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Active substance(s): FELODIPINE / RAMIPRIL

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Increased or irregular heartbeats
Blurred vision
Pain in your joints
Sexual inability in men, reduced sexual desire in men or
• An increased number of certain white blood cells
(eosinophilia) found during a blood test
• Blood tests showing changes in the way your liver,
pancreas or kidneys are working.
Rare (may affect up to 1 in 1,000 people)
• Feeling shaky or confused
• Red and swollen tongue
• Severe flaking or peeling of the skin, itchy, lumpy rash
• Nail problem (e.g. loosening or separation of a nail
from its bed)
• Skin rash or bruising
• Blotches on your skin and cold extremities
• Red, itchy, swollen or watery eyes
• Disturbed hearing and ringing in your ears
• Feeling weak
• Blood tests showing a decrease in the number of red
blood cells, white blood cells or platelets or in the
amount of haemoglobin.
• Reduced sexual function in men or women
Very rare (may affect up to 1 in 10,000 people)
• Being more sensitive to the sun than usual
• Slight swelling of your gums or bleeding gums
• Blood tests showing more sugar than usual in your
Other side effects reported:
Please tell your doctor if any of the following gets serious
or lasts longer than a few days.
• Difficulty concentrating
• Swollen mouth
• Blood tests showing too few blood cells in your blood
• Blood tests showing less sodium than usual in your
• Concentrated urine (dark in colour), feel or are sick,
have muscle cramps, confusion and fits which may
be due to inappropriate ADH (anti-diuretic hormone)
secretion. If you have these symptoms contact your
doctor as soon as possible
• Fingers and toes changing colour when you are cold
and then tingling or feeling painful when you warm up
(Raynaud’s phenomenon)
• Breast enlargement in men
• Slowed or impaired reactions
• Burning sensation
• Change in the way things smell
• Hair loss.
Reporting of side effects
If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects not
listed in this leaflet. You can also report side effects
directly via the Yellow Card Scheme at:
yellowcard or search for MHRA Yellow Card in the Google
Play or Apple App Store.
By reporting side effects you can help provide more
information on the safety of this medicine.

5. How to store Triapin

Package leaflet: information for the user

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is
stated on the carton after EXP. The expiry date refers to
the last day of that month.

Triapin 2.5 mg / 2.5 mg
and Triapin 5 mg / 5 mg prolonged
release tablets

Store the tablets in the pack below 25oC.


Do not throw away any medicines via wastewater or
household waste. Ask your pharmacist how to throw away
medicines you no longer use. These measures will help
protect the environment.
6. Contents of the pack and other information
What Triapin contains
• The active ingredients in Triapin tablets are: ramipril
and felodipine.
- Triapin 2.5mg/2.5mg tablets contain 2.5 mg of
ramipril and 2.5 mg of felodipine
- Triapin 5mg/5mg tablets contain 5 mg of ramipril and
5 mg of felodipine
• The other ingredients are: hydroxypropylcellulose,
hydroxypropylmethylcellulose, lactose anhydrous,
maize starch, microcrystalline cellulose, polyethylene
glycol, polyoxyl 40 hydrogenated castor oil, propyl
gallate, sodium aluminium silicate, sodium stearyl
fumarate, iron oxides E172, titanium dioxide E171 and
What Triapin looks like and contents of the pack
• Triapin 2.5mg/2.5mg tablets are apricot coloured and
have “H/OD” marked on one side and “2.5” marked on
the other side
• Triapin 5mg/5mg tablets are reddish-brown and have
“H/OE” marked on one side and “5” on the other side
• Both strengths of Triapin come in blister packs
containing 10, 14, 15, 21, 28, 30, 50, 98 and 100 tablets
or in bottles containing 56, 250 and 280 tablets
Not all pack sizes may be marketed.

