Kastel (Ramipril, Rosuvastatin Calcium)

Kastel addresses cardiovascular risk by targeting two key pathways: the renin‑angiotensin system and cholesterol synthesis.

• Hypertension: lowers systolic and diastolic blood pressure to reduce strain on the heart and vessels.
• Hyperlipidaemia: decreases LDL‑cholesterol and total cholesterol levels, helping achieve lipid targets.
• Cardiovascular risk reduction: combines blood pressure control and lipid lowering to lower the incidence of myocardial infarction and stroke.

• Ramipril inhibits angiotensin‑converting enzyme, preventing conversion of angiotensin I to the vasoconstrictor angiotensin II, which leads to vasodilation and reduced aldosterone release. Rosuvastatin competitively inhibits HMG‑CoA reductase, the rate‑limiting enzyme in hepatic cholesterol synthesis, resulting in up‑regulation of LDL receptors and increased clearance of circulating LDL‑cholesterol.

Kastel may cause a range of adverse reactions, which are grouped by frequency.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Headache: mild to moderate intensity.
• Dizziness: especially after the first doses.
• Muscle pain: mild myalgia without weakness.
• Gastrointestinal upset: nausea or abdominal discomfort.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe liver injury: jaundice, elevated transaminases.
• Rhabdomyolysis: muscle breakdown with dark urine.
• Acute renal failure: sudden decrease in kidney function.
• Hyperkalemia: elevated blood potassium levels.

Before initiating Kastel, consider the following safety measures.

• Renal function: assess creatinine clearance and adjust therapy if impaired.
• Hepatic status: monitor liver enzymes, especially in patients with existing liver disease.
• Electrolytes: check potassium levels to avoid hyperkalemia.
• Pregnancy and lactation: avoid use unless clearly needed and prescribed.
• Drug allergies: verify no known hypersensitivity to ACE inhibitors or statins.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, and protect from moisture.

Kastel can interact with several medicines; categorisation helps guide monitoring.

Major Interactions (Avoid)

• Aliskiren: concurrent use with ACE inhibitors may increase risk of renal impairment.
• Strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin): can markedly raise rosuvastatin levels.
• Lithium: ACE inhibition may raise lithium concentrations, risking toxicity.

Moderate Interactions (Monitor Closely)

• Diuretics: may enhance hypotensive effect of ramipril.
• Warfarin: rosuvastatin may increase INR, requiring coagulation monitoring.
• NSAIDs: combined use can reduce renal perfusion, necessitating kidney function checks.