Topril
Generic Name
Ramipril
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| topril 50 mg tablet | ৳ 2.80 | ৳ 28.00 |
Description
Overview of the medicine
Topril (Ramipril) is an Angiotensin Converting Enzyme (ACE) inhibitor used to treat high blood pressure, heart failure, and to reduce the risk of cardiovascular events in high-risk patients.
Uses & Indications
Dosage
Adults
For Hypertension: Initial dose 2.5 mg once daily, adjusted to 2.5-10 mg daily. For Heart Failure: Initial dose 1.25 mg once daily, may be increased up to 10 mg daily.
Elderly
Lower initial doses (e.g., 1.25 mg once daily) should be considered, with careful titration.
Renal_impairment
Dose adjustment needed based on creatinine clearance. For CrCl < 30 mL/min, initial dose 1.25 mg once daily, max 5 mg daily.
How to Take
Topril tablets should be taken orally once daily, with or without food. It is recommended to take it at the same time each day.
Mechanism of Action
Ramipril acts by inhibiting the Angiotensin Converting Enzyme (ACE), which leads to reduced production of angiotensin II (a potent vasoconstrictor) and decreased aldosterone secretion. This results in vasodilation, lower blood pressure, and reduced fluid retention.
Pharmacokinetics
Onset
Antihypertensive effect begins within 1-2 hours, maximal effect within 3-6 hours.
Excretion
Primarily renal (approximately 60% of the dose) as metabolites and unchanged drug.
Half life
Ramiprilat has a prolonged effective half-life of 13-17 hours (due to saturable binding to ACE).
Absorption
Well absorbed after oral administration, peak plasma concentrations of ramiprilat (active metabolite) occur within 2-4 hours.
Metabolism
Ramipril is a prodrug, extensively hydrolyzed in the liver to its active metabolite, ramiprilat, and other inactive metabolites.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Bilateral renal artery stenosis
- Pregnancy (second and third trimesters)
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Drug Interactions
Lithium
Increased serum lithium levels and lithium toxicity.
Diuretics
Increased risk of symptomatic hypotension.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and worsen renal function.
Potassium-sparing diuretics or potassium supplements
Increased risk of hyperkalemia.
Dual blockade of the Renin-Angiotensin-Aldosterone System (RAAS) with ARBs, ACEIs, or aliskiren
Increased risk of hypotension, hyperkalemia, and renal impairment.
Storage
Store below 30°C in a dry place, protected 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 supportive, including IV fluids for hypotension, and possibly hemodialysis to remove ramiprilat.
Pregnancy & Lactation
Pregnancy Category D (second and third trimesters): ACE inhibitors can cause fetal harm or death. Discontinue if pregnancy is detected. Lactation: Not recommended, as ramipril and its metabolites may be excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date.
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory bodies worldwide, including DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ramipril has been extensively studied in large clinical trials, such as the HOPE study (Heart Outcomes Prevention Evaluation), demonstrating its efficacy in reducing cardiovascular events.
Lab Monitoring
- Monitor blood pressure regularly.
- Monitor renal function (serum creatinine, BUN) and serum electrolytes (especially potassium) periodically.
- Liver function tests.
Doctor Notes
- Monitor patients for signs of angioedema, especially after the first dose.
- Regularly assess renal function and serum potassium levels, especially in high-risk patients.
- Advise patients about the potential for dry cough and postural hypotension.
Patient Guidelines
- Take as directed by your doctor, usually once daily.
- Do not stop taking this medicine without consulting your doctor.
- Report any signs of angioedema (swelling of face, lips, tongue) immediately.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Topril may cause dizziness or lightheadedness, especially at the start of treatment or when changing doses. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Maintain a healthy diet low in sodium.
- Regular exercise.
- Avoid smoking and excessive alcohol consumption.
- Monitor your blood pressure at home if advised.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.