Ripril
Generic Name
Ramipril
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ripril 5 mg tablet | ৳ 8.00 | ৳ 80.00 |
| ripril 25 mg tablet | ৳ 5.00 | ৳ 50.00 |
Description
Overview of the medicine
Ripril (Ramipril) is an ACE inhibitor used to treat high blood pressure, heart failure, and to reduce the risk of heart attack or stroke.
Uses & Indications
Dosage
Adults
For hypertension: Initial dose 2.5 mg once daily, adjusted based on response up to 10 mg daily. For heart failure: Initial dose 1.25 mg once daily, may be titrated.
Elderly
Lower initial doses may be considered, particularly in patients with impaired renal function.
Renal_impairment
Dosage adjustment is necessary. For CrCl <30 mL/min, initial dose of 1.25 mg daily, maximum 5 mg daily.
How to Take
Can be taken with or without food. Administer orally once daily, usually in the morning.
Mechanism of Action
Ramipril inhibits the angiotensin-converting enzyme (ACE), preventing the conversion of angiotensin I to angiotensin II. This leads to vasodilation, decreased aldosterone secretion, and reduced blood pressure.
Pharmacokinetics
Onset
Onset of action within 1-2 hours.
Excretion
Primarily excreted renally (approximately 60%) and some via feces.
Half life
The effective half-life of ramiprilat is 13-17 hours for higher doses, longer for lower doses.
Absorption
Well absorbed after oral administration, peak plasma concentration within 1 hour. Ramipril is a prodrug, rapidly hydrolyzed to its active metabolite, ramiprilat.
Metabolism
Extensively metabolized in the liver to ramiprilat 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
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Drug Interactions
Lithium
Increased serum lithium levels and 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.
NSAIDs (Nonsteroidal anti-inflammatory drugs)
May reduce antihypertensive effect and increase 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 include severe hypotension, bradycardia, and electrolyte disturbances. Management involves symptomatic and supportive measures, including intravenous fluid administration.
Pregnancy & Lactation
Contraindicated in the 2nd and 3rd trimesters of pregnancy. Use during lactation is not recommended as Ramipril is excreted in breast milk.
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
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Drug Interactions
Lithium
Increased serum lithium levels and 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.
NSAIDs (Nonsteroidal anti-inflammatory drugs)
May reduce antihypertensive effect and increase 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 include severe hypotension, bradycardia, and electrolyte disturbances. Management involves symptomatic and supportive measures, including intravenous fluid administration.
Pregnancy & Lactation
Contraindicated in the 2nd and 3rd trimesters of pregnancy. Use during lactation is not recommended as Ramipril is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Generic versions available, patent expired
WHO Essential Medicine
YesClinical Trials
Ramipril has been extensively studied in major clinical trials such as HOPE, MICRO-HOPE, and AIRE trials, demonstrating significant benefits in cardiovascular risk reduction and outcomes.
Lab Monitoring
- Serum creatinine and electrolytes (especially potassium) should be monitored periodically, especially at the initiation of therapy and after dose adjustments.
- Blood pressure monitoring.
Doctor Notes
- Initiate therapy with low dose and titrate slowly.
- Monitor renal function and electrolytes closely, especially in high-risk patients.
- Educate patients on symptoms of angioedema and persistent cough.
Patient Guidelines
- Take Ripril exactly as prescribed by your doctor.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Report any unusual swelling (especially of the face, lips, tongue, throat) or persistent dry cough to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or when changing doses. Avoid driving or operating machinery until you know how Ripril affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium.
- Engage in regular physical activity.
- Avoid smoking and excessive alcohol consumption.
- Monitor your blood pressure regularly at home.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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