Triapin

What is it?

An antihypertensive preparation combining a class II calcium antagonist and ACE inhibitor, available as film-coated, bi-layered, brown tablets containing 5mg of felodipine in sustained-release form and 5mg of ramipril. All are marked HOE and 5. Also, TRIAPIN MITE, film-coated, bi-layered, orange tablets containing 2.5mg of felodipine in sustained-release form and 2.5mg of ramipril, all marked HOD and 2.5.

Medical Uses

High blood pressure in patients whose condition is controlled by the same drugs in these proportions given separately.

Dosage

Adults, 1 tablet once each day.

Special Care

Enlarged, obstructed heart, renovascular high blood pressure, narrowed aortic or mitral valve of heart, mild to moderate kidney or liver disorders with impaired function, narrowed renal arteries, collagen vascular disease. There is high risk of severe low blood pressure in patients with low blood sodium levels, volume depletion or heart failure treated with large doses of diuretics. Kidney function must be checked before treatment starts and then monitored as therapy proceeds.

Avoid Use

Children, pregnancy, breastfeeding, heart block (2nd or 3rd degree), heart shock, seriously impaired liver or kidney function, stroke, angina which is not stabilised, heart attack, heart failure which is untreated, previous angioneurotic oedema (widespread swelling due to fluid retention), haemodialysis or apheresis using high-flux membranes.

Possible Drug and Food Interactions

Potassium supplements and potassium-sparing diuretics, oral hypoglycaemics, insulin, corticosteroids, drugs affecting cytdchrome P450, NSAIDs, procainamide, immunosuppressants, desensitisation treatment for insect stings and bites, heparin, grapefruit juice, theophylline, cytostatics, lithium, allopurinol.

Known Side Effects

Cough, overgrowth of gum tissue, liver or kidney failure, swelling of ankles, serious low blood pressure, dizziness, gastrointestinal upset, headache, rapid heartbeat, skin effects. Stop treatment immediately in event of angioedema. Effects on blood - agranulocytosis and neutropenia; patients should report signs of infection. Any adverse side effects should be reported to the Committee on the Safety of Medicines (CSM).