Primace 1.25 mg Capsule

ACE inhibitor for:

• High blood pressure
• Heart failure, and after a heart attack with heart failure signs
• Reducing the risk of heart attack, stroke and cardiovascular death in high-risk patients
• Kidney disease with protein in the urine (including diabetic nephropathy)

Hypertension: start 1.25–2.5 mg once daily; usual 2.5–5 mg; maximum 10 mg daily.

Heart failure / after heart attack: start 1.25–2.5 mg once or twice daily, increased gradually to 5 mg twice daily.

Cardiovascular prevention: 2.5 mg daily, increased to 10 mg once daily.

Kidney impairment / elderly / on diuretics: start 1.25 mg.

• Take at the same time each day, with or without food.
• The first dose may cause dizziness — take it at bedtime.

• History of angioedema (swelling of face, lips, tongue, throat), including with any ACE inhibitor
• Pregnancy
• Use with sacubitril/valsartan (within 36 hours), or with aliskiren in diabetes/kidney impairment
• Bilateral renal artery stenosis
• Dialysis with certain high-flux membranes

Common: dry tickly cough, dizziness, headache, tiredness, low blood pressure, raised potassium, raised creatinine, nausea.

Less common: rash, itching, taste changes, stomach upset.

Rare but serious: angioedema (seek emergency help), kidney failure, low white cells, liver problems, pancreatitis.

• Check kidney function and potassium before and 1–2 weeks after starting or increasing the dose.
• Avoid dehydration; stop temporarily during severe vomiting/diarrhoea (on advice).
• Cough may require switching to an ARB (e.g. losartan).

Contraindicated in pregnancy (harms the baby's kidneys and skull). Switch before planned pregnancy. Avoid while breastfeeding a newborn; other ACE inhibitors (enalapril) are preferred if needed.

• Potassium supplements, salt substitutes, spironolactone, trimethoprim (high potassium)
• NSAIDs (reduced effect, kidney risk)
• Lithium (toxicity)
• ARBs, aliskiren, sacubitril (avoid combinations)
• Diuretics (low blood pressure at the start)
• Insulin and diabetes tablets (low blood sugar risk)

Low blood pressure, slow heartbeat, kidney failure. Lie down with legs raised; seek medical care.

Store below 30°C.