Market Authorisation Holder:
One Onslow Street
Tel: 0845 372 7101

Read all of this leaflet carefully before you start
taking this medicine because it contains important
information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or
• This medicine has been prescribed for you only. Do not
pass it on to others. It may harm them, even if their
signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects not
listed in this leaflet. See section 4.
What is in this leaflet:
1. What Triapin is and what it is used for
2. What you need to know before you take Triapin
3. How to take Triapin
4. Possible side effects
5. How to store Triapin
6. Contents of the pack and other information

× You have ever had a serious allergic reaction called
“angioedema”. The signs include itching, hives
(urticaria), red marks on the hands, feet and throat,
swelling of the throat and tongue, swelling around
the eyes and lips, difficulty breathing and swallowing.
Taking this medicine may increase the risk of having a
more serious attack of this condition
× You have taken or are currently taking sacubitril/
valsartan, a medicine used to treat a type of long-term
(chronic) heart failure in adults.
× You have heart problems such as heart failure,
obstructions in your heart, angina which is unstable, a
heart condition known as atrioventricular block II or III,
a heart attack (acute myocardial infarction) or a stroke
(disturbance of the blood circulation in the brain)
× You have a severe kidney problem
× You are having dialysis
× You have a severe liver problem
× You are pregnant, trying to get pregnant or
breast-feeding (see ‘Pregnancy and breast-feeding’
× You have diabetes or impaired kidney function and you
are treated with a blood pressure lowering medicine
containing aliskiren.
Do not take this medicine if any of the above apply to
you. If you are not sure, talk to your doctor or pharmacist
before taking Triapin tablets.

1. What Triapin is and what it is used for
Triapin 2.5 mg / 2.5 mg and Triapin 5 mg / 5 mg
prolonged release tablets (also called Triapin tablets in
this leaflet) both contain two medicines called ramipril
and felodipine.
• Ramipril belongs to a group of medicines called
‘angiotensin converting enzyme inhibitors’ (ACE
inhibitors). It works by stopping the production of
substances that raise blood pressure and makes your
blood vessels relax and widen.
• Felodipine belongs to a group of medicines called
‘calcium antagonists’. It makes your blood vessels relax
and widen. This helps to lower your blood pressure.
Triapin tablets are used to treat high blood pressure
(hypertension). High blood pressure can mean you are
more likely to have problems such as heart disease,
kidney disease and stroke. This medicine lowers your
blood pressure and lowers the risk of these problems.
2. What you need to know before you take Triapin

Chinoin Private Co. Ltd

This leaflet was last revised in February 2018


Do not take Triapin tablets if:
× You are allergic to:
- ramipril or any other ACE inhibitor
- felodipine or any other calcium antagonists
- any of the other ingredients of this medicine
(listed in section 6)

Warnings and precautions
Talk to your doctor or pharmacist before taking
Triapin tablets if:
You have kidney problems, diabetes mellitus or
are taking medicines which increase potassium.
Your doctor may carry out regular blood tests,
particularly for checking the levels of potassium in
your blood
You are taking medicines or have conditions which may
decrease sodium levels in your blood. Your doctor may
carry out regular blood tests, particularly for checking the
levels of sodium in your blood especially if you are elderly.
You are taking medicines that may increase the risk
of angioedema, a serious allergic reaction, such as
mTOR inhibitors (e.g. temsirolimus, everolimus,
sirolimus), vildagliptin, neprisylin (NEP) inhibitors (such
as racecadotril) or sacubitril/valsartan. For sacubitril/
valsartan, see section 2 ‘Do not take Triapin tablets if’.
You have kidney artery problems
You have narrowing of the main blood vessel leading
from the heart (aortic stenosis) or heart muscle disease
(hypertrophic cardiomyopathy)
You have any other heart problem
You have systemic lupus erythmatosus or scleroderma
You suffer from liver problems
You are going to have an anesthestic or surgery
You are taking medicines which lower the number of
certain blood cells
You are black because the medicine may have less effect
on your blood pressure and more side effects
You are going to have treatment to lower the effect of
an allergy to bee or wasp stings (desensitization)
You are having treatment where your blood is treated
outside the body, such as ‘low-density lipoprotein

• You have swelling in your gums which may be a sign of
gingivitis or periodontitis. Careful dental hygiene may
be necessary to avoid additional gum problems, such as
a condition which increases the size of your gums.
• You are taking any of the following medicines used to
treat high blood pressure:
- an angiotensin II receptor blocker (ARBs) (also
known as sartans-for example valsartan, telmisartan,
irbesartan), in particular if you have diabetes-related
kidney problems.
- aliskiren
Your doctor may check your kidney function, blood
pressure, and the amount of electrolytes (e.g. potassium)
in your blood at regular intervals.
See also information under the heading “Do not take
Triapin tablets”.

Sirolimus, everolimus (for prevention of graft rejection)
Racecadotril - used against diarrhoea
Temsirolimus (for cancer)
Cytostatics – used to treat cancer
Insulin, glibenclamide, metformin, vildagliptin, and
other medicines used for diabetes mellitus
• Glucocorticoids (‘steroids’)
• Potassium salts
• Trimethoprim alone or in combination with
sulfamethoxazole used for infections
• St John’s Wort
Your doctor may need to change your dose and/or to take
other precautions:
• If you are taking an angiotensin II receptor blocker
(ARB) or aliskiren (see also information under the
headings “Do not take Triapin tablets” and “Warnings
and precautions”).
If you are not sure if any of the above apply to you, talk to
your doctor or pharmacist before taking Triapin tablets.

Other medicines and Triapin tablets
Tell your doctor or pharmacist if you are using, have
Triapin tablets with food and drink
recently taken or might take any other medicines. This
• Taking your tablet with alcohol may increase the effect
includes medicines obtained without a prescription,
of your medicine
including herbal medicines. This is because Triapin tablets

Taking this medicine with grapefruit juice is not
can affect the way some other medicines work. Also some
medicines can affect the way Triapin tablets work.
• Increasing the amount of salt in your diet may lower
the effect of this medicine
In particular, tell your doctor if you are taking or being
• Take the tablets on an empty stomach or after eating a
treated with any of the following:
light meal
• Sacubitril/valsartan - used for treating a type of longterm (chronic) heart failure in adults (see section 2 ‘Do
Pregnancy and breastfeeding
not take Triapin tablets if’)
Do not take Triapin tablets if:
• Medicines for lowering high blood pressure
(antihypertensives), including those containing aliskiren, • You are pregnant, might become pregnant or think you
may be pregnant. This is because the medicine could
and other medicines that lower blood pressure (nitrates,
harm your baby
antipsychotics, narcotics and anesthetics)

You are breastfeeding or planning to breastfeed. This is
• Medicines to treat HIV infection
because small amounts may pass into the mothers’ milk
• Procainamide – used for treating heart rhythm
suspect you have become pregnant while
taking Triapin tablets, you should talk to your doctor
• Water tablets (diuretics) which can cause high
blood potassium such as amiloride, spironolactone,
Ask your doctor or pharmacist for advice before taking any
• Heparin – used for thinning the blood
• Lithium preparations - used to treat mania, depression
and manic-depressive illness
Driving and using machines
• Phenytoin, carbamazepine and barbiturates. These
You may feel dizzy or light-headed after taking this medicine.
medicines are usually used to treat epilepsy, fits and
If this happens, do not drive or use any tools or machines.
convulsions. Barbiturates are also used for sleeping
Triapin tablets contain lactose and hydrogenated
• Theophylline – used for treating asthma
castor oil
• Sympathomimetics such as adrenaline, noradrenaline
This medicine contains lactose, a type of sugar. If you
or ephedrine (medicines which act on the heart and
have been told by your doctor that you cannot tolerate
blood vessels)
some sugars, talk to your doctor before taking this
• Erythromycin, itraconazole, ketoconazole – used for
medicine. This medicine contains hydrogenated castor oil.
treating infections
It may cause stomach upset or diarrhoea.
• Rifampicin – used for treatment of tuberculosis
• Allopurinol – used for treating gout
3. How to take Triapin
• Non-steroidal anti-inflammatory drugs (NSAIDs) – used
take this medicine exactly as your doctor has told
to relieve pain and inflammation
• Immunosuppressants – used in rheumatoid arthritis or you. Check with your doctor or pharmacist if you are not
sure. Triapin tablets are for adults only. Do not give them
after organ transplants
to children.
• Tacrolimus which is a medicine given to prevent the
Taking this medicine
body from rejecting a transplanted organ, such as a
• Take this medicine by mouth
kidney or liver

