Co-Tritace (2.5/12.5mg) 28 Tablets

Hydrochlorothiazide and Ramipril are combined in this tablet to treat hypertension. Hydrochlorothiazide is a diuretic that increases urine production by inhibiting the reabsorption of sodium and chloride in the distal tubule of the kidneys, leading to increased fluid and sodium excretion, which reduces blood volume and lowers blood pressure. Ramipril, on the other hand, is an angiotensin-converting enzyme (ACE) inhibitor. It blocks the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This action reduces blood pressure by promoting vasodilation, decreasing vascular resistance, and reducing the workload on the heart. Additionally, Ramipril inhibits the degradation of bradykinin, a vasodilator, further contributing to blood pressure reduction.

Hydrochlorothiazide, Ramipril

Angiotensin-converting enzyme inhibitor, Thiazide diuretic.

Tablet

The following are the uses of Hydrochlorothiazide, Ramipril Tablet:

• Used for controlling high blood pressure (hypertension)
• Used to lower blood pressure and reduce the risk of heart-related events
• Used in cases of fluid retention (edema) due to conditions like heart disease or kidney issues
• Used to treat symptoms of heart failure
• Used to improve survival rates after a heart attack
• Used to reduce the workload on the heart in various cardiovascular conditions
• Used to manage hypertension in diabetic patients
• Used to prevent kidney complications in diabetic patients with high blood pressure

In the case of an overdose of Hydrochlorothiazide and Ramipril Tablets, individuals may experience symptoms such as dizziness, hypotension (low blood pressure), and electrolyte imbalances. Prompt medical intervention is necessary, and healthcare professionals should be contacted immediately. Treatment for overdose may involve supportive measures, monitoring vital signs, and managing any complications that arise. It is important to seek professional advice and not delay treatment to prevent potential health risks associated with excessive medication intake.

In the case of a missed dose of Hydrochlorothiazide, it is generally recommended to take the missed dose as soon as you remember, but if it's almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one. For Ramipril, if you miss a dose, take it as soon as you remember, but if it's close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. It is important not to take extra medication to make up for any missed doses for both these medications.

To take the Hydrochlorothiazide, Ramipril Tablet, swallow the tablet whole with a full glass of water, preferably in the morning, as directed by your healthcare professional. It is recommended to take the tablet at the same time each day to maintain consistent blood levels and maximize its effectiveness.

Following are the conditions or circumstances when Hydrochlorothiazide, Ramipril Tablet should not be used:

• Should not be used in individuals with a known allergy to either Hydrochlorothiazide or Ramipril or any of the tablet's components.
• Contraindicated in pregnant women as it can potentially cause harm to the fetus.
• Not recommended for breastfeeding mothers as the drugs may pass into breast milk.
• Should be avoided in individuals with severe kidney disease or those with impaired kidney function.
• Not suitable for patients with severe liver disease or liver disorders.
• Contraindicated in individuals with a history of angioedema, especially those related to previous ACE inhibitor therapy.
• Should not be used in patients with a history of hypersensitivity reactions to sulfonamides, as Hydrochlorothiazide is a sulfonamide-derived diuretic.
• Not recommended for individuals with low blood sodium levels (hyponatremia) or low blood potassium levels (hypokalemia).
• Should be used with caution in patients with diabetes, as it may alter glucose tolerance and increase blood sugar levels.
• Avoid using this medication in individuals with a history of aortic stenosis (narrowing of the aortic valve in the heart).

