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Rami Sandoz
Last reviewed: 23.04.2024
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Indications Rami Sandoz
- arterial hypertension;
- inadequate cardiac activity (chronic course, including in the post-infarction state);
- significant glomerular or initial stage of nephropathy, whether or not associated with diabetes;
- the prevention of heart attacks, strokes in patients with pronounced coronary heart disease;
- Distal vascular disease or diabetes with signs of cardiovascular disease.
Pharmacodynamics
The active ingredient of the drug inhibits the action of the enzyme dipeptidyl-carboxypeptidase I. In the 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 bradykinin peptide. Reducing the level of angiotensin II and inhibition of the decay of bradykinin lead to an expansion of the vascular lumen.
An additional property of angiotensin II is the stimulation of the output of aldosterone, so the active component of the drug helps to reduce the production of aldosterone.
Using Rami Sandoz can 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 medication in patients with signs of arterial hypertension provokes a decrease in BP without a simultaneous increase in the frequency of cardiac activity.
In the main part of the patients, the pressure-stabilizing effect is observed 60-120 minutes after taking the drug. The maximum effect can be detected after 4-5 hours and lasts about a day. The limiting therapeutic effect with regular application is established after 21-30 days. It is proved that the pressure-stabilizing effect can be preserved with long-term treatment for 2 years.
The abrupt cancellation of Rami Sandoz does not lead to a sudden and sudden increase in pressure indicators.
[5]
Pharmacokinetics
After ingestion, the active ingredient is well absorbed in the digestive tract: the limiting amount of the drug in the blood is detected during the first hour. The average degree of absorption is determined in 56%, and this value is invariable even in the presence of food masses in the stomach. The limiting amount of the active ingredient in plasma is observed approximately 3 hours after the use of the medication. At a standard dosage (once a day), the drug can be equilibrated on the 4th day of therapy.
The active component binds to plasma proteins by 73%.
Drug withdrawal occurs mainly 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 saturability of the enzyme enzyme with respect to the binding of the active ingredient of the drug.
With a single use of Rami Sandoz, the active ingredient was not found in breast milk. The degree of penetration into milk with repeated use has not been studied.
Dosing and administration
The drug Rami Sandoz is administered every day at the same time. The tablet is swallowed whole, not crushing and chewing, with enough liquid. Simultaneous eating does not affect the assimilation of the drug: for this reason, the use of tablets may not depend on the time of ingestion.
In some cases, the tablet is divided 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 assumes taking 0.0025 g once a day. If necessary, increase the dose, doubling it once every 14-28 days. Alternatively, additional use of diuretics and calcium channel blockers can be used.
The standard maintenance dosage is from 0.0025 to 0.005 g per day.
The limiting dosage per day is 0.01 g.
When therapy for heart failure is recommended, taking 1.25 mg once a day. If the doctor appoints a dosage more than 2.5 mg, then it is divided into a two-time reception.
In the treatment of postinfarction, Rami Sandoz's treatment begins two days after the infarction. Initially, take 2.5 mg of the drug twice a day. After three days, the dosage can be changed. The limiting daily dosage of 10 mg (0.01 g), taken in two doses.
To prevent the development of a heart attack or stroke start with the intake of 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 restraining amount of the drug is prescribed - 10 mg (0.01 g) once a day.
For elderly patients, treatment starts with a low dosage of 1.25 mg per day. The dosage is then adjusted, taking into account the possible development of adverse events.
[12]
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 you need to take medication 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;
- Quincke's edema in the anamnesis;
- arterial spasm in one or two kidneys;
- complicated kidney failure;
- primary increased production of aldosterone;
- pregnancy and breastfeeding;
- childhood;
- tendency to lowered pressure;
- instability of hemodynamics.
Side effects Rami Sandoz
Side effects of Rami Sandoz are not uncommon and can be manifested by the following symptoms:
- an increase in the antinuclear factor, anaphylaxis;
- arterial collapse, hypotonic syncope, cardiac muscle ischemia, cardiac rhythm disturbance, puffiness of the limbs, weakening of perfusion pressure, inflammation and vasospasms;
- in the blood signs of eosinophilia, neutropenia, agranulocytosis, a decrease in hemoglobin and platelet counts;
- pain in the head, sensitivity disorders of the limbs, dizziness, vestibular disorders, psychomotor disorders;
- mood swings, anxiety, sleep disorder, irritability;
- blurred vision, inflammation of the conjunctiva;
- deterioration of auditory functions, tinnitus;
- dry cough, sinusitis, bronchospasm;
- inflammatory processes of the oral mucosa and digestive tract, dyspeptic disorders, pancreatitis;
- disorders of taste;
- hyperkalaemia, impaired appetite, emaciation;
- an increase in the number of liver enzymes, cholestasis;
- signs of acute renal failure, increased diuresis, increased amounts of urea and creatinine in the blood;
- erectile dysfunction, decreased sexual activity, imbalance of sex hormones;
- allergic manifestations, increased sweating, dermatitis;
- pain and spasms in the muscles, tenderness of the joints;
- pain in the chest, a sense of fatigue.
Overdose
Signs of an overdose of Rami Sandoz are most often manifested in the excessive expansion and relaxation of peripheral vessels, which is expressed in the following symptoms:
- hypotension, right up to arterial collapse;
- slowing of cardiac activity;
- electrolyte exchange disorders;
- impaired renal function.
The condition of an overdose requires constant monitoring by a doctor. Use symptomatic and maintenance therapy: it is necessary to rinse the stomach, prescribe sorbents (activated charcoal, sorbes), means for normalization of hemodynamics. Hemodialysis in this case is ineffective.
Interactions with other drugs
Combined use of antihypertensive drugs, diuretics, opium preparations, anesthetics, tricyclics and antipsychotics may lead to an increase in hypotensive effect.
Combination with non-steroidal anti-inflammatory drugs (aspirin, indomethacin), estrogen-containing drugs, sympathomimetics and salt-containing preparations and products may lead to a decrease in the hypotensive effect.
Combination with potassium-containing drugs can lead to a marked increase in potassium levels in the blood serum.
It is not recommended to take Rami Sandoz with lithium-containing agents: this can increase the toxicity of lithium.
If combined therapy with antidiabetic drugs (including insulin) is carried out, then this may lead to an increase in hypoglycemic effects.
Combined use with cytostatics, immunosuppressants, corticosteroid agents increases the risk of developing leukopenia.
Rami Sandoz enhances the effect of alcohol.
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Storage conditions
Combined use of antihypertensive drugs, diuretics, opium preparations, anesthetics, tricyclics and antipsychotics may lead to an increase in hypotensive effect.
Combination with non-steroidal anti-inflammatory drugs (aspirin, indomethacin), estrogen-containing drugs, sympathomimetics and salt-containing preparations and products may lead to a decrease in the hypotensive effect.
Combination with potassium-containing drugs can lead to a marked increase in potassium levels in the blood serum.
It is not recommended to take Rami Sandoz with lithium-containing agents: this can increase the toxicity of lithium.
If combined therapy with antidiabetic drugs (including insulin) is carried out, then this may lead to an increase in hypoglycemic effects.
Combined use with cytostatics, immunosuppressants, corticosteroid agents increases the risk of developing leukopenia.
Rami Sandoz enhances the effect 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.