Ramipril + Amlodipine Pharmacology

Ramipril + Amlodipine

About Ramipril + Amlodipine
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Mechanism of Action of Ramipril + Amlodipine
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Pharmacokinets of Ramipril + Amlodipine
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Onset of Action for Ramipril + Amlodipine
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Duration of Action for Ramipril + Amlodipine
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Half Life of Ramipril + Amlodipine
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Side Effects of Ramipril + Amlodipine
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Contra-indications of Ramipril + Amlodipine
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Special Precautions while taking Ramipril + Amlodipine
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Ramipril + Amlodipine
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Interactions for Ramipril + Amlodipine
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Typical Dosage for Ramipril + Amlodipine
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Schedule of Ramipril + Amlodipine
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Storage Requirements for Ramipril + Amlodipine
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Effects of Missed Dosage of Ramipril + Amlodipine
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Effects of Overdose of Ramipril + Amlodipine
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Ramipril

About Ramipril
Angiotensin - converting enzyme inhibitor, Antihypertensive.
Mechanism of Action of Ramipril
It is a prodrug and converted in to active Ramiprilat; which is an angiotensin converting enzyme inhibitor prevents the conversion of angiotensin-1 to angiotensin-2 and abolishes the pressor actions of angiotensin. It decreases aldosterone secretion, sodium and water retention, and total peripheral resistance, leads to fall in BP. The arterioles dilate and the compliance of larger arteries is increased. Both systolic and diastolic BP is lowered. The drug does not compromise renal, cerebral, and coronary blood flow. The drug also increases plasma kinin levels and potentiate the hypotensive action of exogenously administered bradykinin. It is used for treatment of systolic heart failure, because it improves symptoms, decrease mortality and reduce ventricular hypertrophy. It reduces both preload and after load and thus increasing cardiac out put in patients with heart failure.
Pharmacokinets of Ramipril
Absorption: Absorbed orally up to 60%, Distribution: Widely distributed in the tissues, Metabolism: Metabolized in the body in to active metabolite, Ramiprilat. Excretion: Excreted mainly through urine and also excreted through faeces.
Onset of Action for Ramipril
1 to 2 hours
Duration of Action for Ramipril
24 hours
Half Life of Ramipril
8 to 48 hours
Side Effects of Ramipril
1.Cough
2.Angioedema
3.Hypotension
4.Chest pain
5.Hyperkalemia
6.Rashes
7.Urticaria
8.Swelling of lips, mouth, nose, and larynx
9.Fetopathic in later half of pregnancy
10.Headache
11.Diarrhoea
12.Fatigue
13.Dizziness
14.Nausea
15.Neutropenia
16.Thrombocytopenia
17.Acute renal failure is precipitated in renal artery stenosis


Contra-indications of Ramipril
1.Hypersensitivity to the drug
2.Renal artery stenosis
3.Aortic stenosis
4.Coarctation of aorta

Special Precautions while taking Ramipril
1.Renal impairment
2.Hepatic impairment
3.Use cautiously in patient at high risk of cardiogenic shock, severe heart failure etc
4.Anaesthesia and surgery

Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Ramipril
1.Hypertension
2.Heart failure

Interactions for Ramipril
Antacids: May decrease bioavailability of ramipril.
Phenothiazines: Pharmacologic effects enhanced by phenothiazines.
Allupurinol: Higher risk of hypersensitivity reactions.
Digoxin: Increases plasma digoxin levels.
Potassium preparations & Potassium sparing diuretics: Hyperkalaemia and increased risk of renal failure.
Lithium: Toxicity due to increased serum concentration of lithium.
Typical Dosage for Ramipril
Starts with 1.25mg once daily. Increases the dose to 2.5 to 5mg once daily; depending on patient`s response.
Maximum dose: 10mg once daily.
In CHF patients starts the dosage with 1.5mg once daily dosage and gradually increases at 2 to3 weeks` intervals to usual dosage.

Schedule of Ramipril
H
Storage Requirements for Ramipril
Store at a temperature range of 15 to 30 degree C. in a well closed container and protect from moisture.






Effects of Missed Dosage of Ramipril
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Ramipril
Treatment is supportive and symptomatic. To remove drug from the body perform induced emesis and gastric lavage. Administer activated charcoal to reduce absorption. In severe cases haemodialysis is considered if required. Treatment includes I.V. infusion of normal saline solution.

Amlodipine

About Amlodipine
Calcium Channel Blocker, Anti hypertensive,anti angina.
Mechanism of Action of Amlodipine
Amlodipine is a second generation dihydropyridine Ca channel blocker. It exerts it`s antihypertensive, antianginal actions through blocking the influx of Ca ions through voltage gated L-type Ca channels to the peripheral vascular smooth muscle cells, Coronary smooth muscle cells and to the myocardial cells. Thus causes dilatation of vascular endothelium, decrease peripheral resistance, & reduce myocardial oxygen demand .It markedly relax arterioles and milder effects on veins. They do not compromise haemodynamics and cerebral and renal perfusion.
Pharmacokinets of Amlodipine
Absorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized in liver, but there is no active metabolite.
Onset of Action for Amlodipine
Slow
Duration of Action for Amlodipine
24 hours
Half Life of Amlodipine
N/A
Side Effects of Amlodipine
1.Palpitation
2.Flushing
3.Nausea
4.Vomiting
5.Abdominal pain
6.Edema
7.Headache
8.Dizziness
9.Paresthesia
10.Light headedness
11.Fatigue
12.Aggravates myocardial ischaemia
13.Rashes
Contra-indications of Amlodipine
1.Heart failure
2.Aortic stenosis
3.Hypersensitivity to the drug
4.Unstable angina
5.Hepatic impairment
6.Along with other anti hypertensive drugs.
Special Precautions while taking Amlodipine
1.Cardiovascular disorders: Use cautiously in cardiovascular disorders because it aggravates myocardial ischaemia.
2.Sick sinus syndrome
3.Renal impairment
4.Use cautiously along with other antihypertensive drugs,
Pregnancy Related Information
Contraindicated.
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution.
Children Related Information
Contraindicated
Indications for Amlodipine
1.Hypertension
2.Prinzmetal`s angina
3.Stable angina
Interactions for Amlodipine
ACE inhibitors, Thiazide diuretics: Potentiates effect of these drugs.
Beta Blockers: Best avoided, especially by those with impaired LV function due to depressant effect on myocardial contractibility or AV conduction.
Fentanyl: Severe hypotension or increased fluid volume requirements.
Typical Dosage for Amlodipine
5 mg once daily.
Maximum dose: 10mg/day
Prinzmetal`s angina and Stable angina:
5 to 10mg once daily.
Hypertension: 2.5 to 5mg once daily. Dose may increase up to 10mg once daily as required by the individual needs.
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Schedule of Amlodipine
H
Storage Requirements for Amlodipine
Store at room temperature below 30 degree C. Protect from moisture and light.

Effects of Missed Dosage of Amlodipine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Amlodipine
Monitor &support cardiac and respiratory functions. Measure the BP. Give cardiovascular support by elevating the limbs and maintaining fluid balance. Administer vasopressers like nor epinephrine and Calcium gluconate if required.

Home Delivery for Ramipril + Amlodipine in Your City

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Ramipril + Amlodipine is a generic medicine name and there are several brands available for it. Some of the brands for ramipril + amlodipine might be better known than ramipril + amlodipine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have ramipril + amlodipine in stock, you can ask for one of the branded alternatives for ramipril + amlodipine.