Be aware of dose ranges for new ramipril with felodipine combination (Triasyn) (see erratum below) Be aware of dose ranges for new ramipril with felodipine combination (Triasyn) (see erratum below)

A new fixed-dose combination preparation of ramipril with felodipine (Triasyn) was PBS listed on 1 August 2007. Note that:

• the dose range available for the combination preparation is more restricted than with the individual single-ingredient preparations (see table below)
• dose titration with the fixed-dose combination will be more difficult than with the single-ingredient medicines
• some patients, including elderly people and those with impaired renal function, must be started on an initial dose of ramipril 1.25 mg. This is not possible with the fixed-dose combination product. See the Triasyn product information for details.
• it is suggested that patients be stabilised on the corresponding doses of ramipril and felodipine as single-ingredient preparations before changing to the fixed-dose combination
• the brand name does not clearly indicate that this is a combination preparation; ensure patients discontinue single-ingredient ramipril and felodipine if switching to Triasyn
• the tablets cannot be split or divided.

Erratum: The original online version of this article (as per subscriber email of 1 August 2007) incorrectly stated that the PBS listing required patients to be stabilised on single-ingredient preparations before changing to the fixed-dose combination. The PBS listing is for hypertension in a patient not adequately controlled with either ramipril or felodipine monotherapy.