Triteis Tablet 2.5 mg (Ramipril)

Adult dose

1. Hypertension ① Adults not receiving diuretics: The initial dose of ramipril is 2.5㎎ once daily, taken orally with plenty of water during or after a meal. Depending on the patient's response, the dose may be increased at intervals of 2‐3 weeks, initially up to 5㎎ daily and thereafter up to a maximum of 10㎎ daily; a diuretic may be administered concomitantly. ② Adults receiving diuretics: Since an undesirably excessive decrease in blood pressure may occur after the first dose, discontinue the diuretic 2‐3 days before starting treatment, if possible. If this is not possible, administer an initial dose of 1.25㎎ once daily and adjust appropriately as needed. ③ Patients with renal impairment 1) Creatinine clearance of 50㎖/min or more (serum creatinine less than 1.5㎎/㎗): No dose adjustment is necessary. 2) Creatinine clearance of 20~50㎖/min (serum creatinine 1.5‐3㎎/㎗): Administer an initial dose of 1.25㎎ once daily; the dose may be increased to a maximum of 5㎎ once daily. 3) Creatinine clearance below 20㎖/min (serum creatinine 3㎎/㎗ or more): Administer an initial dose of 1.25㎎ every other day; the maintenance dose should not exceed 2.5㎎ once daily. ④ Patients with hepatic impairment: Administer under the careful supervision of a physician and do not exceed 2.5㎎ daily. 2. Heart failure after myocardial infarction ① Patients not receiving diuretics: The recommended initial dose is 2.5mg twice daily. For patients who develop symptoms of hypotension at this dose, the dose may be changed to 1.25mg twice daily; however, the dose should be titrated gradually in all patients to the target dose of 5mg twice daily. Patients should be monitored closely for at least 2 hours after the first dose of this medicine and for at least an additional 1 hour until blood pressure has stabilized. If hypotension occurs after the first dose, treat the hypotension appropriately and then adjust the dose of this medicine carefully. ② Patients receiving diuretics: Symptomatic hypotension may occur after the first dose of this medicine in patients who have been taking diuretics. To reduce the likelihood of hypotension, discontinue the diuretic 2~3 days before starting this medicine, if possible. Thereafter, if blood pressure is not controlled with this medicine alone, resume the diuretic. If the diuretic cannot be discontinued, administer an initial dose of 1.25mg of this medicine to avoid excessive hypotension. The dose of the concomitantly administered diuretic should be reduced as much as possible to reduce the likelihood of hypotension. ③ Patients with heart failure accompanied by renal failure: The recommended initial dose is 1.25mg once daily. Depending on clinical response and tolerability, the dose may be increased to 1.25mg twice daily and up to a maximum of 2.5mg twice daily. 3. Reduction of the risk of death due to myocardial infarction, stroke, or cardiovascular disease, or of the need for revascularization ① The initial dose is 2.5mg once daily, and the dose is increased gradually according to tolerability. Thus, increase the dose to 5mg daily after one week and to 10mg daily after 3 weeks. The usual maintenance dose is 10mg once daily. Patients stabilized on a lower dose for another indication should be titrated to 10mg once daily. ② Patients with renal impairment: No dose adjustment is necessary in patients with creatinine clearance of 30ml/min (plasma creatinine<165 μmol/l) or more. In patients with creatinine clearance below 30ml/min (plasma creatinine>165 μmol/l), the initial dose is 1.25mg once daily and the maximum dose is 5mg once daily. In patients with severe renal impairment (creatinine clearance of 10ml/min or less and plasma creatinine of 400~650 μmol/l), the initial dose is 1.25mg once daily and should not exceed 2.5mg daily. ③ Patients with hepatic impairment: In patients with hepatic impairment, reduced esterase activity in the liver decreases the metabolism of the parent compound ramipril and, consequently, the formation of its biologically active metabolite ramiprilat, ultimately increasing plasma ramipril levels. Therefore, treatment with Tritace should be initiated at a dose of 1.25mg under close medical supervision. 4. Nephropathy ① Patients not receiving diuretics: The recommended initial dose is 1.25㎎ once daily. Increase the dose according to the patient's tolerability. When increasing the dose, double it at intervals of 2‐3 weeks; the maximum daily dose is 5㎎. ② Patients receiving diuretics: Consider whether to discontinue the diuretic or at least reduce the dose of the diuretic being taken 2‐3 days before starting this medicine. In general, the initial dose of this medicine for patients receiving diuretics is 1.25㎎ once daily. ③ Patients with hepatic impairment: Increase or decrease the dose according to the patient's response. Therefore, treatment with this medicine should be initiated cautiously under a physician's instructions, and the maximum daily dose is 2.5㎎. Adjust the dose appropriately according to age and symptoms.

