Primace Capsule 2.5 mg contains Ramipril, a potent angiotensin-converting enzyme (ACE) inhibitor used primarily for the management of hypertension, heart failure, and cardiovascular risk reduction. Ramipril works by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, which helps relax blood vessels, reduce blood pressure, and decrease the workload on the heart.

Primace is widely prescribed to patients with essential hypertension, patients at risk of cardiovascular events such as myocardial infarction or stroke, and for the treatment of heart failure following a myocardial infarction. By lowering systemic vascular resistance and improving cardiac output, Ramipril helps protect organs such as the heart, kidneys, and brain from damage caused by prolonged high blood pressure.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Indications

Primace Capsule 2.5 mg is indicated for:

• Hypertension: As monotherapy or in combination with other antihypertensive agents to achieve optimal blood pressure control.

• Heart Failure: Management of symptomatic heart failure, particularly after myocardial infarction, to improve survival and reduce hospitalizations.

• Post-Myocardial Infarction: To reduce mortality and prevent heart failure progression in patients recovering from myocardial infarction.

• Cardiovascular Risk Reduction: To reduce the risk of myocardial infarction, stroke, and cardiovascular death in high-risk patients, including those with diabetes or other vascular disease.

• Renal Protection: Particularly in patients with hypertension or diabetes, Ramipril helps slow the progression of diabetic nephropathy by reducing intraglomerular pressure.

Therapeutic Class

Angiotensin-Converting Enzyme (ACE) Inhibitor

Pharmacology

Ramipril is a prodrug converted in the liver to its active form, Ramiprilat, which inhibits the angiotensin-converting enzyme. By preventing the conversion of angiotensin I to angiotensin II, it decreases vasoconstriction, reduces aldosterone secretion, and promotes natriuresis, ultimately lowering blood pressure and reducing cardiac preload and afterload.

Ramipril also improves endothelial function, reduces vascular inflammation, and provides organ-protective effects, including slowing kidney damage in patients with proteinuric renal disease. The antihypertensive effect usually develops within one week of starting therapy, with maximal effect observed after 3–6 weeks.

Dosage and Administration

• Hypertension: Initial dose: 2.5 mg once daily, may be increased to 5 mg once daily depending on patient response. Maximum dose: 10 mg/day.

• Heart Failure/Post-MI: Initial dose: 1.25–2.5 mg once daily, titrated gradually as tolerated.

• Renal or hepatic impairment: Dose adjustments may be necessary.

Capsules should be taken orally, preferably at the same time each day, with or without food. Consistent use is critical to achieving optimal therapeutic outcomes.

Contraindications

• Known hypersensitivity to Ramipril or other ACE inhibitors

• History of angioedema related to previous ACE inhibitor therapy

• Pregnancy (especially in the second and third trimesters)

• Bilateral renal artery stenosis or severe renal impairment

Side Effects

Common adverse effects may include:

• Cough (dry and persistent)

• Dizziness or hypotension, especially after the first dose

• Headache and fatigue

• Gastrointestinal discomfort, nausea

• Hyperkalemia (elevated potassium levels)

• Rare: angioedema, renal impairment, or liver enzyme elevation

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions and Warnings

• Monitor renal function and serum potassium periodically, particularly in patients with renal impairment or those on potassium-sparing diuretics.

• Use caution in patients with hypotension, dehydration, or heart failure.

• ACE inhibitors may cause fetal harm; discontinue promptly if pregnancy is detected.

Pregnancy and Lactation

Ramipril is contraindicated in pregnancy, especially during the second and third trimesters, due to the risk of fetal injury. Limited data is available on excretion in human milk; breastfeeding is not recommended during therapy.

Storage Conditions

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Mode of Action

Ramipril inhibits angiotensin-converting enzyme, reducing levels of angiotensin II. This leads to vasodilation, decreased aldosterone secretion, and improved hemodynamics, resulting in lower blood pressure and reduced cardiovascular stress.