Altace HCT (Ramipril / Hydrochlorothiazide)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules
Altace HCT combines an ACE inhibitor (ramipril) with a thiazide diuretic (hydrochlorothiazide) in a single tablet for effective blood pressure control. By relaxing blood vessels and promoting sodium and water excretion, Altace HCT lowers hypertension and reduces cardiovascular risk. It is indicated for patients whose blood pressure is not adequately controlled on monotherapy.
Ramipril – 5 mg (also available in 2.5 mg and 10 mg strengths)
Hydrochlorothiazide (HCTZ) – 12.5 mg
Other Popular and Common Names
Ramipril/HCTZ Combination
Ramipril + Hydrochlorothiazide
Tritace Plus (other brand)
ACE Inhibitor + Thiazide Diuretic
Altace Plus HCTZ
Ramipril blocks angiotensin‑converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II, resulting in vasodilation and reduced aldosterone release.

Hydrochlorothiazide inhibits sodium reabsorption in the distal renal tubule, increasing sodium and water excretion and decreasing plasma volume.

The synergistic effect leads to greater blood pressure reduction than either agent alone.

Essential Hypertension: As initial therapy for patients likely to need multiple antihypertensives.

Hypertension Uncontrolled on Monotherapy: For those already on ramipril or hydrochlorothiazide with inadequate response.

Reduction of Cardiovascular Events: In high‑risk hypertensive patients (e.g., post‑HOPE trial populations).
Starting Dose: One tablet (5 mg/12.5 mg) once daily in the morning.
Maintenance: May increase to two tablets (10 mg/12.5 mg) once daily or, if needed, switch to 10 mg/25 mg strength.
Administration: Take with or without food; routine monitoring of blood pressure, renal function, and electrolytes is recommended.
Renal Impairment: Use with caution; lower starting doses advised if creatinine clearance <30 mL/min.
Elderly: Initiate at lower dose due to higher sensitivity.
Formulation: Film‑coated tablet

Strengths Available: 2.5 mg/12.5 mg, 5 mg/12.5 mg, 10 mg/12.5 mg, 10 mg/25 mg

Route: Oral

Legal Status: Prescription Only Medicine
Pregnancy: Category D – Contraindicated in second and third trimesters (risk of fetal renal damage).

Breastfeeding: Not recommended – both ramipril and HCTZ excrete in milk.

Children: Safety and efficacy not established in <18 years.

Monitoring: Check serum electrolytes (especially potassium), renal function, and blood pressure periodically.
Dizziness or light‑headedness (especially on standing)

Cough (ACE inhibitor–related)

Increased urination
Headache
Fatigue
Serious:
Angioedema (facial, airway swelling)
Severe hypotension
Hyperkalemia
Hyponatremia

Acute renal failure
Angioedema: Discontinue immediately and do not rechallenge.

Volume Depletion: Correct hypovolemia before initiation to avoid symptomatic hypotension.

Renovascular Hypertension: Use with caution in bilateral renal artery stenosis—risk of acute renal failure.

Electrolyte Imbalance: Monitor potassium and sodium; HCTZ may cause hypokalemia, ramipril may cause hyperkalemia.

Gout: Thiazide diuretics may precipitate gout attacks.
Therapeutic Class: Antihypertensive Combination

Pharmacologic Class: ACE Inhibitor (Ramipril) + Thiazide Diuretic (Hydrochlorothiazide)

Legal Category: Prescription Only
Potassium‑Sparing Diuretics / Supplements: Additive risk of hyperkalemia.

NSAIDs: May reduce antihypertensive effect and increase risk of renal impairment.

Lithium: Ramipril may increase lithium levels and toxicity.

Other Antihypertensives: Additive blood pressure–lowering effects; monitor for hypotension.

Corticosteroids/Amphotericin B: Enhanced electrolyte disturbances.
HOPE Trial (2000): Ramipril reduced major cardiovascular events by 22 % in high‑risk patients (including hypertensives) when added to standard therapy.
Pharmacodynamic Studies: Combination therapy with thiazides demonstrates superior BP control versus monotherapy in multiple randomized trials.
Comparison with Blackmores Conceive Well Gold
Altace HCT manages cardiovascular risk and hypertension, while Blackmores Conceive Well Gold provides preconception nutritional support. Women with hypertension planning pregnancy should transition to pregnancy‑safe antihypertensives and appropriate supplements under medical guidance.
FAQs – Altace HCT (Ramipril / HCTZ)
Q1. Can Altace HCT be taken at night?
A: Morning dosing is preferred to reduce nocturia from the thiazide component.

Q2. What if I miss a dose?
A: Take it as soon as remembered unless it’s within 12 hours of the next dose; do not double dose.

Q3. Why combine ramipril with hydrochlorothiazide?
A: The combination provides complementary mechanisms—vasodilation plus diuresis—for enhanced blood pressure reduction.

Q4. Does Altace HCT cause persistent cough?
A: Cough is related to ramipril; switching to an ARB may be considered if bothersome.

Q5. How quickly does blood pressure lower?
A: Initial effects occur within 1 hour (ramipril) and 2 hours (HCTZ); full effect may take 2–4 weeks.

Q6. Can I take Altace HCT with diabetes medications?
A: Yes, but ACE inhibitors may enhance insulin sensitivity; monitor blood glucose levels.

Q7. Is electrolyte monitoring necessary?
A: Yes; both potassium and sodium levels can be affected, so periodic laboratory tests are recommended.
Altace HCT, Ramipril Hydrochlorothiazide, ACE Inhibitor Diuretic Combo, Hypertension Treatment, Cardiovascular Risk Reduction, Tritace Plus, Antihypertensive Therapy, Blood Pressure Control, EZ Chemist