Tanatril

Managing high blood pressure with an ACE inhibitor is a well-established approach in cardiovascular therapy, helping to protect the heart, kidneys, and blood vessels over the long term. Tanatril tablets are a branded prescription ACE inhibitor containing imidapril hydrochloride, licensed for the treatment of essential hypertension in adults. Imidapril acts on the renin-angiotensin system to lower blood pressure through a similar mechanism to other ACE inhibitors in current use. A prescription can only be issued following a clinical consultation.

Tanatril is a branded oral prescription medicine containing imidapril hydrochloride as the active ingredient. Imidapril belongs to the ACE inhibitor class of medicines, which work by blocking the angiotensin-converting enzyme to lower blood pressure and reduce cardiovascular strain. Tanatril is manufactured by Viatris and is licensed in the UK specifically for the treatment of essential hypertension in adults.

Imidapril is a prodrug. After absorption, it is converted in the body to imidaprilat, the active form that exerts the ACE inhibiting effect. This conversion occurs primarily in the liver, which means adequate hepatic function is important for imidapril to work as intended.

The licensed indication for Tanatril is hypertension only. Unlike some other ACE inhibitors such as ramipril and perindopril, Tanatril does not have additional licensed indications for heart failure or cardiovascular risk reduction.

Tanatril is available in three strengths: 5 mg, 10 mg, and 20 mg. These strengths support dose titration from a cautious starting dose to an effective maintenance dose. Generic imidapril products may also be available, though Tanatril is the originator branded product.

Tanatril lowers blood pressure by acting on the renin-angiotensin system through ACE inhibition.

The Renin-Angiotensin System and Blood Pressure

The renin-angiotensin system is a hormonal pathway that regulates BP regulation and fluid balance. Renin, released by the kidneys, triggers a cascade that leads to the production of angiotensin II. Angiotensin II causes blood vessels to narrow and promotes sodium and water retention, both of which raise blood pressure. In patients with hypertension, sustained angiotensin II activity contributes to elevated blood pressure and, over time, to damage in the blood vessels, heart, and kidneys.

ACE Inhibition by Imidaprilat

Imidaprilat, the active metabolite of imidapril, blocks the angiotensin-converting enzyme (ACE). This prevents the conversion of angiotensin I to angiotensin II. Without angiotensin II, blood vessels remain relaxed, sodium and water retention is reduced, and blood pressure falls. Imidaprilat also inhibits the breakdown of bradykinin, a vasodilatory compound that contributes to the blood pressure lowering effect but is also responsible for the dry cough associated with the ACE inhibitor class.

The antihypertensive effect of imidapril is maintained over 24 hours with once daily dosing, supporting consistent blood pressure control throughout the day and night. As with all ACE inhibitors, the blood pressure lowering effect is greatest in patients with higher baseline renin activity, and individual response may vary.

Always take Tanatril exactly as your prescriber instructs. The information below summarises key points from the current UK SmPC. Read the Patient Information Leaflet supplied with your medicine before starting treatment.

• Take one tablet once daily, at approximately the same time each day.
• Tanatril should be taken before a meal. The SmPC recommends taking imidapril before food, as food may reduce its absorption.
• Swallow the tablet whole with a glass of water.
• If you miss a dose, take it as soon as you remember on the same day. If you only remember the following day, skip the missed dose and continue as normal. Do not take two doses on the same day.
• Do not stop taking Tanatril without speaking to your prescriber first. High blood pressure requires ongoing management, and stopping suddenly can allow blood pressure to rise again.
• Your prescriber will typically start you at a lower dose and increase it over several weeks based on your blood pressure response, kidney function, and potassium levels.
• A first dose blood pressure drop is a known risk with ACE inhibitors, particularly in patients who are volume depleted or on diuretics. Your prescriber will manage this through careful dose titration.
• Attend all follow up appointments to allow your response to treatment to be safely assessed.