The side effects of Hydrochlorothiazide, Ramipril Tablet may include:

• Dizziness
• Lightheadedness
• Fatigue or weakness
• Headache
• Nausea and vomiting
• Diarrhea
• Skin rash or itching
• Muscle cramps

Following are the precautions and warnings for Hydrochlorothiazide, Ramipril Tablet:

• This medication should be used with caution in patients with impaired kidney function, as it may affect renal blood flow and electrolyte balance.
• Regular monitoring of kidney function and electrolytes is necessary, especially in elderly patients or those with pre-existing kidney disease.
• Patients with a history of angioedema should be closely monitored, as Ramipril may cause swelling of the face, lips, tongue, or throat.
• It may cause dizziness or lightheadedness, especially when standing up from a sitting or lying position. Patients should exercise caution to avoid falls.
• Avoid using potassium supplements or salt substitutes containing potassium without medical advice, as Hydrochlorothiazide can affect potassium levels.
• Diabetic patients should monitor blood sugar levels regularly as Ramipril may alter glucose tolerance.
• Inform your doctor if you have any heart or liver problems before taking this medication.
• Do not use this medication during pregnancy or breastfeeding without medical advice, as it may cause harm to the fetus or infant.

Following are the drug interactions for Hydrochlorothiazide, Ramipril Tablet:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the blood pressure-lowering effect of Ramipril and may increase the risk of kidney damage.
• Ramipril may increase the levels of lithium, potentially leading to lithium toxicity. Close monitoring of lithium levels is necessary.
• The combination with angiotensin receptor blockers (ARBs) or aliskiren in patients with diabetes or renal impairment is contraindicated due to the risk of significant hypotension and renal impairment.
• Hydrochlorothiazide may increase blood levels of calcium, leading to hypercalcemia when used with calcium supplements or calcium-containing antacids.
• Potassium-sparing diuretics (e.g., spironolactone, eplerenone) or potassium supplements may cause hyperkalemia when used with Ramipril.
• Drugs that may increase serum potassium levels, such as potassium-containing salt substitutes, should be used with caution to avoid hyperkalemia.
• The antihypertensive effect of Ramipril may be reduced by non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors.
• The risk of severe hypotension and renal dysfunction may increase when Ramipril is used with other antihypertensive medications or diuretics.

Following are the food interactions for Hydrochlorothiazide, Ramipril Tablet:

• Grapefruit and grapefruit juice should be avoided as they can increase the levels of Ramipril in the blood, leading to potential side effects and increased blood pressure-lowering effects.
• Salt substitutes containing potassium should be used with caution as Hydrochlorothiazide can increase potassium levels, and excessive potassium intake may be harmful.
• Alcohol consumption may increase the risk of dizziness and lightheadedness, especially when standing up from a sitting or lying position.
• Limit your sodium intake as Hydrochlorothiazide is a diuretic, and excessive salt can reduce its effectiveness.
• Avoid or limit foods rich in potassium, such as bananas, oranges, and tomatoes, as Hydrochlorothiazide can affect potassium levels.
• Avoid or reduce the consumption of licorice, as it can decrease the effectiveness of Hydrochlorothiazide by promoting sodium and water retention.
• Consult your healthcare provider about any dietary restrictions or recommendations, especially regarding potassium and sodium intake.
• Always follow the dietary advice provided by your doctor or pharmacist to ensure the medication's effectiveness and safety.

Hydrochlorothiazide, Ramipril Tablets should be stored in a cool and dry place, preferably at room temperature, ensuring protection from light and moisture. It is crucial to keep the tablets in their original container, tightly sealed, to maintain their integrity and prevent contamination. Avoid storing them in areas exposed to extreme temperatures, such as the bathroom, kitchen, or near heating devices. Regularly check the expiration date, and if the medication is no longer needed or has expired, it should be disposed of responsibly. Proper disposal methods should be followed to prevent environmental harm; do not flush or pour the medication down the drain. Always consult a pharmacist or healthcare professional for guidance on safe disposal practices, and keep all medications out of children's reach to prevent accidental consumption.

Following are the quick tips for Hydrochlorothiazide, Ramipril Tablet:

• Always take the tablet as directed by your doctor, typically once daily.
• It's best to take the tablet at the same time each day to maintain a consistent routine.
• Swallow the tablet whole with a full glass of water; do not crush, chew, or break it.
• You can take it with or without food, but taking it with food may help prevent stomach upset.
• Avoid drinking alcohol while on this medication as it may increase side effects.
• Regularly monitor your blood pressure and kidney function as advised by your doctor.
• Store the tablets in a cool, dry place, away from direct sunlight and moisture.