Acecard 2.5 mg

Description

Indications:

Acecard tablet is indicated for the following conditions:

• Hypertension: Used to lower blood pressure either as a monotherapy or in combination with other antihypertensive medications.
• Congestive Heart Failure (CHF): Often used in conjunction with diuretics to manage CHF.
• Acute Myocardial Infarction (Post-Acute Phase): Effective for patients who show signs of CHF within the first few days after a heart attack.
• Nephropathy: Beneficial in the treatment of non-diabetic and diabetic patients with overt or incipient glomerular nephropathy.
• Cardiovascular Risk Reduction: Helps decrease the risk of heart attack, stroke, or cardiovascular death in patients with an increased risk, including those with coronary artery disease (with or without a history of heart attack), stroke history, peripheral vascular disease, or diabetes mellitus with at least one other cardiovascular risk factor (such as microalbuminuria, high blood pressure, elevated cholesterol, low HDL cholesterol, or smoking).

Please follow the guidance of a registered medical professional for usage.

Pharmacology:

Ramipril, the active ingredient in Acecard, is classified as an angiotensin-converting enzyme (ACE) inhibitor. After conversion to ramiprilat, it blocks the conversion of angiotensin I into angiotensin II, a vasoconstrictor. This leads to reduced levels of angiotensin II, which decreases vasoconstriction and aldosterone secretion, ultimately lowering blood pressure. Ramipril also aids in heart failure management and reduces the likelihood of stroke, myocardial infarction, and cardiovascular-related deaths. Due to its long-lasting effect and good tolerability, it is suitable for long-term therapy.

Dosage:

The dosage of Ramipril should be tailored to the patient’s individual response and tolerance:

• For Hypertension: The usual starting dose is 1.25-2.5 mg once daily, with adjustments made every 2 weeks as necessary. The typical maintenance dose ranges from 2.5 mg to 20 mg daily, taken either as a single dose or divided into two doses. If blood pressure remains uncontrolled, a diuretic may be added.

• For Congestive Heart Failure after Myocardial Infarction: Treatment can begin as early as 2 days post-heart attack. A starting dose of 2.5 mg twice daily is recommended, with possible adjustments to 1.25 mg twice daily in case of hypotension. The dose can be gradually increased to 5 mg twice daily as tolerated.

• For Cardiovascular Event Prevention: Start with 2.5 mg once daily for the first week, then increase to 5 mg once daily for the next 3 weeks. If tolerated, the dose may be further raised to a maintenance dose of 10 mg once daily.

• For Renal Impairment:

  • For patients with hypertension and renal impairment, the initial dose should be 1.25 mg once daily, with adjustments based on tolerance and blood pressure response, up to a maximum of 5 mg daily.
  • For heart failure patients with renal impairment, start with 1.25 mg once daily, which can be increased to 1.25 mg twice daily, up to a maximum of 2.5 mg twice daily based on clinical response.

Please follow the guidance of a registered medical professional for usage.

Administration:

Acecard tablets should be taken with a sufficient amount of liquid. The tablets should not be chewed or crushed. Food does not significantly affect the absorption of Ramipril, so it can be taken before, during, or after meals.

Please follow the guidance of a registered medical professional for usage.

Interaction:

• Diuretics: Concomitant use with diuretics may cause serious hypotension, especially with potassium-sparing diuretics, leading to hyperkalemia.
• Lithium: The use of lithium alongside Ramipril may increase lithium serum levels.
• Blood Pressure Reduction: Lowered blood pressure may impair the ability to drive or operate machinery, which can be worsened by alcohol consumption.
• NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the effectiveness of Acecard and lead to deterioration of renal function.

Contraindications:

Ramipril should not be used in the following situations:

• In patients with hypersensitivity to Ramipril, other ACE inhibitors, or any component of the tablet.
• In patients with a history of angioedema.
• If used concurrently with sacubitril/valsartan therapy. Do not initiate Ramipril until sacubitril/valsartan is cleared from the body.
• In patients with renal artery stenosis or any significant renal impairment.
• In patients who are hypotensive or hemodynamically unstable.
• In combination with aliskiren-containing medications for diabetic patients or those with moderate to severe renal impairment (creatinine clearance <60 ml/min).
• During pregnancy.
• In patients undergoing certain extracorporeal treatments (e.g., dialysis with certain high-flux membranes) that can cause severe anaphylactoid reactions.

Side Effects:

While Acecard is generally well tolerated, some common side effects include dizziness, headache, fatigue, and weakness. Less frequent side effects may include symptomatic low blood pressure, cough, nausea, vomiting, diarrhea, skin rash, hives, reduced urine output, anxiety, and memory issues. Rarely, more severe reactions such as angioedema, anaphylactic reactions, and hyperkalemia may occur.

Pregnancy & Lactation:

Acecard should not be used during pregnancy. Patients should be assessed for pregnancy before starting treatment. If pregnancy occurs while on Ramipril, the medication should be discontinued immediately. There is a risk of harm to the fetus. Ramipril is also not recommended for use during breastfeeding.

Precautions & Warnings:

• Use with caution in patients with renal dysfunction, hyperkalemia, low blood pressure, or liver dysfunction.
• Elderly Patients: A lower starting dose of 1.25 mg per day is recommended.
• Hepatic Impairment: Treatment should be closely monitored, and the maximum daily dose should not exceed 2.5 mg.
• Renal Impairment: For patients with creatinine clearance between 50 and 20 ml/min, the recommended initial dose is 1.25 mg. The maximum dose should not exceed 5 mg.

Overdose Effects:

Overdosage may lead to severe peripheral vasodilation (with significant hypotension), bradycardia, electrolyte imbalances, and renal failure. Immediate intervention may include gastric lavage, administration of absorbents, and electrolyte correction. In case of hypotension, α1-adrenergic agonists or angiotensin II may be considered, along with fluid and salt replacement.

Therapeutic Class: Angiotensin-converting enzyme (ACE) inhibitors

Storage Conditions: Store below 30°C, away from light, and out of the reach of children. Do not use past the expiry date. To be dispensed only with a prescription from a licensed healthcare provider.