Tanatril tablets are available in three strengths, supporting a stepwise approach to dose titration. All dose decisions are made by your prescriber based on your blood pressure response and individual clinical circumstances.

Tanatril 5 mg Tablets

The 5 mg tablet is the starting dose for most patients with essential hypertension. The recommended starting dose per the current UK SmPC is 5 mg once daily, taken before a meal. In patients at higher risk of a first dose blood pressure drop, such as those also taking diuretics, those who are volume depleted, or older patients, the prescriber may begin at 2.5 mg (half a 5 mg tablet, if the tablet can be divided). After two to four weeks, the prescriber will assess your blood pressure response and consider a dose increase if needed.

Tanatril 10 mg Tablets

The 10 mg tablet is an intermediate strength used when the 5 mg starting dose has not achieved adequate blood pressure control. Increasing to 10 mg once daily is a typical next step in the titration process. This strength allows the prescriber to optimise blood pressure control before considering the maximum dose, and is a common maintenance dose for many patients with essential hypertension.

Tanatril 20 mg Tablets

The 20 mg tablet is the maximum recommended dose for Tanatril. It is used in patients whose blood pressure remains inadequately controlled at 10 mg once daily. The maximum licensed dose per the current UK SmPC is 20 mg once daily. If blood pressure is not adequately controlled at 20 mg, your prescriber may consider adding a second antihypertensive from a different class, such as a calcium channel blocker or a diuretic, rather than exceeding the maximum imidapril dose. Do not change your dose without medical advice.

Like all medicines, Tanatril can cause side effects. The information below is based on the current UK SmPC. Refer to the Patient Information Leaflet for the full list.

Common Side Effects (may affect up to 1 in 10 people)

• Dry, persistent cough. This is the most commonly reported side effect of Tanatril and all ACE inhibitors. It is caused by the accumulation of bradykinin following ACE inhibition. The cough can develop at any time during treatment and is not harmful, though it may be troublesome. If it significantly affects your quality of life, speak to your prescriber about alternatives.
• Dizziness or lightheadedness, particularly on standing up quickly. More likely at the start of treatment or after a dose increase.
• Headache.
• Fatigue.

Uncommon Side Effects (may affect up to 1 in 100 people)

• Nausea or gastrointestinal discomfort.
• Raised blood potassium (hyperkalaemia).
• Changes in kidney function, particularly in patients with pre existing kidney disease.
• Skin rash or itching.

Serious Side Effects: Seek Urgent Medical Attention

Go to your nearest accident and emergency department or call 999 immediately if you experience:

• Angioedema: sudden swelling of the face, lips, tongue, or throat. This is rare but potentially life threatening and is a class effect of all ACE inhibitors. Throat swelling can obstruct breathing and requires emergency medical care immediately. If you have had angioedema from any ACE inhibitor, you must not take Tanatril.
• Signs of severely raised potassium such as muscle weakness, an irregular heartbeat, or confusion.
• A marked reduction in urine output, which may suggest acute kidney injury.

Report any suspected side effect to your prescriber, pharmacist, or via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Tanatril Tablets May Be Suitable If You:

• Are an adult aged 18 or over with a confirmed diagnosis of essential hypertension.
• Are unable to tolerate a different ACE inhibitor due to side effects and have been recommended imidapril as an alternative by your prescriber.
• Are already prescribed Tanatril and require a repeat prescription through an online prescribing service.

Tanatril Tablets Are Not Suitable If You:

• Are pregnant or planning to become pregnant. Tanatril is contraindicated in pregnancy. ACE inhibitors cause serious harm to the developing baby, particularly in the second and third trimesters, including kidney damage, skull abnormalities, and foetal death. Contact your prescriber immediately if you become pregnant while taking Tanatril.
• Are breastfeeding.
• Have a history of angioedema related to previous ACE inhibitor treatment, or hereditary or idiopathic angioedema.
• Have severe kidney impairment or are on dialysis.
• Have significant liver disease. Tanatril is a prodrug that requires hepatic conversion to its active form.
• Are taking aliskiren and have diabetes or moderate to severe kidney impairment.
• Have a known allergy or hypersensitivity to imidapril, any other ACE inhibitor, or any excipient listed in the SmPC.
• Are under 18 years of age.

