R Pil 2.5 Tablet

✔️ R Pil Dosage should be individualized according to patient tolerance and clinical response.

Hypertension:
Initial dose: 1.25–2.5 mg once daily.
Maintenance dose: 2.5–20 mg per day, as a single or divided dose.

Congestive Heart Failure after MI:
Start with 2.5 mg twice daily (reduce to 1.25 mg if hypotension occurs).
Target dose: 5 mg twice daily.

Prevention of Cardiovascular Events:
Start with 2.5 mg once daily for one week, then 5 mg daily for three weeks.
Maintenance dose: up to 10 mg once daily.

Renal Impairment:
Initial dose: 1.25 mg once daily; titrate up to a maximum of 5 mg daily depending on tolerance and renal function.

Administration:
Swallow tablets whole with water. Ramipril may be taken before or after meals.

✔️ Side Effects

Generally well tolerated. Common side effects include dizziness, headache, fatigue, hypotension, and dry cough.
Rarely, patients may experience angioedema, rash, nausea, diarrhea, urticaria, hyperkalemia, or allergic reactions.

✔️ Interaction

• Diuretics: May increase the risk of hypotension.
• Potassium-sparing diuretics: Risk of hyperkalemia.
• NSAIDs: May reduce antihypertensive efficacy and impair renal function.
• Lithium: Increases serum lithium concentration.
• Alcohol: May potentiate hypotensive effects.

✔️ Contraindications

• Hypersensitivity to ramipril or other ACE inhibitors.
• History of angioedema.
• Concomitant use with sacubitril/valsartan or aliskiren (in diabetics or renal impairment).
• Renal artery stenosis, hypotension, or hemodynamic instability.
• Pregnancy and lactation.
• During extracorporeal treatments involving negatively charged surfaces (e.g. certain dialysis membranes, LDL apheresis with dextran sulfate).

✔️ Use in Pregnancy & Lactation

Ramipril is contraindicated during pregnancy, as ACE inhibitors can cause fetal harm. It should also be avoided during breastfeeding.

✔️ Precautions & Warnings

Use cautiously in patients with renal or hepatic impairment, hyperkalemia, or hypotension.

Monitor serum electrolytes and renal function periodically.

In patients on diuretics, consider reducing or stopping the diuretic before starting R-Pil to minimize the risk of hypotension.

✔️ Storage:

Store below 30°C, away from light and moisture. Keep out of reach of children. Dispense only on the prescription of a registered physician.