Imidapril

Indications
Oral
Hypertension
Adult: Initially, 5 mg once daily. 1st dose preferably given at bedtime. Maintenance: 10 mg daily. Max: 20 mg/day.
Elderly: Initially, 2.5 mg daily. Max Dose: 10 mg daily.
Renal impairment: Initially, 2.5 mg daily.
Hepatic impairment: Initially, 2.5 mg daily.

Special Populations: Recommended dose in patients on diuretics: 2.5 mg daily.
Contraindications
Aortic stenosis or outflow tract obstruction; renovascular disease; ascites. Pregnancy and lactation.
Warnings / Precautions
Peripheral vascular diseases, generalised atherosclerosis, idiopathic or hereditary angioedema, heart failure, patients likely to be salt or water depleted. Assess renal function before and during therapy; monitor for proteinuria. Conduct regular WBC counts in SLE and scleroderma patients. Liver cirrhosis. Discontinue diuretics 2-3 days before starting therapy and resume later if required. Elderly.
Adverse Reactions
Dizziness, headache, fatigue, GI and taste disturbances, persistent dry cough and other upper respiratory tract symptoms, skin rash, angioedema, photosensitivity, renal impairment, hyperkalaemia, hyponatraemia, blood disorders, proteinuria, chest pain, palpitations, tachycardia, stomatitis, pancreatitis, cholestatic jaundice, alopecia, muscle cramps, paraesthesias, mood and sleep disturbances, impotence.
Potentially Fatal: Excessive hypotension, which could result in MI or stroke in patients with ischaemic heart disease or cerebrovascular disease.
Drug Interactions
Additive hyperkalaemic effects with potassium-sparing diuretics, potassium supplements, and other hyperkalaemic drugs. Reduced antihypertensive effects or additive adverse renal effects with NSAIDs.
Potentially Fatal: Marked hypotension with diuretics, other antihypertensives, alcohol, other agents that lower BP.
See Below for More imidapril Drug Interactions
Mechanism of Actions
Imidapril prevents the conversion of angiotensin I to angiotension II by inhibiting ACE. It may also inhibit the degradation of bradykinin. It reduces preload and afterload in heart failure, and reduces left ventricular remodelling in MI.
Absorption: Absorption of imidapril is about 70%; peak plasma levels of imidaprilat reached in about 7 hr.
Distribution: Protein-binding: 85% (imidapril); 53% (imidaprilat).
Metabolism: Imidapril is hydrolysed to imidaprilat in the liver.
Excretion: 40% of an oral dose is excreted renally, the remaining dose in the faeces. Terminal half-life: >24 hr (imidaprilat).
Administration
Should be taken on an empty stomach. (Take 15 min before meals. However, when initiating therapy, 1st dose should be given at bedtime.)
Storage Conditions
Oral: Store below 25°C.
ATC Classification
C09AA16 - imidapril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.
Storage
Oral: Store below 25°C.
Available As
  • Imidapril 10 mg
  • Imidapril 5 mg
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