Tritace
Generic Name
Ramipril
Manufacturer
Sanofi
Country
Germany (originator), manufactured globally
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tritace 5 mg tablet | ৳ 14.04 | ৳ 196.56 |
| tritace 25 mg tablet | ৳ 9.53 | ৳ 133.42 |
Description
Overview of the medicine
Tritace (Ramipril) is an ACE inhibitor used to treat high blood pressure, heart failure, and to reduce the risk of heart attack, stroke, and kidney problems in high-risk patients.
Uses & Indications
Dosage
Adults
Hypertension: Initially 2.5 mg once daily, adjusted based on response up to 10 mg once daily. Heart failure: Initially 1.25 mg once daily, titrated up to 10 mg daily.
Elderly
Lower initial doses may be considered, starting with 1.25 mg once daily.
Renal_impairment
Dose adjustment required. For CrCl < 30 mL/min, maximum recommended dose is 5 mg/day.
How to Take
Oral administration. Can be taken with or without food. Should be taken at the same time each day.
Mechanism of Action
Ramipril inhibits the angiotensin-converting enzyme (ACE), which leads to decreased production of angiotensin II. Angiotensin II is a potent vasoconstrictor, so its reduction results in vasodilation (widening of blood vessels) and reduced blood pressure. It also reduces aldosterone secretion, which helps decrease sodium and water retention.
Pharmacokinetics
Onset
1-2 hours
Excretion
Mainly renal (approximately 60%) and fecal (approximately 40%) as metabolites and unchanged drug.
Half life
Ramiprilat: 13-17 hours (effective half-life)
Absorption
Approximately 50-60% absorbed orally; rapidly hydrolyzed to the active metabolite ramiprilat in the liver.
Metabolism
Primarily hepatic hydrolysis to active ramiprilat, then to inactive metabolites.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Second and third trimesters of pregnancy
- 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.
Diuretics
Increased risk of hypotension.
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 direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension, bradycardia, electrolyte disturbances, and renal failure. Management involves symptomatic and supportive treatment, including IV fluid administration and vasopressors for severe hypotension. Hemodialysis may be considered.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to risk of fetal harm. Not recommended during lactation as ramiprilat is excreted in breast milk.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Second and third trimesters of pregnancy
- 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.
Diuretics
Increased risk of hypotension.
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 direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension, bradycardia, electrolyte disturbances, and renal failure. Management involves symptomatic and supportive treatment, including IV fluid administration and vasopressors for severe hypotension. Hemodialysis may be considered.
Pregnancy & Lactation
Contraindicated during the second and third trimesters of pregnancy due to risk of fetal harm. Not recommended during lactation as ramiprilat is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by major regulatory authorities worldwide
Patent Status
Generic versions available
WHO Essential Medicine
YesClinical Trials
The HOPE (Heart Outcomes Prevention Evaluation) study demonstrated ramipril's benefits in reducing cardiovascular events in high-risk patients.
Lab Monitoring
- Regular monitoring of blood pressure, renal function (creatinine, BUN), and serum electrolytes (especially potassium) is recommended.
- Complete blood count (CBC) may be monitored periodically.
Doctor Notes
- Monitor blood pressure, renal function, and serum potassium regularly, especially in the elderly and those with pre-existing renal impairment.
- Caution when co-administering with NSAIDs, diuretics, or potassium supplements.
- Educate patients on symptoms of angioedema and the importance of immediate medical attention if it occurs.
Patient Guidelines
- Take Tritace exactly as prescribed by your doctor.
- Do not stop taking this medicine without consulting your doctor, even if you feel better.
- Report any swelling of the face, lips, tongue, or throat immediately to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Tritace may cause dizziness or fatigue, especially at the start of treatment or when changing doses. Use caution when driving or operating machinery until you know how the medicine 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 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.
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