Tell your prescriber about all medicines you take. The following interactions are of particular clinical importance for Tanatril:

• Potassium supplements, potassium-sparing diuretics (such as spironolactone or amiloride), and potassium-containing salt substitutes: these can raise blood potassium to dangerous levels when combined with Tanatril.
• NSAIDs such as ibuprofen: regular use can reduce the blood pressure lowering effect of Tanatril and increase the risk of kidney problems.
• Lithium: ACE inhibitors can increase lithium blood levels. Close monitoring is required if both medicines are taken together.
• Diuretics: adding Tanatril to existing diuretic treatment increases the risk of a significant first dose blood pressure drop. Your prescriber will manage this carefully.
• Aliskiren: contraindicated in combination with Tanatril in patients with diabetes or significant kidney impairment.
• Antidiabetic medicines including insulin: ACE inhibitors may enhance the blood glucose lowering effect. Patients with diabetes should monitor blood glucose carefully when starting Tanatril.

Your prescriber will review all current medicines during the clinical assessment before any prescription is considered.

Tanatril is a Prescription Only Medicine. The clinical consultation is the essential first step. A prescription will only be issued if a registered prescriber concludes, based on their individual assessment of your circumstances, that Tanatril is clinically appropriate for you.

During your online consultation with Pharmacy Planet, a registered prescriber will review the information you provide. This includes your blood pressure history, current medicines, kidney function where available, and other relevant medical information. The prescriber will assess which strength is appropriate and whether online prescribing is suitable for your situation.

If you are under the care of your GP or a specialist for hypertension or a related condition, please keep them informed of all medicines prescribed through online services. Coordinated care supports the safest approach to BP regulation and cardiovascular therapy.

Store below 25°C. Store in the original packaging to protect from moisture and light. Keep out of the sight and reach of children. Do not use after the expiry date printed on the packaging. Do not dispose of medicines via household waste or wastewater. Return unused or out of date tablets to your pharmacist for safe disposal. Full storage instructions are provided in the Patient Information Leaflet supplied with your medicine.

Pharmacy Planet is a GPhC-registered online pharmacy providing access to prescription medicines through a clinically led consultation process. Our registered prescribers and pharmacists are committed to patient safety, clinical accuracy, and responsible prescribing. We follow GPhC standards, MHRA guidance, and ASA advertising regulations in all aspects of our service. Every prescription is reviewed and dispensed by qualified healthcare professionals. We provide clear, factual information to help patients understand their antihypertensive medication and make informed decisions about their blood pressure control and cardiovascular therapy. If you have questions about Tanatril, imidapril, or any other medicine, our pharmacy team is available to help. We are committed to transparent, patient centred care.

References

1. Electronic Medicines Compendium (eMC). Tanatril 5 mg, 10 mg and 20 mg tablets — Summary of Product Characteristics. https://www.medicines.org.uk/emc. Accessed May 2026.
2. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. NICE guideline NG136. https://www.nice.org.uk/guidance/ng136. Accessed May 2026.
3. NHS. High blood pressure (hypertension). https://www.nhs.uk/conditions/high-blood-pressure-hypertension. Accessed May 2026.
4. Joint Formulary Committee. British National Formulary (BNF). Imidapril hydrochloride. BMJ Group and Pharmaceutical Press. https://bnf.nice.org.uk. Accessed May 2026.
5. Medicines and Healthcare products Regulatory Agency (MHRA). Yellow Card — report a side effect. https://yellowcard.mhra.gov.uk. Accessed May 2026.

ACE Inhibitor Tablets and Capsules

The table below compares commonly prescribed ACE inhibitor tablets and capsules available at Pharmacy Planet. All are prescription-only medicines that act on the renin-angiotensin system to lower blood pressure.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation.