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.
Single-ingredient preparations
Fixed-dose combination preparation
Active ingredient
ramipril
felodipine
ramipril with felodipine
Brand names
Tritace, Ramace, Prilace
Felodur, Plendil
Triasyn
Doses available
1.25 mg, 2.5 mg, 5 mg, 10 mg
2.5 mg, 5 mg, 10 mg
2.5 mg / 2.5 mg, 5 mg / 5 mg
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.
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