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Medical Forum / General / Cardiology / February 2009Ramipril (Altace) dosage (1 pill every 12 hours or 2 pills every 24 hours) ?
What is the difference (pharmaco-kinetically speaking) of taking two 10mg pills of Ramipril every 24 hours, or taking one 10mg pill every 12 hours? The active metabolite of Ramipril is ramiprilat. If I wanted a higher average circulating level of ramiprilat, which dosing method would achieve it? Two pills taken at the same time, once a day, or one pill taken twice a day? > What is the difference (pharmaco-kinetically speaking) of taking two > 10mg pills of Ramipril every 24 hours, or taking one 10mg pill every 12 > hours? Instead of a tablet, ramipril is a capsule. Spacing out the dosage to a 10 mg capsule every 12 hrs results in a more level blood concentration profile, that is typically better tolerated than 20 mg every 24 hrs. Love in the truth, Andrew <>< -- Andrew B. Chung, MD/PhD Board-certified Cardiologist http://T3WIJ.com > Spacing out the dosage to a 10 mg capsule every 12 hrs results in > a more level blood concentration profile, that is typically better > tolerated than 20 mg every 24 hrs. Toleration issues aside - Will a bolus of 20 mg once per 24 hours result in a higher average circulation level of the metabolite compared with a 10 mg dose spaced every 12 hours? Also: Coughing is a known side effect of Ramipril. Is a *reduction* in coughing over time (1 to 2 years) a possible indication that the current dose of Ramipril is losing effectiveness at treating hypertension? Or can the body develop a tolerance to Ramipril that results in a reduction in coughing but does not reduce the effectiveness of Ramipril at lowing blood pressure? Also - What do you think of the recent clinical trials for Telmisartan? > Andrew, in the Holy Spirit, boldly wrote: > [quoted text clipped - 7 lines] > circulation level of the metabolite compared with a 10 mg dose spaced > every 12 hours? Not typically. > Also: Coughing is a known side effect of Ramipril. Is a *reduction* in > coughing over time (1 to 2 years) a possible indication that the current > dose of Ramipril is losing effectiveness at treating hypertension? No. > Or can the body develop a tolerance to Ramipril that results in a > reduction in coughing but does not reduce the effectiveness of Ramipril > at lowing blood pressure? Yes. > Also - > > What do you think of the recent clinical trials for Telmisartan? Disappointing. Replacing ramipril with telmisartan does not appear to be justifiable based on the recent clinical trial data. Love in the truth, Andrew <>< -- Andrew B. Chung, MD/PhD Board-certified Cardiologist http://T3WIJ.com |
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