Polpril – composition, action and dosage, indications, contraindications, side effects

Proven content

The drug Polpril is a preparation used in cardiology and family medicine. It is used to treat high blood pressure. The active substance of Ramipril is ramipril, which acts on the cardiovascular system by lowering blood pressure. Polpril is available as hard capsules and tablets with different ramipril content. It can only be purchased with a prescription. When may the doctor recommend the use of Polpril? In what cases should it not be used and when should you be especially careful? How to dose the drug Polpril? Can its use cause side effects in a patient?

Polpril – general characteristics of the drug

Polpril belongs to a group of medicines called ACE inhibitors or angiotensin converting enzyme inhibitors. Polpril is a drug used to reduce high blood pressure. The active substance in this medicine, ramipril, has a proven effect on the cardiovascular system by lowering blood pressure.

This medicine is available in the form of tablets and hard capsules. Polpril tablets they are packed in blisters or containers containing 10, 14, 20, 28, 30, 42, 50, 98 and 100 tablets. On the other hand, hard capsules are packed in blisters containing 28 capsules. Both tablets and hard capsules of the drug may contain a different amount of the active ingredient. They can be distinguished from each other by color and shape.

In the case of Polpril tablets:

1. The 2,5 mg tablets are yellow, uncoated and shaped like a flat capsule 10,0 x 5,0 mm with a score line on one side and sidewalls. They are marked with R2. The tablets can be divided into equal halves;
2. The 5 mg tablets are pink, uncoated and shaped like a flat capsule of 8,8 x 4,4 mm, with a score line on one side and sidewalls. They are marked with R3. The tablets can be divided into equal halves;
3. The 10 mg tablets are white to off-white, uncoated and shaped like a flat capsule 11,0 x 5,5 mm with a score line on one side and sidewalls. They are marked with R4, the tablets can be divided into equal halves.

In turn, the hard capsules of Polpril are:

1. 2,5 mg capsules – are light green (marked ‘R’) – light gray (marked ‘2,5’). They contain a white or off-white powder;
2. 5 mg capsules – are green (marked ‘R’) – light gray (marked ‘5’). The capsules contain a white to off-white powder;
3. 10 mg capsules – dark green capsules (marked ‘R’) – light gray (marked ’10’). The capsules contain a white to off-white powder.

The entity responsible for the production and distribution of Polpril is Zakłady Farmaceutyczne POLPHARMA SA. Zakłady Farmaceutyczne Polpharma SA is a Polish pharmaceutical company based in Starogard Gdański. This concern mainly produces drugs that are used in cardiology, gastroenterology and neurology. The company was founded in 1935 as the Polish Chemical and Pharmaceutical Factory “Polpharma”. The company has 7 production plants located in Poland, Our Country and Kazakhstan, as well as seven research and development centers.

How do ACE inhibitors work and what are the indications for their use? Check: Angiotensin converting enzyme inhibitors – what are they?

Polpril – composition and action of the drug

Polpril is primarily a blood pressure-lowering drug. The active substance of the preparation, i.e. ramipril, is responsible for its healing properties.

Ramipril is a medicine that belongs to the group of angiotensin converting enzyme inhibitors. These are drugs that act on one of the enzymes in the renin-angiotensin-aldosterone system.

This system plays an important role in regulating blood pressure. This is due to the action of angiotensin II and aldosterone, which affect the cardiovascular system, the central nervous system, as well as the water and electrolyte balance.

In this process, renin, which is produced in the kidneys, increases the production of angiotensin I, which is then converted to angiotensin II by the enzyme angiotensin-converting enzyme, which in turn has a variety of biological effects. The mechanism of action is primarily related to the cardiovascular and central nervous systems. However, attention is also paid to the prothrombotic action, the action within the kidneys and the adrenal glands. Aldosterone also increases sodium ion reabsorption and the excretion of potassium and hydrogen in the kidney. In turn, the activation of the RAA system results in an increase in blood pressure.

Angiotensin converting enzyme inhibitors, including the main component of Polpril, inhibit the conversion of angiotensin I to angiotensin II. Thanks to their action, blood vessels relax and blood pressure is lowered.

This drug increases the cardiac output, reduces the load on the heart and improves the systolic and diastolic function of the heart chambers. It also causes the reversal of structural changes in the heart and vessels. In turn, in congestive heart failure, it reduces clinical symptoms and increases exercise tolerance. Importantly, it significantly reduces the risk of a heart attack.

Ramipril is rapidly absorbed and converted into the active form, ramiprilat, by the liver. Peak levels of ramipril are achieved within 1 hour of ingestion, and ramiprilat concentrations within 2-4 hours. hours after taking the drug. The antihypertensive effect is noticeable within 1-2 hours after taking the drug and is strongest between 3-6 months of use. hour. The antihypertensive effect develops fully after approximately 3-4 years. weeks of taking Polpril.

The drug Polpril also includes auxiliary substances appropriate for a given form of preparation.

The excipients of Polpril tablets are sodium bicarbonate, lactose monohydrate, croscarmellose sodium, pregelatinized maize starch, sodium stearyl fumarate, yellow iron oxide (E172) (2,5 mg and 5 mg tablets only) and red iron oxide (E172) (only 5 mg tablets).

However, in the case of hard capsules of Polpril, excipients include gelled and corn starch, gelatin, water, black iron oxide (E172), yellow iron oxide (E172), titanium dioxide (E171), indigo carmine (E132), shellac, iron oxide black (E172), propylene glycol, ammonium hydroxide.

Can hypertension be dealt with without medication? Read: You can lower your blood pressure without medication. Just practice five minutes a day

Polpril – indications for the use of the drug

Polpril is a preparation that is used in cases of irregularities in the functioning of the cardiovascular system. It is worth noting that Ramipril works by reducing your body’s production of substances that can raise your blood pressure, by making blood vessels relaxed and widened, and by making it easier for your heart to pump blood around your body.

Polpril is used primarily:

1. to treat high blood pressure (hypertension);
2. to reduce the risk of a heart attack or stroke;
3. to reduce the risk or delay the worsening of kidney function (in both diabetic and nondiabetic patients);
4. to treat heart disease when the heart is unable to pump enough blood to support the body’s needs (heart failure);
5. after a heart attack complicated by heart failure.

What is worth knowing about hypertension? Read on: Hypertension – Causes, Symptoms and Treatment. How to take a measurement?

Polpril – contraindications to the use of the drug

The drug Polpril, despite its effectiveness in reducing the effects of improper functioning of the cardiovascular system, cannot be used by every patient struggling with this type of ailments.

Contraindications to the use of Polpril are:

1. hypersensitivity to the active substance, any of the excipients of the drug or another ACE inhibitor;
2. haemodynamic significant stenosis of 2 renal arteries or 1 renal artery in the case of only 1 kidney;
3. very low or unstable blood pressure;
4. history of angioedema;
5. arterial hypotension;
6. hemodynamic instability;
7. dialysis therapy or blood filtration of a different type – depending on the type of device used;
8. kidney disease in which blood supply to the kidney is reduced;
9. diabetes or impaired renal function with initiated blood pressure-lowering drug containing aliskiren;
10. the use of sacubitril with valsartan – a medicine used to treat a certain type of long-term (chronic) heart failure in adults. In this case, the risk of angioedema (rapid swelling of the tissues under the skin in places such as the throat) increases;
11. XNUMXnd and XNUMXrd trimester of pregnancy;
12. parallel use of ACE inhibitors and extracorporeal circulation when the blood is exposed to surfaces that are negatively charged (risk of severe anaphylactoid reactions).

What habits can contribute to the development of hypertension? Check: Habits that lead to high blood pressure – all there is to know about it

Polpril – precautions

Before and during the use of Polpril, follow the precautions included in the package leaflet.

Precautions should be taken in the following cases:

1. patients at higher risk of hypotension. These are patients with severe arterial hypertension, haemodynamically significant impairment of blood inflow / outflow from the left ventricle, in whom there is or may occur intravascular volume depletion, depletion of electrolytes. This applies to those patients who undergo major surgery or are anesthetized with agents that may induce hypotension, and those at increased risk of myocardial or cerebral ischemia with acute hypotension;
2. heart, liver and / or kidney disease;
3. loss of a significant amount of fluid or salt;
4. planned treatment to reduce allergy to wasp or bee stings;
5. planned administration of anesthetic drugs during surgical or dental procedures;
6. high or low level of sodium in the blood;
7. collagenosis such as systemic lupus erythematosus or scleroderma;
8. pregnancy or suspicion of it;
9. simultaneous use of drugs that lower blood pressure, angiotensin II receptor antagonists, aliskiren, racecadotril, drugs for the prevention of organ transplant rejection and in the treatment of cancer, and vildagliptin;
10. angioedema;
11. hyperkalemia;
12. neutropenia or agranulocytosis;
13. ethnic differences ie black race;
14. rare hereditary problems of galactose intolerance, the lactase deficiency or glucose-galactose malabsorption.

How should you measure your blood pressure correctly? Read on: How do I measure my blood pressure? Check that you are not making any mistakes

Polpril – dosage and method of use

Polpril should always be used exactly as described in the package leaflet or according to the doctor’s or pharmacist’s instructions. The correct dosage of the drug depends on the condition the patient is being treated for.

Dosage of Polpril in the treatment of hypertension:

1. the starting dose is 1,25 mg or 2,5 mg once a day;
2. the doctor adjusts the dose until blood pressure is controlled;
3. the maximum dose is 10 mg once daily.

If you are taking diuretics, your doctor may advise you to stop taking them or reduce the dose before starting treatment with Polpril.

Dosage of Polpril to reduce the risk of a heart attack or stroke:

1. the starting dose is 2,5 mg once a day;
2. your doctor may advise you to increase the dose;
3. the usual dose is 10 mg once a day.

Dosage of Ramipril to reduce the risk or delay the worsening of kidney function:

1. the starting dose is 1,25 mg or 2,5 mg once a day;
2. your doctor may adjust the dosage of your medicine
3. the usual dose is 5 mg or 10 mg once a day. 

Dosage of Polpril in the treatment of heart failure:

1. the starting dose is 1,25 mg once a day;
2. the doctor may adjust the dosage of the drug;
3. the maximum dose is 10 mg daily. 

It is recommended to take the drug in two divided doses.

Dosage of Polpril in treatment after a heart attack:

1. the starting dose is 1,25 mg once a day to 2,5 mg twice a day;
2. the doctor may adjust the dosage of the drug;
3. the usual dose is 10 mg daily.

Both Polpril tablets and hard capsules should be taken orally at the same time each day. Tablets and capsules should not be chewed or crushed. They should be swallowed with some liquid.

If you take more than the prescribed dose of Polpril, contact your doctor urgently. The patient should also ask for immediate transport to the nearest hospital emergency department. After taking too high a dose, the patient cannot drive the vehicle on his own.

What is a Pulse Oximeter and how does this device work? Read: Pulse oximeter – operation and application. What types of pulse oximeters are there and how much do they cost?

Polpril – side effects

Polpril, like any other drug, may cause side effects in patients. It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

The frequency classification of adverse body reactions (ADRs) is based on the following principles: very common (≥1 / 10), common (≥1 / 100 to <1/10), uncommon (≥1 / 1 to <000/1), rare (≥ 100 / 1 to <10 / 000), very rare (<1 / 1), not known (cannot be estimated from the available data).

If you notice any of the following symptoms while taking Polpril, stop the treatment and contact your doctor as soon as possible:

1. swelling of the face, lips or throat which make it difficult to swallow or breathe, as well as itching and rash. They can pose symptom of a severe hypersensitivity reaction to the drug Polpril;
2. severe skin changes including rashes, mouth ulcers, worsening of a pre-existing skin disease, redness, blistering or detachment of skin (such as Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme).

In addition, there may also be other side effects that must be reported to your doctor. These are:

1. fast heart beat, uneven or forceful heartbeat (palpitations), chest pain, tightness in the chest or more serious problems including heart attack or stroke;
2. shortness of breath or cough. These may indicate lung problems;
3. easy bruising, bleeding for longer than usual, any signs of bleeding (e.g. bleeding gums), purple spots on the skin or more frequent infections, sore throat and fever, tiredness, weakness, dizziness or pale skin. These can be signs of blood or bone marrow problems;
4. severe stomach pain which may reach through to your back. This could be a symptom of pancreatitis;
5. fever, chills, weakness, loss of appetite, stomach pain, nausea, yellowing of the skin or the whites of the eyes (jaundice). They may be a symptom of liver problems such as liver inflammation or damage.

The package leaflet also indicates side effects, classified according to their frequency.

Common side effects after taking Polpril (affects less than 1 in 10 patients):

1. headache or feeling tired;
2. dizziness. The risk of occurrence is higher at the start of taking Ramipril and after increasing the dose;
3. fainting, hypotension (abnormally low blood pressure), especially if you stand up or when you stand up quickly
4. dry, tiring cough, sinusitis or bronchitis, shortness of breath;
5. stomach pain, diarrhea, indigestion, nausea or vomiting;
6. rash with or without prominent lesions;
7. pain in the chest;
8. muscle cramps or pain;
9. blood potassium levels that are higher than usual in laboratory tests.

Uncommon side effects after taking Polpril (affects less than 1 in 100 patients):

1. balance problems (vertigo);
2. itching of the skin and sensory disturbances such as numbness, tingling, prickling, burning or a feeling of crawling on the skin (paraesthesia);
3. loss or disturbance of the sense of taste;
4. sleep disturbance;
5. depression, anxiety, nervousness or restlessness;
6. stuffy nose, difficulty breathing or worsening of asthma;
7. a swelling in your gut called “intestinal angioedema” presenting with symptoms like abdominal pain, vomiting and diarrhea;
8. heartburn, constipation or dry mouth;
9. Passing more urine than usual during the day;
10. increased sweating;
11. loss or decreased appetite (anorexia);
12. fast or irregular heartbeat;
13. swelling of the arms and legs. May be a sign that you are holding onto more water than usual;
14. hot flushes;
15. blurred vision;
16. arthralgia;
17. fever;
18. impotence, decreased sex drive in men and women;
19. high number of certain white blood cells (eosinophilia) shown in blood tests;
20. blood test results that show changes in the liver, pancreas or kidneys.

