Piramil PLUS Tablet

Hydrochlorothiazide + Ramipril

25mg + 2.5mg

Novartis (Bangladesh) Ltd.

Pack size	28's pack
Unite Price	BDT

Indications

Piramil PLUS Tablet is used for: Hypertension, Diabetic nephropathy, Congestive heart failure

Adult Dose

Oral Essential hypertension Adult: Per tablet contains ramipril 2.5 mg and hydrochlorthiazide 12.5 mg: 1 tablet daily up to a max of 4 tablets daily.

Child Dose

Renal Dose

Administration

Contra Indications

Anuria, hypersensitivity, history of angioedema, bilateral renal artery stenosis, unilateral renal artery stenosis

Precautions

Severe renal disease, impaired hepatic, allergy or bronchial asthma, systemic lupus erythematosus, acute gout, diabetes mellitus, elderly, collagen vascular diseases, should be discontinued before carrying out tests for parathyroid function. Pregnancy and lactation.

Pregnancy-Lactation

Interactions

Hydrochlorthiazide in combination with alcohol, barbiturates, or narcotics potentiates orthostatic hypotension. When coadministered with other antihypertensive gives additive effect. Absorption is reduced with cholestyramine and colestipol resins. Hypokalemia is observed with corticosteroids, tubocurarine responsiveness to the muscle relaxant is increased. It decreases the renal clearance of lithium and increases the risk of lithium toxicity. Non-steroidal anti-inflammatory agents can reduce the diuretic and natriuretic effect of hydrochlorthiazide. Ramipril with potassium-sparing diuretics results in severe hyperkaelemia. May increase serum lithium concentration, NSAIDs may reduce the effect of the drug and cause deterioration of renal function.

Side Effects

Side effects of Hydrochlorothiazide + Ramipril : Pancreatitis, jaundice, diarrhoea, nausea, vomiting, cramps, constipation, gastric irritation, anorexia, aplastic anaemia, agranulocytosis, leukopaenia, haemolytic anaemia, thrombocytopaenia, vasculitis, resp distress, including pneumonitis and pulmonary oedema, photosensitivity, fever, urticaria, rash, hyperglycaemia, glycosuria, hyperuricaemia, muscle spasm, vertigo, paraesthesias, dizziness, headache, restlessness, renal failure, renal dysfunction, interstitial nephritis, erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis, alopoecia, transient blurred vision, xanthopsia, impotence, dizziness, fatigue, headache, abdominal pain, cough, rarely symptomatic hypotension, angioneurotic oedema of face, lips, tongue, glottis and larynx, syncope, renal impairment, hypersensitivity reactions. Potentially Fatal: Anaphylactic reactions, electrolyte imbalance, hypotension.

Mode of Action

Ramipril is a long-acting ACE inhibitor which is metabolised into the active metabolite ramiprilat. Supine and standing blood pressures (BP) are reduced witho reflex tachycardia. Ventricular hypertrophy is reversed and renal blood flow increased. In CHF (CHF), pulmonary artery pressure and pulmonary capillary wedge pressure are reduced. Cardiac function is improved. Hydrochlorothiazide is a thiazide diuretic. It increases excretion of Na and chloride in approx equiv amounts. Natriuresis may be accompanied by some loss of K and bicarbonate. The rationale behind this combination is that these have a synergistic effect in lowering BP and offer an advantage of once-daily dosing convenience.

Note

Piramil PLUS 25mg + 2.5mg Tablet generic name is Hydrochlorothiazide + Ramipril. Piramil PLUS 25mg + 2.5mg Tablet is manufactured by Novartis (Bangladesh) Ltd.Piramil PLUS is availble in all over Bangladesh. Mes BD drug index information on Piramil PLUS Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.

Some other brands of Hydrochlorothiazide + Ramipril :

Tablet

Mypril Plus ^{25mg + 5mg}

Eskayef Pharmaceuticals Ltd.

Tablet

Piramil PLUS ^{25mg + 5mg}

Novartis (Bangladesh) Ltd.

Tablet

Protace H ^2.5mg+12.5mg

Unimed & Unihealth Manufacturers Ltd.

Tablet

Ramicard 2.5 Plus ^{12.5 mg + 2.5 mg}

Drug International Ltd.

Tablet

Ramicard 5 Plus ^{25 mg + 5 mg}

Drug International Ltd.