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Polypill Reduces Cardiovascular Mortality by 33% in Patients Treated After a Heart Attack

Written and medically reviewed by Dorcas Morak, Pharm.D

Patients who have previously experienced a heart attack are typically prescribed a certain set of drugs to lower their risk of experiencing another cardiovascular emergency. Typically, this preventive intervention consists of several medications which include: an antiplatelet (such as low-dose aspirin), lipid-lowering medications (such as statins), and blood pressure-lowering medications (e.g. Ramipril).

It is crucial to adhere to the regimen of these medications to prevent further cardiac episodes. However, polypharmacy, which means taking multiple medications simultaneously, makes adherence extremely difficult. As a result of this, experts have been attempting to properly co-formulate numerous drugs into a single pill (Polypill) to encourage therapeutic adherence. However, they require proof of this strategy's efficacy and safety.

In this article, you will learn about Polypills, their effectiveness for cardiovascular events, their strength, and its limitation.

What is Polypill?

A Polypill is a single pill that combines several medications that are frequently prescribed together to treat high blood pressure and heart disease. It gains attention to improve pill-taking adherence which declines as the number of pills increases.

What does Polypill Contain?

Typically, a Polypill combines many of these drugs in different formulations:

  • Antiplatelet e.g. low dose aspirin
  • Cholesterol-lowering medications e.g. statins
  • Drugs to make the heart pulse more slowly
  • Blood pressure-lowering drugs

What are Examples of Polypill for Preventing Cardiovascular Crisis and the Polypill Manufacturers?

These are common brands of Polypill, their composition, and their manufacturer.

| Brand of Polypill | Compositions | Manufacturer | | --- | --- | --- | | Red Heart Pill 1 | Aspirin (75 mg), Atenolol (50 mg), Lisinopril (Zestril) (10 mg), Simvastatin (Flolipid) (40 mg) | Dr. Reddy’s Laboratories, India | | Red Heart Pill 2 | Aspirin (75 mg), Hydrochlorothiazide (12.5 mg), Lisinopril (Zestril) (10 mg), Simvastatin (Flolipid) (40 mg) | Dr. Reddy’s Laboratories, India | | Trinomia | Aspirin (100 mg), Ramipril (Altace) (2,5 mg, 5 mg or 10 mg), Atorvastatin (20 mg) | Ferrer Internacional, Spain | | Polycap | Atenolol (50 mg), Hydrochlorothiazide (12.5mg), Ramipril (Altace)(5 mg), Simvastatin (Flolipid) (20 mg), Aspirin (100 mg) | Cadila Pharmaceuticals Ltd., India | | Starpill | Aspirin (75 mg), Losartan (50 mg), Atenolol (50 mg), Atorvastatin (Lipitor) (10 mg) | Cipla, India | | PolyIran | Aspirin (81 mg), Enalapril (Epaned) (5 mg) / Valsartan (40 mg), Hydrochlorothiazide (12.5 mg), Atorvastatin (Lipitor) (20 mg) | Alborz Darou Pharmaceutical Company, Iran | | Ramitorva | Aspirin (75 mg), Ramipril (Altace)(5 mg), Atorvastatin (Lipitor) (10 mg) | Zydus Cadila, India |

Is Polypill Effective to Prevent Cardiovascular Morbidity?

According to a trial including 2,500 people who had a heart attack during the previous six months, taking Polypill reduces cardiovascular mortality by 33% compared to the traditional practice of polypharmacy. This demonstrated the effectiveness of Polypill in preventing heart attacks.

Polypill gives a better outcome because it aids treatment adherence. Also, it improves the quality of life of the patients through increased adherence and improved clinical response.

The researcher hopes that their finding will be persuasive for the Food and Drug Administration (FDA) to approve Polypills for the prevention of cardiovascular events in the United States. The FDA has not approved Polypill due to strict regulatory hurdles.

Limitations of Polypill for the Prevention of Cardiovascular Crisis

The limitations of Polypill include:

  • Impact of drug intolerance: If the patient does not tolerate one of the components, it is difficult to figure out which one.
  • Lack of flexibility: Patients may not need all the components of the drugs