated with ACE inhibitors. Its warning explains that swelling of the lips, tongue, face or throat can develop at any point during treatment, including after weeks or years of use.
Such swelling can obstruct the airway and cause difficulty breathing or swallowing, making prompt medical attention essential. Mr Patel noted "Here's the important bit, this is not a normal allergy, so taking an antihistamine is probably not going to work."
Urgent Action Required
The MHRA explains that some cases are caused by a mechanism involving bradykinin rather than histamine, meaning standard allergy treatments may not be effective. Anyone who develops sudden swelling of the lips, mouth, tongue or throat should call 999, particularly if breathing or swallowing becomes difficult, as per the NHS.
Mr Patel urged viewers: "If you get swelling of the lips, tongue, face or throat, get urgent help straight away and please don't take another tablet." The MHRA advises people with suspected ACE inhibitor-related angioedema not to take further doses and to inform a healthcare professional immediately.
The reaction is uncommon, and patients should not stop prescribed ramipril simply because they have seen the warning. Anyone with concerns about their medication should speak to a healthcare professional, while suspected angioedema requires urgent assessment rather than waiting for a routine appointment.
