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Safety Advices
বাংলা
English
UNSAFE
Piramil may cause excessive drowsiness with alcohol.
CONSULT YOUR DOCTOR
Piramil is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
CONSULT YOUR DOCTOR
Piramil is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
UNSAFE
Piramil may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
Piramil should be used with caution in patients with kidney disease. Dose adjustment of Piramil may be needed. Please consult your doctor.
Regular monitoring of blood pressure is recommended for dose adjustment.
CAUTION
Piramil should be used with caution in patients with liver disease. Dose adjustment of Piramil may be needed. Please consult your doctor.
Inform your doctor if you develop any signs and symptoms of jaundice while taking this medicine.
Medicine Overview of Piramil 5mg Tablet
Introduction
Piramil belongs to a group of medicines known as angiotensin converting enzyme (ACE) inhibitors. It is widely used to treat high blood pressure and heart failure and may be prescribed after a heart attack. It also lowers the chances of having a heart attack or stroke. Piramil can be prescribed either alone or in combination with other medicines. It may be taken empty stomach or with a meal. This medicine should be taken at the same time each day to get the maximum benefit. It is important to continue taking it regularly even if you feel well or even if...
... Show moreUses of Piramil
- Hypertension (high blood pressure)
- Prevention of heart attack and stroke
- Heart failure
Side effects of Piramil
Common
- Decreased blood pressure
- Dizziness
- Fatigue
- Vomiting
- Dry cough
How to use Piramil
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Piramil may be taken with or without food, but it is better to take it at a fixed time.
How Piramil works
Piramil is an angiotensin converting enzyme (ACE) inhibitor. It works by reducing stress on the heart and relaxing blood vessel so that blood flows more smoothly and the heart can pump blood more efficiently.
What if you forget to take Piramil?
If you miss a dose of Piramil, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
- Piramil can make you feel dizzy for the first few days, so rise slowly if you have been sitting or lying down. You can also prefer taking it at bedtime to avoid dizziness throughout the day.
- Let your doctor know about any cough, or throat irritation that does not go away.
- It may increase the level of potassium in blood. Avoid taking potassium supplements and potassium-rich foods such as banana and broccoli.
- Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Brief Description
Indication
Congestive heart failure, MI, HTN, CV events, Stroke
Administration
May be taken with or without food.
Adult Dose
Oral Hypertension, Diabetic Nephropathy Adult: Hypertension Initial (not on diuretic): 2.5 mg once daily at bedtime. Initial (with diuretic): 1.25 mg once daily at bedtime. Maintenance: 2.5-5 mg/day as a single dose, Max: 10 mg/day. Congestive Heart failure Adult: Initially, 1.25 mg once daily. Max: 10 mg daily. Doses >2.5 mg may be given in 2 divided doses. Max Dosage: 10 mg daily in 1-2 divided doses. Post myocardial infarction Adult: Initially, 2.5 mg bid, may increase to 5 mg bid after 2 days. Start treatment: 3-10 days after infarction. Maintenance: 2.5-5 mg bid. Prophylaxis of cardiovascular events in high-risk...
... Show moreChild Dose
Safety and efficacy not established
Renal Dose
Renal impairment:
CrCl (ml/min) Dosage Recommendation
10-30 Initially, 1.25 mg/day. Max: 5 mg/day.
30-60 Not necessary to adjust the initial dose. Max maintenance dose: 5 mg/day.
Contraindication
Hypersensitivity, bilateral renal artery stenosis, or a single kidney with unilateral renal artery stenosis. Aortic stenosis or outflow tract obstruction. History of angioedema (hereditary, idiopathic or due to previous angioedema w/ ACE inhibitors). Pregnancy and lactation.
Mode of Action
Ramipril, a prodrug of ramiprilat, competitively inhibits ACE from converting angiotensin I to angiotensin II (a potent vasoconstrictor) resulting in increased plasma renin activity and reduced aldosterone (a hormone that causes water and Na retention) secretion. This promotes vasodilation thus producing a hypotensive effect and a beneficial effect in CHF.
Precaution
Renal impairment, hypovolaemia, hyperkalaemia, valvular stenosis; before, during or immediately after anaesthesia. Severe resistant hypertension, elderly, peripheral vascular disease or generalised atherosclerosis. Patient Counselling Inform patients to refrain from activities involving mental alertness and physical coordination after drug intake. Monitoring Parameters Correct volume and/or salt depletion prior to treatment. Monitor BP, serum creatinine and K levels. Monitor renal function during the 1st few wk of treatment and periodically thereafter.
Lactation: Possibly excreted in breast milk; nursing not recommended
Side Effect
>10%
Cough (7-8%),Hypotension (2-11%)
1-10%
Headache (1-5%),Angina pectoris (3%),Dizziness (2-4%),Nausea (2%),Vomiting (2%),Postural hypotension (2%),Syncope (2%),Vertigo (2%),Abnormal kidney function (1%),Diarrhea (1%)
<1%
Angioedema (0.3%)
Potentially Fatal: Severe hypotension and renal failure, angioedema.
Interaction
May enhance hypotensive effect w/ diuretics and other antihypertensives. May increase risk of renal function deterioration w/ NSAIDs. May increase serum levels and toxicity of lithum. May increase hyperkalaemic effect w/ K-sparing diuretics and supplements.
Potentially Fatal: Concomitant use w/ aliskiren aliskiren may increase the risk of hyperkalaemia, hypotension and nephrotoxicity in patients w/ diabetes or renal impairment
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