Comparative Pharmacology
Head-to-head clinical analysis: RAMIPRIL versus UNIRETIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: RAMIPRIL versus UNIRETIC.
RAMIPRIL vs UNIRETIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Ramipril is a prodrug that is hydrolyzed in the liver to its active metabolite ramiprilat, which inhibits angiotensin-converting enzyme (ACE), thereby decreasing angiotensin II production, reducing vasoconstriction, aldosterone secretion, and sodium retention.
Uniretic is a combination of an angiotensin-converting enzyme (ACE) inhibitor (moexipril) and a thiazide diuretic (hydrochlorothiazide). Moexipril inhibits ACE, preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. Hydrochlorothiazide inhibits sodium reabsorption in distal convoluted tubule, increasing excretion of sodium and water.
Initial: 2.5 mg orally once daily; Maintenance: 2.5-20 mg/day in 1-2 divided doses; Maximum: 20 mg/day.
1-2 tablets (each containing hydrochlorothiazide 25 mg and spironolactone 25 mg) orally once daily. Maximum dose: 4 tablets/day.
None Documented
None Documented
Clinical Note
moderateRamipril + Torasemide
"The risk or severity of adverse effects can be increased when Ramipril is combined with Torasemide."
Clinical Note
moderateRamipril + Etacrynic acid
"The risk or severity of adverse effects can be increased when Ramipril is combined with Etacrynic acid."
Clinical Note
moderateRamipril + Furosemide
"The risk or severity of adverse effects can be increased when Ramipril is combined with Furosemide."
Clinical Note
moderateRamipril + Bumetanide
Terminal half-life of ramiprilat is 13–17 hours (prolonged to 50 hours in renal impairment). Accumulation half-life is 110 hours after multiple doses.
Terminal elimination half-life 13-17 hours; clinical context: supports once-daily dosing
Primarily renal (60% as unchanged drug and metabolites) and fecal (40% via biliary elimination).
Renal: 50-70% unchanged; biliary/fecal: 10-15% as metabolites
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor and Diuretic
"The risk or severity of adverse effects can be increased when Ramipril is combined with Bumetanide."