This medication can cause sudden swelling in the face, lips, tongue, or throat, so you must inform a doctor immediately if these symptoms occur. If angioedema develops while taking this medication, discontinue use and seek emergency treatment. During pregnancy, especially in the second and third trimesters, it can cause serious harm to the fetus, so discontinue use immediately upon confirmation of pregnancy. Caution is required in patients with severely impaired kidney function or in children, as there is insufficient experience with the use of this medication in these populations. Patients with a history of allergies to this medication or similar drugs, or a history of angioedema, should not take this medication. Patients with specific heart valve diseases, those who have had a kidney transplant, or patients with end-stage renal disease should also avoid this medication. Patients with very low or unstable blood pressure, patients with hyperkalemia, and certain diabetic patients should avoid taking it. Careful monitoring by a doctor is necessary when this medication is used in combination with other blood pressure-lowering medications, as it can cause blood pressure to drop too low or affect kidney function. Patients with impaired liver function should exercise caution, as metabolism of this medication may be slowed, altering its efficacy. When first taken, it may cause a rapid drop in blood pressure, so start with a low dose and monitor the condition closely. Regular blood tests and kidney function tests must be conducted to check for adverse reactions during administration. This medication may cause a dry cough; if the cough persists, it is advisable to consult a doctor. There are many interactions with other medications, so consult with a physician or pharmacist regarding any medications you are taking along with this one. Women who are pregnant or may become pregnant should not take this medication, and nursing mothers should avoid it or discontinue breastfeeding. Elderly patients may be more sensitive to this medication, so dose adjustment and careful observation are necessary. Dizziness or light-headedness may occur while taking this medication, so it is safest to avoid driving or operating hazardous machinery. In the event of overdose, severe hypotension or renal failure may occur, so seek immediate emergency treatment if symptoms arise. The safety and efficacy of this medication in children have not been established, so its use is not recommended. This medication should be kept out of reach of children and should not be transferred to other containers.

Angioedema, face, limbs, lips, tongue, laryngeal, glottic edema, abdominal pain, nausea, vomiting, angina pectoris, myocardial infarction, myocardial ischemia, tachycardia, arrhythmia, palpitations, peripheral edema, eosinophilia, leukopenia, erythrocytopenia, decreased hemoglobin levels, thrombocytopenia, bone marrow failure, aplastic anemia, hemolytic anemia, headache, dizziness, vertigo, sensory disturbances, ageusia, dysgeusia, tremors, balance disorders, ischemic stroke, transient ischemic attack, psychomotor disturbances, flushing, parosmia, blurred vision, visual impairment, conjunctivitis, hearing impairment, tinnitus, dry cough with an itchy throat, bronchitis, sinusitis, shortness of breath, bronchospasm, congestion, gastrointestinal inflammatory response, dyspepsia, abdominal discomfort, indigestion, diarrhea, nausea, vomiting, pancreatitis, increased pancreatic enzymes, small intestine vascular edema, gastritis, epigastric pain, constipation, dry mouth, glossitis, aphthous stomatitis, acute renal failure, kidney disorders, increased urine output, worsening proteinuria, elevated blood urea, increased blood creatinine, rash, angioedema, pruritus, hyperhidrosis, exfoliative dermatitis, urticaria, onycholysis, photosensitivity reactions, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythroderma, pemphigus, exacerbation of psoriasis, psoriatic dermatitis, lichenoid rash, alopecia, muscle cramps, myalgia, arthralgia, inappropriate secretion of antidiuretic hormone syndrome, elevated blood potassium, loss of appetite, decreased appetite, decreased blood sodium, hypotension, orthostatic hypotension, syncope, flushing, vascular stenosis, reduced perfusion, vasculitis, Raynaud's phenomenon, chest pain, fatigue, fever, weakness, anaphylaxis, anaphylactic reaction, increased antinuclear antibodies, elevated liver enzymes, increased bilirubin polymers, cholestatic jaundice, hepatocellular damage, acute liver failure, cholestasis, cellular hepatitis, temporary erectile dysfunction, decreased libido, gynecomastia, low mood, anxiety, nervousness, restlessness, drowsiness, sleep disorders, confusional state, attention deficit, cough

This medication should be stored in an airtight container to prevent air exposure, away from direct sunlight, and at room temperature. Room temperature refers to a general indoor temperature that is neither too hot nor too cold.

Appearance

Light yellow, oval-shaped tablet with a groove on both sides.

Package unit

30 tablets, 100 tablets/bottle