Wild swings in BP can lean to more HTN damage including stroke.  In Medical School we called this the Berry aneurysm tolerance test.  Medical student humor here.

Most recommend starting with a diuretic first and then add ramipril if diuretic does not get to goal.  

You should also learn to DASH so you will need less meds and maybe even no meds. 

I would call and ask if it is not better to take 1/2 the dose every day rather than skipping a day completely.  MD may also be able to call in emergency supply where you are.

Some need to take it 2 x a day.  Do you take it am or pm.

Sometimes a pharm will give you an emergency supply if you have bottle.