Hydrochlorothiazide + Ramipril is indicated for the treatment of essential hypertension in Adults.

Hypertension (Hight Blood Pressure)

• Ramipril + Hydrochlorothiazide is available as tablets.
• If ramipril (or another ACE inhibitor such as) or hydrochlorothiazide (or another thiazide diuretic) alone fails to manage blood pressure, the patient may be shifted to combination therapy with Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg or Ramipril 5 mg + Hydrochlorothiazide 25 mg tablet.
• A maximum dose of  10 mg ramipril and 50 mg hydrochlorothiazide (four tablets of Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg or two tablets of Ramipril 5 mg + Hydrochlorothiazide 25 mg) is allowed

Renal Impairment: Treatment with Ramipril 1.25 mg monotherapy should be started in patients with a creatinine clearance of 60 to 30 ml/min. If blood pressure isn't regulated well enough, Ramipril's dose might be increased to 2.5 mg. If blood pressure still isn't under control, the patient may be transferred to Ramipril + Hydrochlorothiazide 5 mg+25 mg once a day.

Side effects commonly reported with the use of Ramipril + Hydrochlorothiazide are-

• Headache
• Dizziness
• Asthenia
• Nausea
• Hypotension
• Dry cough
• Diarrhoea
• Fever
• Edema
• Photosensitivity
• Hyperglycaemia
• Hyperuricaemia 

Headache	Dizziness	Asthenia
Nausea	Dry Cough	Edema

Caution should be exercised when treating following group of patients with Ramipril + Hydrochlorothiazide-

• Patients with heart failure
• Salt and volume depleted patients
• Patients with renal artery stenosis
• Patients with activated RAAS system