<s>[INST] hello, i take 5mg of ramipril daily and have started having severe paid and discomfort in my left knee, have had xray which suggests just wear and tear, but by end of day i am i real pain, could this be linked to ramipril and if so what can i take to reduce the pain, many thanks [/INST] Hello, ramipril has indeed been linked to joint and muscular pain, but this is an uncommon side effect. Your doctor should first exclude other potential causes and only then attribute any symptom to April. The only way to find out is to stop April - let your doctor prescribe another Chat Doctor.  If the symptoms recur then April would have a high chance of being the real offender. I hope I've answered your question. Please let me know if you need further assistance. Kind  </s>