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Rami Sandoz
Last reviewed: 03.07.2025
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Indications Rami Sandoz
- arterial hypertension;
- insufficient cardiac activity (chronic course, including in the post-infarction state);
- significant glomerular or early stage nephropathy, whether or not associated with diabetes;
- prevention of heart attacks and strokes in patients with severe ischemic heart disease;
- distal vascular disease or diabetes with signs of cardiovascular damage.
Pharmacodynamics
The active component of the drug inhibits the action of the enzyme dipeptidyl carboxypeptidase I. In the blood serum and tissue structures, this protein promotes the transition of angiotensin I to the active octapeptide hormone angiotensin II, and to the breakdown of the peptide bradykinin. A decrease in the level of angiotensin II and inhibition of the breakdown of bradykinin lead to the expansion of the vascular lumen.
An additional property of angiotensin II is stimulation of the release of aldosterone, therefore the active component of the drug helps to reduce the production of aldosterone.
The use of Rami Sandoz allows to significantly reduce the distal resistance of arterial walls. As a rule, this drug does not significantly affect the blood circulation in the kidneys and the dynamics of filtration in the glomerular system.
The use of the drug in patients with signs of arterial hypertension provokes a decrease in blood pressure without a simultaneous increase in heart rate.
In most patients, the pressure-stabilizing effect is observed 60-120 minutes after taking the medicine. The maximum effect can be detected after 4-5 hours and lasts for about a day. The maximum therapeutic effect with regular use is established after 21-30 days. It has been proven that the pressure-stabilizing effect can be maintained with long-term treatment for 2 years.
Abrupt discontinuation of Rami Sandoz does not result in an immediate and sudden increase in blood pressure readings.
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Pharmacokinetics
After oral administration, the active ingredient is well absorbed in the digestive tract: the maximum amount of the drug in the blood is detected within the first hour. The average degree of absorption is determined to be 56%, and this value is unchanged even in the presence of food masses in the stomach. The maximum amount of the active ingredient in the plasma is observed approximately 3 hours after taking the drug. With a standard dosage (once a day), the equilibrium of the drug can be achieved on the 4th day of therapy.
The active component binds to plasma proteins by 73%.
The drug is eliminated primarily through the urinary system. The half-life is 13 to 17 hours at a dosage of 0.005-0.01 g, or more at a dosage of 0.00125 g-0.0025 g. This is due to the saturation of the enzyme enzyme in relation to the binding of the active ingredient of the drug.
When Rami Sandoz was used once, the active ingredient was not detected in breast milk. The extent of penetration into milk after repeated use has not been studied.
Dosing and administration
The drug Rami Sandoz is taken daily at the same time. The tablet is swallowed whole, without crushing or chewing, with a sufficient amount of liquid. Simultaneous consumption of food does not affect the absorption of the drug: for this reason, the use of tablets may not depend on the time of food intake.
In some cases, it is permissible to split the tablet into two parts.
For the treatment of hypertension, the dosage is selected individually, and Rami Sandoz can be prescribed as an independent drug or in combination with other antihypertensive drugs. The standard initial dosage involves taking 0.0025 g once a day. If necessary, the dose is increased, doubling it once every 14-28 days. Alternatively, additional prescription of diuretics and calcium channel blockers can be used.
The standard maintenance dosage is 0.0025 to 0.005 g per day.
The maximum daily dosage is 0.01 g.
When treating heart failure, it is recommended to take 1.25 mg once a day. If the doctor prescribes a dosage of more than 2.5 mg, it is divided into two doses.
When treating a post-infarction condition, Rami Sandoz is taken two days after the infarction. Initially, 2.5 mg of the drug is taken twice a day. After three days, the dosage can be changed. The maximum daily dosage is 10 mg (0.01 g), taken in two doses.
To prevent the development of a heart attack or stroke, start with taking 2.5 mg of the drug once a day. Then the dosage can be revised upwards. Usually the dosage is doubled after 7-14 days of therapy, and after 14-20 days a maintenance amount of the drug is prescribed - 10 mg (0.01 g) once a day.
For elderly patients, treatment begins with a low dosage of 1.25 mg per day. The dosage is then adjusted, taking into account the possible development of side effects.