• Take the tablets on an empty stomach or after eating a
light meal
• Swallow the tablets whole with half a glass of water or
other drink. Do not break, crush or chew the tablets
• Do not take your tablets with grapefruit juice or alcohol.
How much to take
• The usual dose is 1 Triapin 2.5mg/2.5mg tablet or 1
Triapin 5mg/5mg tablet taken once a day
• Your doctor may start you on Triapin 2.5mg/2.5mg
tablets and then change you to Triapin 5mg/5mg tablet
to increase your dose
• The maximum dose is either 2 Triapin 2.5mg/2.5mg
tablets once a day or 1 Triapin 5mg/5mg tablet once a
• If you are already taking diuretics (water tablets), your
doctor may stop or reduce the amount of the diuretic
you take before beginning treatment with Triapin
Use in children
Do not give Triapin to children.
If you take more Triapin than you should
If you take more Triapin than you should, tell a doctor or
go to the nearest hospital casualty department straight
away. Take the medicine pack with you. This is so the
doctor knows what you have taken. You may feel dizzy
and light-headed because your blood pressure is too low.
If you forget to take Triapin
If you forget to take a dose and remember on the same
• Take it as soon as you remember
• On the next day, take your usual dose of Triapin
If you forget to take a dose and remember this the next
• Take only your usual dose of Triapin
• Do not take a double dose to make up for a forgotten
If you stop taking Triapin
Keep taking treatment until your doctor tells you to stop.
Do not stop taking this medicine just because you feel
better. If you stop, your blood pressure may rise again.
If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.

Tell your doctor immediately if you experience:
• Faster heart rate, uneven or forceful heartbeat
(palpitations), chest pain, tightness in your chest or more
serious problems including heart attack and stroke
• Shortness of breath or a cough. These could be signs of
lung problems
• Bruising more easily, bleeding for longer than normal,
any sign of bleeding (e.g. bleeding from the gums),
purple spots, blotching on the skin or getting infections
more easily than usual, sore throat and fever, feeling
tired, faint, dizzy or having pale skin. These can be signs
of blood or bone marrow problems
• Severe stomach pain which may reach through to your
back. This could be a sign of pancreatitis (inflammation
of the pancreas)
• Fever, chills, tiredness, loss of appetite, stomach pain,
feeling sick, yellowing of your skin or eyes (jaundice).
These can be signs of liver problems such as hepatitis
(inflammation of the liver) or liver damage.
Other side effects include:
Please tell your doctor if any of the following gets serious
or lasts longer than a few days.
Very Common (may affect more than 1 in 10 people)
• Swollen arms and legs. This may be a sign of your body
holding onto more water than usual
Common (may affect up to 1 in 10 people)
• Headache or feeling tired
• Feeling dizzy. This is more likely to happen when you
start taking Triapin tablets or start taking a higher dose
• Fainting, hypotension (abnormally low blood pressure),
especially when you stand or sit up quickly
• Flushing
• Dry tickly cough, inflammation of your sinuses (sinusitis)
or bronchitis, shortness of breath
• Stomach or gut pain, diarrhoea, indigestion, feeling or
being sick
• Skin rash with or without raised area
• Chest pain
• Cramps or pain in your muscles
• Blood tests showing more potassium than usual in your

Uncommon (may affect up to 1 in 100 people)
• Balance problems (vertigo)
• Itching and unusual skin sensations such as numbness,
tingling, pricking, burning or creeping on your skin
Stop taking Triapin tablets and see a doctor straight
• Loss or change in the way things taste
away, if you notice any of the following serious side
• Sleep problems
effects - you may need urgent medical treatment.
• Feeling depressed, anxious, more nervous than usual or
• Swelling of the face, lips or throat which make it
difficult to swallow or breathe, as well as itching and
• Blocked nose, difficulty breathing or worsening of
rashes. These could be signs of a severe allergic reaction
to Triapin.
• A swelling in your gut called “intestinal angioedema”
• Severe skin reactions including rash, ulcers in your
presenting with symptoms like abdominal pain,
mouth, worsening of a pre-existing skin disease,
vomiting and diarrhoea
reddening, blistering or detachment of skin (such as
• Heartburn, constipation or dry mouth
Stevens-Johnson syndrome, toxic epidermal necrolysis
• Passing more water (urine) than usual over the day
or erythema multiforme).
• Sweating more than usual
• Loss or decrease of appetite (anorexia)
4. Possible side effects
Like all medicines, this medicine can cause side effects,
although not everybody gets them.


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