RePACE H
Generic Name
Ramipril + Hydrochlorothiazide
Manufacturer
Generic Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| repace h 50 mg tablet | ৳ 8.03 | ৳ 80.30 |
Description
Overview of the medicine
RePACE H is a combination medication used to treat high blood pressure (hypertension). It contains Ramipril, an ACE inhibitor, and Hydrochlorothiazide, a diuretic, which work together to lower blood pressure and reduce the risk of cardiovascular events.
Uses & Indications
Dosage
Adults
Usually 2.5 mg Ramipril / 12.5 mg Hydrochlorothiazide once daily, adjusted based on response up to a maximum of 10 mg Ramipril / 25 mg Hydrochlorothiazide once daily.
Elderly
Lower initial doses may be required, titrate carefully.
Renal_impairment
Dosage adjustment required. Contraindicated in severe renal impairment (CrCl < 30 mL/min).
How to Take
Take orally, once daily in the morning, with or without food.
Mechanism of Action
Ramipril inhibits the angiotensin-converting enzyme (ACE), preventing the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced aldosterone secretion. Hydrochlorothiazide increases the excretion of sodium and water by inhibiting sodium reabsorption in the distal convoluted tubule, thereby reducing blood volume and blood pressure.
Pharmacokinetics
Onset
Ramipril: 1-2 hours. Hydrochlorothiazide: 2 hours.
Excretion
Ramiprilat: Primarily renal (urine). Hydrochlorothiazide: Renal (unchanged drug).
Half life
Ramiprilat: 13-17 hours (effective half-life). Hydrochlorothiazide: 5.6-14.8 hours.
Absorption
Ramipril: Rapidly absorbed and hydrolyzed to ramiprilat. Hydrochlorothiazide: Moderately absorbed (60-80%).
Metabolism
Ramipril: Prodrug, hydrolyzed in the liver to active ramiprilat. Hydrochlorothiazide: Not metabolized.
Side Effects
Contraindications
- Hypersensitivity to ramipril, hydrochlorothiazide, or any sulfonamide-derived drugs.
- History of angioedema with previous ACE inhibitor therapy.
- Bilateral renal artery stenosis.
- Anuria.
- Severe renal impairment (CrCl < 30 mL/min).
- Pregnancy (second and third trimesters).
Drug Interactions
NSAIDs
Reduced antihypertensive effect and increased risk of renal impairment.
Lithium
Increased serum lithium levels and toxicity.
Aliskiren
Contraindicated in diabetic patients.
Diuretics
Potentiated hypotensive effect.
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 may include severe hypotension, electrolyte disturbances, renal failure. Treatment is symptomatic and supportive, including intravenous fluid administration and monitoring of vital signs and electrolytes. Dialysis may be considered for severe cases.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to fetal toxicity. Use during the first trimester is not recommended. Not recommended during breastfeeding.
Side Effects
Contraindications
- Hypersensitivity to ramipril, hydrochlorothiazide, or any sulfonamide-derived drugs.
- History of angioedema with previous ACE inhibitor therapy.
- Bilateral renal artery stenosis.
- Anuria.
- Severe renal impairment (CrCl < 30 mL/min).
- Pregnancy (second and third trimesters).
Drug Interactions
NSAIDs
Reduced antihypertensive effect and increased risk of renal impairment.
Lithium
Increased serum lithium levels and toxicity.
Aliskiren
Contraindicated in diabetic patients.
Diuretics
Potentiated hypotensive effect.
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 may include severe hypotension, electrolyte disturbances, renal failure. Treatment is symptomatic and supportive, including intravenous fluid administration and monitoring of vital signs and electrolytes. Dialysis may be considered for severe cases.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to fetal toxicity. Use during the first trimester is not recommended. Not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensively studied in clinical trials for hypertension and cardiovascular risk reduction, demonstrating efficacy and safety.
Lab Monitoring
- Serum electrolytes (potassium, sodium)
- Renal function (creatinine, BUN)
- Blood pressure monitoring
Doctor Notes
- Monitor renal function and serum electrolytes regularly, especially at initiation and after dose changes.
- Educate patients on symptoms of angioedema and hyperkalemia.
- Caution in patients with diabetes or severe heart failure.
Patient Guidelines
- Take medication as directed by your doctor.
- Do not stop taking the medicine without consulting your doctor.
- Report any swelling of face, lips, tongue, or throat immediately.
- Avoid potassium supplements or salt substitutes containing potassium without medical advice.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness, especially at the start of treatment or when changing dosage. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Adopt a healthy diet (low sodium, rich in fruits and vegetables).
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.