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Use Rami Sandoz during pregnancy
The use of Rami Sandoz during pregnancy is not recommended due to the lack of information about the effect of the drug on the fetus and the course of the gestation process.
If it is necessary to take the medicine during breastfeeding, lactation should be temporarily stopped.
Contraindications
Contraindications to the use of Rami Sandoz may be:
- hypersensitivity to the active component of the drug, or to other ACE inhibitors;
- history of Quincke's edema;
- arterial spasm in one or both kidneys;
- complicated renal failure;
- primary increased production of aldosterone;
- pregnancy and breastfeeding;
- childhood;
- tendency to low blood pressure;
- hemodynamic instability.
Side effects Rami Sandoz
Side effects of Rami Sandoz are not uncommon and may include the following symptoms:
- increased antinuclear factor, anaphylaxis;
- arterial collapse, hypotonic syncope, myocardial ischemia, cardiac arrhythmia, swelling of the extremities, decreased perfusion pressure, inflammation and vascular spasms;
- in the blood there are signs of eosinophilia, neutropenia, agranulocytosis, decreased hemoglobin and platelet levels;
- headaches, sensory disturbances in the extremities, dizziness, vestibular disorders, psychomotor disorders;
- mood swings, anxiety, sleep disorders, irritability;
- blurred vision, conjunctival inflammation;
- deterioration of hearing functions, tinnitus;
- dry cough, sinusitis, bronchospasm;
- inflammatory processes of the oral mucosa and digestive tract, dyspeptic disorders, pancreatitis;
- taste disorders;
- hyperkalemia, loss of appetite, weight loss;
- increased liver enzymes, cholestasis;
- signs of acute renal failure, increased diuresis, increased levels of urea and creatinine in the blood;
- erectile dysfunction, decreased sexual activity, imbalance of sex hormones;
- allergic reactions, increased sweating, dermatitis;
- muscle pain and spasms, joint pain;
- chest pain, feeling tired.
Overdose
Signs of an overdose of Rami Sandoz most often manifest themselves in excessive dilation and relaxation of peripheral vessels, which is expressed in the following symptoms:
- hypotension, up to arterial collapse;
- slowing of cardiac activity;
- electrolyte metabolism disorders;
- renal dysfunction.
The overdose condition requires constant medical supervision. Symptomatic and supportive therapy is used: it is necessary to wash the stomach, prescribe sorbents (activated carbon, sorbex), and means for normalizing hemodynamics. Hemodialysis is ineffective in this case.
Interactions with other drugs
The combined use of antihypertensive, diuretic, opiate, anesthetic, tricyclic and antipsychotic drugs may lead to increased hypotensive action.
Combined use with non-steroidal anti-inflammatory drugs (aspirin, indomethacin), estrogen-containing drugs, sympathomimetics and salt-containing drugs and products may lead to a decrease in the hypotensive effect.
Combined use with potassium-containing drugs may lead to a significant increase in serum potassium levels.
It is not recommended to take Rami Sandoz with lithium-containing products: this may increase lithium toxicity.
If combined therapy is carried out with the use of antidiabetic drugs (including insulin), this may lead to an increase in the hypoglycemic effect.
Combined use with cytostatics, immunosuppressants, and corticosteroids increases the risk of developing leukopenia.
Rami Sandoz enhances the effects of alcohol.
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Storage conditions
The combined use of antihypertensive, diuretic, opiate, anesthetic, tricyclic and antipsychotic drugs may lead to increased hypotensive action.
Combined use with non-steroidal anti-inflammatory drugs (aspirin, indomethacin), estrogen-containing drugs, sympathomimetics and salt-containing drugs and products may lead to a decrease in the hypotensive effect.
Combined use with potassium-containing drugs may lead to a significant increase in serum potassium levels.
It is not recommended to take Rami Sandoz with lithium-containing products: this may increase lithium toxicity.
If combined therapy is carried out with the use of antidiabetic drugs (including insulin), this may lead to an increase in the hypoglycemic effect.
Combined use with cytostatics, immunosuppressants, and corticosteroids increases the risk of developing leukopenia.
Rami Sandoz enhances the effects of alcohol.
Shelf life
Shelf life: up to 2 years.
Attention!
To simplify the perception of information, this instruction for use of the drug "Rami Sandoz" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.