Ramoril
Generic Name
Ramipril
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ramoril 5 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Ramoril 5 mg Tablet contains Ramipril, an ACE inhibitor used to treat high blood pressure, heart failure, and to reduce the risk of cardiovascular events.
Uses & Indications
Dosage
Adults
Hypertension: Initial dose 2.5 mg once daily, adjusted up to 10 mg once daily. Heart Failure: Initial dose 1.25 mg once daily, adjusted up to 5 mg once daily.
Elderly
Start with lower doses (e.g., 1.25 mg once daily) and titrate carefully.
Renal_impairment
Initial dose 1.25 mg once daily; maximum dose should not exceed 5 mg/day for CrCl < 40 mL/min.
How to Take
Take orally, once daily, with or without food. Swallow the tablet whole with water.
Mechanism of Action
Ramipril inhibits the angiotensin-converting enzyme (ACE), preventing the conversion of angiotensin I to angiotensin II. This leads to vasodilation, reduced aldosterone secretion, and decreased blood pressure.
Pharmacokinetics
Onset
Onset of action within 1-2 hours.
Excretion
Primarily excreted via the kidneys (approximately 60%) and feces (approximately 40%) as metabolites.
Half life
Effective half-life of ramiprilat is 13-17 hours.
Absorption
Well absorbed after oral administration; approximately 50-60% bioavailability for ramiprilat.
Metabolism
Prodrug, extensively metabolized in the liver to its active metabolite, ramiprilat.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Bilateral renal artery stenosis
- Pregnancy (second and third trimesters)
- Hypersensitivity to ramipril or any other ACE inhibitor
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Drug Interactions
ARBs
Increased risk of hypotension, hyperkalemia, and renal impairment (avoid concomitant use).
NSAIDs
May reduce antihypertensive effect and increase risk of renal impairment.
Lithium
Increased serum lithium levels and lithium toxicity.
Aliskiren
Increased risk of hypotension, hyperkalemia, and renal impairment (contraindicated in diabetics or renally impaired).
Diuretics
Increased hypotensive effect.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C, in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe hypotension, shock, bradycardia, electrolyte disturbances, and renal failure. Management involves symptomatic and supportive treatment, including intravenous fluid expansion and vasopressors if needed.
Pregnancy & Lactation
Contraindicated during pregnancy (especially 2nd and 3rd trimesters) due to risk of fetal injury/death. Not recommended during lactation as ramipril or its metabolites may be excreted in breast milk.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Bilateral renal artery stenosis
- Pregnancy (second and third trimesters)
- Hypersensitivity to ramipril or any other ACE inhibitor
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Drug Interactions
ARBs
Increased risk of hypotension, hyperkalemia, and renal impairment (avoid concomitant use).
NSAIDs
May reduce antihypertensive effect and increase risk of renal impairment.
Lithium
Increased serum lithium levels and lithium toxicity.
Aliskiren
Increased risk of hypotension, hyperkalemia, and renal impairment (contraindicated in diabetics or renally impaired).
Diuretics
Increased hypotensive effect.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C, in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe hypotension, shock, bradycardia, electrolyte disturbances, and renal failure. Management involves symptomatic and supportive treatment, including intravenous fluid expansion and vasopressors if needed.
Pregnancy & Lactation
Contraindicated during pregnancy (especially 2nd and 3rd trimesters) due to risk of fetal injury/death. Not recommended during lactation as ramipril or its metabolites may be excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (DGDA)
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Ramipril has been extensively studied in major clinical trials such as the HOPE (Heart Outcomes Prevention Evaluation) study, which demonstrated its cardiovascular protective benefits, and the AIRE (Acute Infarction Ramipril Efficacy) study.
Lab Monitoring
- Serum electrolytes (especially potassium)
- Renal function (creatinine, BUN)
- Blood pressure
Doctor Notes
- Initial dose titration is crucial, especially in patients who are volume-depleted or on diuretics.
- Monitor renal function and serum potassium regularly, particularly after initiating therapy or increasing dose.
- Educate patients about the signs of angioedema and the need for immediate medical attention if it occurs.
Patient Guidelines
- Take Ramoril at the same time each day.
- Avoid sudden changes in position (e.g., standing up too quickly) to prevent dizziness.
- Report any swelling of the face, lips, tongue, or throat immediately.
- Inform your doctor about any persistent dry cough.
Missed Dose Advice
If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness, especially at the start of treatment or when changing dosage. Patients should exercise caution when driving or operating machinery.
Lifestyle Advice
- Follow a low-sodium diet, engage in regular exercise, avoid smoking, and limit alcohol intake as advised by your doctor.
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