Losartan potassium + Ramipril Pharmacology

Losartan potassium + Ramipril

About Losartan potassium + Ramipril
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Mechanism of Action of Losartan potassium + Ramipril
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Pharmacokinets of Losartan potassium + Ramipril
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Onset of Action for Losartan potassium + Ramipril
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Duration of Action for Losartan potassium + Ramipril
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Half Life of Losartan potassium + Ramipril
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Side Effects of Losartan potassium + Ramipril
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Contra-indications of Losartan potassium + Ramipril
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Special Precautions while taking Losartan potassium + Ramipril
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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 Losartan potassium + Ramipril
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Interactions for Losartan potassium + Ramipril
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Typical Dosage for Losartan potassium + Ramipril
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Schedule of Losartan potassium + Ramipril
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Storage Requirements for Losartan potassium + Ramipril
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Effects of Missed Dosage of Losartan potassium + Ramipril
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Effects of Overdose of Losartan potassium + Ramipril
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Losartan Potassium

About Losartan Potassium
An angiotensin II receptor antagonist, Antihypertensive.
Mechanism of Action of Losartan Potassium
It is a competitive antagonist of angiotensin-2 at AT-1 receptor. It decreases peripheral resistance and lowers BP in hypertensive individuals. It blocks all overt actions of angiotensin-2 such as: - 1. Vasoconstriction, 2. Central & Peripheral sympathetic stimulus, 3. Release of aldosterone and adrenaline, 4. Salt and water reabsorption, 5. Central actions like thirst, vasopressin release, and growth promoting actions on heart and blood vessels.
Pharmacokinets of Losartan Potassium
Absorption: Well absorbed orally, but bioavailability is about 33% due to first pass metabolism.
Distribution: Distributed in to the body in a protein bound form, but there is no brain penetration.
Metabolism: Metabolized in the liver in to active carboxylic acid metabolite and other metabolites.
Excretion: Excreted through faeces and urine.
Onset of Action for Losartan Potassium
1 hour
Duration of Action for Losartan Potassium
N/A
Half Life of Losartan Potassium
2 hours
Half life of active metabolite: 6 to 9 hours
Side Effects of Losartan Potassium
1. Hypotension
2. Hyperkalemia
3. Headache
4. Breathlessness
5. Chest pain
6. Sore throat
7. Infections
8. Weakness
9. Dizziness
10. Elevated liver enzyme levels
11. Myalgia
12. Fetopathic
13. Precipitate renal failure in renal artery stenosis, and in insufficient renal blood flow
14. Rashes
15. Insomnia
16. Nightmares
Contra-indications of Losartan Potassium
1. Hypersensitivity to the drug
Special Precautions while taking Losartan Potassium
1.Hepatic impairment
2.Renal impairment
3.Heart failure
4.Volume depleted individuals
5.Monitor serum potassium levels and avoid use along with potassium sparing diuretics
6. Avoid driving or operating heavy machinery during therapy
7. Avoid alcohol use during therapy
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Losartan Potassium
1. Hypertension
Interactions for Losartan Potassium
Diuretics, other antihypertensives: Potentiate the hypotensive effect of losartan.
Potassium sparing diuretics, potassium suppliments: Risk of hyperkalaemia.
NSAIDs: May blunt hypotensive effect of losartan.
Cytochrome P450 inhibitors like ketoconazole: Increase in AUC of losartan by 18 % but has no effect on its active metabolite.
Phenobarbital: Results in 20% reduction in AUC of losartan and its active metabolite.
Typical Dosage for Losartan Potassium
25 to 50mg once daily. Gradually increases up to 100mg once daily or as two divided doses.
Schedule of Losartan Potassium
H
Storage Requirements for Losartan Potassium
Store at room temperature at a range of 15 to 30 degree C. protect from moisture and store in a tightly closed container.
Effects of Missed Dosage of Losartan Potassium
Take the missed dose as soon as remember; if it is the time of next dose then skip the missed dose and take the regular dose.
Effects of Overdose of Losartan Potassium
Treatment is supportive and symptomatic.

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.

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