Rare side effects after taking Ramipril (affects less than 1 in 1000 patients):

1. feeling of uncertainty, distraction, confusion;
2. red, swollen tongue;
3. severe peeling of the skin, itchy lumpy rash;
4. nail diseases (e.g., loosening or separation of a nail from its bed);
5. skin rash or bruising;
6. spots on the skin and cold extremities;
7. redness, itching, swelling and watery eyes;
8. hearing impairment and ringing in the ears;
9. weakness;
10. a decrease in the number of red blood cells, white blood cells or platelets, or the level of hemoglobin shown in blood tests.

Very rare side effects after taking Polpril (affects less than 1 in 10000 patients):

1. hypersensitivity to sunlight.

Which blood pressure monitor is best to choose? Read on: Automatic or traditional? Which blood pressure monitor should you choose?

Polpril – interactions with other drugs

Before starting treatment with Polpril, please inform your doctor or pharmacist about all the medicines you are taking or have recently taken. You should also inform what medications the patient plans to take in the near future.

Medicines that may make Polpril less effective:

1. Medicines used to relieve pain and inflammation (e.g. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen or indomethacin and acetylsalicylic acid);
2. medicines used to treat low blood pressure, shock, heart failure, asthma or allergies, such as ephedrine, noradrenaline or adrenaline. Your doctor will need to check your blood pressure.

Medicines that, in combination with the use of Polpril, may increase the risk of side effects:

1. sacubitril in combination with valsartan – used to treat long-term (chronic) heart failure in adults;
2. medicines used to relieve pain and inflammation (e.g., non-steroidal anti-inflammatory drugs [NSAIDs] such as ibuprofen or indomethacin and acetylsalicylic acid);
3. diuretics (water tablets) such as furosemide;
4. potassium supplements (including salt substitutes), potassium-sparing diuretics (such as spironolactone, triamterene, amiloride) and other drugs that increase blood potassium levels (e.g. trimethoprim and co-trimoxazole, used for infections caused by bacteria; cyclosporine, an immunosuppressant used to prevent rejection of a transplanted organ and heparin, a medicine used to thin the blood, to prevent clots);
5. steroidal anti-inflammatory drugs such as prednisolone;
6. allopurinol used to lower uric acid levels in the blood;
7. procainamide for heart rhythm problems;
8. temsirolimus used to treat cancer;
9. sirolimus, everolimus, and other mTOR inhibitors used to prevent rejection of a transplant;
10. vildagliptin used to treat type 2 diabetes;
11. racecadotril used to treat diarrhea.

In addition, you should report to your doctor if you are taking any antidiabetic drugs, as Polpril may lower blood glucose levels.

Which drugs should never be combined with each other? Check: Dangerous interactions

Polpril and pregnancy and breastfeeding

The use of any medications or dietary supplements during pregnancy requires consultation with the attending physician. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking Polpril.

Your doctor will usually advise you to stop taking Ramipril before you become pregnant or as soon as you know you are pregnant, and will recommend a different medicine. Polpril is not recommended during the first trimester of pregnancy, and must not be taken after the third month of pregnancy, as it may cause serious harm to your baby if used during this period.

In the case of breastfeeding, the use of Polpril is also not recommended. If you wish to breastfeed, your doctor may advise you to use other medications, especially if your baby is newborn or was born prematurely.

What is worth knowing about proper supplementation during pregnancy? Check: Conscious choices. Diet and supplementation in pregnancy

Polpril – the price of the preparation

The price of the drug Polpril may differ depending on the city in which the preparation will be purchased or the pharmacy chosen by the patient. The price of the product also depends on the number of tablets contained in the package and the content of the active substance.

Polpril is reimbursed with the exception of 2,5 mg hard capsules. The preparation is free of charge for people over 75 in all reimbursement indications. Partial reimbursement also applies to all patients covered by the indications as at the date of the decision. In addition, the refund applies to children and adolescents up to 18 years of age with chronic kidney diseases not listed in the product specification or treated with renoprotection.

The price of the drug Polpril in tablets without refund:

1. 28 tablets of 2,5 mg – approx. 5 zlotys;
2. 28 tablets of 5 mg – approx. 10 zlotys;
3. 28 tablets of 10 mg – about PLN 20.

The price of the drug Polpril in hard capsules without refund:

1. 28 capsules 2,5 mg – about 5 zlotys;
2. 28 capsules 5 mg – about 10 zlotys;
3. 28 capsules of 10 mg – about PLN 20.

How much money does the average Pole spend on treatment? Check: The Pole is not expected to see a doctor

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