Primace
Generic Name
Ramipril
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| primace 5 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Primace 5 mg Tablet contains Ramipril, an ACE inhibitor used to treat high blood pressure, reduce the risk of heart attack and stroke, and improve survival after a heart attack. It also helps protect the kidneys in diabetic patients.
Uses & Indications
Dosage
Adults
Hypertension: Initially 2.5 mg once daily; usual maintenance 2.5-10 mg daily. CHF: Initially 1.25 mg once daily; usual maintenance 2.5-10 mg daily. Post MI: Initially 2.5 mg twice daily; usual maintenance 5 mg twice daily.
Elderly
Lower initial doses may be considered, starting with 1.25 mg daily, and titrated slowly under close monitoring.
Renal_impairment
Initial dose of 1.25 mg once daily if CrCl < 60 mL/min. Max dose 5 mg/day for severe impairment.
How to Take
Primace 5 mg Tablet should be taken orally, preferably at the same time each day, with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew.
Mechanism of Action
Ramipril is an angiotensin-converting enzyme (ACE) inhibitor. It blocks the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to vasodilation, reduced peripheral resistance, decreased aldosterone secretion, and reduced sodium and water retention, thereby lowering blood pressure.
Pharmacokinetics
Onset
Usually within 1-2 hours; maximal effect within 3-6 hours.
Excretion
Primarily excreted via the kidneys (60%), with some excretion in feces (40%).
Half life
Ramiprilat has an effective half-life of 13-17 hours, influenced by dose and indication.
Absorption
Rapidly absorbed from the gastrointestinal tract, peaking in about 1 hour. Bioavailability of ramiprilat (active metabolite) is about 45%.
Metabolism
Extensively metabolized in the liver to ramiprilat (active metabolite) and other inactive metabolites.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Pregnancy (especially 2nd and 3rd trimesters)
- Bilateral renal artery stenosis
- Hypersensitivity to ramipril or any other ACE inhibitor
- Concomitant use with aliskiren in diabetic or renally impaired patients
Drug Interactions
Lithium
Increased serum lithium concentrations and risk of toxicity.
Aliskiren
Contraindicated in diabetic or renally impaired patients due to increased risk of renal impairment, hyperkalemia, and hypotension.
Diuretics
Increased hypotensive effect. Monitor blood pressure closely.
Other antihypertensives
Additive hypotensive effect.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, shock, bradycardia, electrolyte disturbances, and renal failure. Treatment is primarily supportive. If recently ingested, gastric lavage and activated charcoal may be considered. IV fluids for hypotension, hemodialysis for severe cases.
Pregnancy & Lactation
Pregnancy: Category D. Contraindicated during the 2nd and 3rd trimesters; use in 1st trimester should be avoided. Discontinue as soon as pregnancy is detected. Lactation: Not recommended during breastfeeding as ramipril and its metabolites may be excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide (e.g., FDA, EMA, DGDA)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials (e.g., HOPE study) have demonstrated the efficacy of Ramipril in reducing cardiovascular morbidity and mortality in high-risk patients.
Lab Monitoring
- Blood pressure
- Renal function (serum creatinine, BUN)
- Serum electrolytes (especially potassium)
- Complete blood count (periodically, especially with renal impairment or collagen vascular disease)
Doctor Notes
- Always assess renal function and serum electrolytes before initiating therapy and periodically thereafter.
- Educate patients on the risk of angioedema and to seek immediate medical attention if it occurs.
- Counsel patients on the importance of adherence to therapy for long-term cardiovascular benefits.
Patient Guidelines
- Take as directed by your doctor.
- Do not stop taking this medicine without consulting your doctor, even if you feel well.
- Report any swelling of the face, lips, tongue, or throat immediately.
- Avoid potassium supplements or salt substitutes containing potassium without medical advice.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or fatigue, especially at the start of treatment or when changing dose. Patients should be cautioned about operating machinery or driving until they know how Primace affects them.
Lifestyle Advice
- Maintain a healthy diet low in sodium and high in fruits and vegetables.
- Engage in regular physical activity.
- Limit alcohol intake and quit smoking.
- Monitor blood pressure regularly at home if advised by your doctor.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.