Felodipine + Ramipril
Find more information about this combination medication at the webpages for ramipril and felodipine
Hypertension , Variant Angina Pectoris ... show more
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
None
Controlled Drug Substance
NO
Summary
Felodipine and ramipril are used to treat high blood pressure, which is also known as hypertension. Ramipril is also used to reduce the risk of heart attacks and strokes in certain patients and to improve survival after a heart attack. Both medications help manage blood pressure, but ramipril has additional benefits in heart protection.
Felodipine works by blocking calcium channels, which are pathways in the blood vessels, helping them relax and widen. This makes it easier for the heart to pump blood. Ramipril inhibits the angiotensin-converting enzyme, which reduces a substance that narrows blood vessels, lowering blood pressure and reducing heart strain. Both aim to lower blood pressure but through different mechanisms.
Felodipine is usually taken as 5 to 10 mg once daily, depending on the individual's response. Ramipril typically starts at 2.5 mg once daily, with adjustments based on patient needs. Both medications are taken orally, meaning by mouth, and doses are adjusted according to blood pressure control and tolerance. It's important to follow healthcare provider instructions for dosing.
Common side effects of felodipine include swelling of the ankles or feet, which is due to fluid retention, and headaches. Ramipril may cause a persistent dry cough and dizziness, especially when starting the medication. Both medicines can lead to low blood pressure, which might cause fainting or lightheadedness. Monitoring for these side effects is important to ensure safe use.
Felodipine should be used cautiously in people with severe heart conditions, as it can affect heart rate and blood pressure. Ramipril is contraindicated in patients with a history of angioedema, which is swelling under the skin, related to previous ACE inhibitor use. Both medications should not be used during pregnancy due to potential harm to the unborn baby.
Indications and Purpose
How does combination of Felodipine and Ramipril work?
Felodipine works by blocking calcium channels in the blood vessels, leading to relaxation and dilation of the vessels, which reduces blood pressure. Ramipril inhibits the angiotensin-converting enzyme (ACE), decreasing the production of angiotensin II, a substance that narrows blood vessels. Both medications lower blood pressure by improving blood flow, but they target different pathways in the body to achieve this effect.
How effective is combination of Felodipine and Ramipril?
Clinical studies have demonstrated that both Felodipine and Ramipril effectively lower blood pressure, reducing the risk of cardiovascular events such as heart attacks and strokes. Felodipine's effectiveness is primarily due to its ability to relax blood vessels by blocking calcium channels, while Ramipril's efficacy is attributed to its inhibition of the ACE enzyme, reducing angiotensin II levels. Both medications have been shown to improve cardiovascular outcomes, but they achieve these results through different mechanisms.
Directions for Use
What is the usual dose of combination of Felodipine and Ramipril?
The usual adult daily dose for Felodipine is 5 mg once a day, which can be adjusted between 2.5 mg and 10 mg based on the patient's response. For Ramipril, the starting dose is typically 2.5 mg once a day, which can be increased to a maintenance dose of 2.5 mg to 20 mg per day, either as a single dose or divided into two doses. Both medications require dose adjustments based on individual response and are used to manage high blood pressure, but they have different dosing ranges and frequency.
How does one take combination of Felodipine and Ramipril?
Felodipine should be taken once daily, either without food or with a light meal, and the tablets should not be crushed or chewed. Patients should avoid grapefruit juice, as it can increase Felodipine levels in the blood. Ramipril can be taken with or without food, and the capsules can be swallowed whole or opened and mixed with applesauce or juice. Both medications require consistent daily intake, and patients should follow any specific dietary instructions provided by their healthcare provider.
For how long is combination of Felodipine and Ramipril taken?
Both Felodipine and Ramipril are typically used as long-term treatments for managing high blood pressure. Patients may need to take these medications for the rest of their lives to maintain blood pressure control and prevent complications. While Felodipine provides immediate blood pressure control, Ramipril may take several weeks to reach its full effect. Both medications require ongoing use to sustain their benefits.
How long does it take for combination of Felodipine and Ramipril to work?
Felodipine typically starts to lower blood pressure within 2 to 5 hours after administration, with its effects lasting for 24 hours. Ramipril, on the other hand, begins to work within a few hours, but it may take several weeks to achieve its full blood pressure-lowering effect. Both medications are used to manage high blood pressure, but Felodipine acts more quickly in the short term, while Ramipril may take longer to show its full benefits. Both medicines work to relax blood vessels, but they do so through different mechanisms.
Warnings and Precautions
Are there harms and risks from taking combination of Felodipine and Ramipril?
Common side effects of Felodipine include headache, flushing, dizziness, and swelling of the gums. Ramipril may cause dizziness, headache, cough, and fatigue. Both medications can lead to low blood pressure, which may cause lightheadedness or fainting. Serious adverse effects, such as angioedema (swelling of the face, lips, or throat), are rare but require immediate medical attention. While both medications share some side effects, they also have unique reactions due to their different mechanisms of action.
Can I take combination of Felodipine and Ramipril with other prescription drugs?
Felodipine can interact with CYP3A4 inhibitors like ketoconazole and erythromycin, leading to increased drug levels. Ramipril may interact with diuretics, NSAIDs, and other medications affecting the renin-angiotensin system, potentially causing changes in blood pressure or kidney function. Both medications require careful monitoring when used with other drugs that affect blood pressure or electrolyte levels to prevent adverse effects.
Can I take combination of Felodipine and Ramipril if I am pregnant?
Felodipine's safety during pregnancy is not well-documented, so it should be used only if clearly needed. Ramipril is contraindicated during pregnancy, especially in the second and third trimesters, due to the risk of fetal harm, including kidney damage and developmental issues. Both medications require careful consideration, and alternative treatments are usually recommended for pregnant women to avoid potential risks to the fetus.
Can I take combination of Felodipine and Ramipril while breastfeeding?
Felodipine's safety during breastfeeding is not well-established, so caution is advised. Ramipril may pass into breast milk in small amounts, and while it is generally considered safe, it is best to consult a healthcare provider. Both medications require careful consideration of the benefits and risks when used during lactation, and alternative treatments may be recommended based on individual circumstances.
Who should avoid taking combination of Felodipine and Ramipril?
Felodipine should be used cautiously in patients with severe liver disease, as it can lead to increased drug levels. Ramipril is contraindicated in pregnancy due to the risk of fetal harm. Both medications can cause low blood pressure, so patients should be monitored for symptoms like dizziness or fainting. Additionally, patients with a history of angioedema should avoid Ramipril. Both drugs require careful monitoring in patients with kidney impairment.
