Ramigexal

Ramigexal is classified as a drug that affects the cardiovascular system – the renin-angiotensin system – a monocomponent ACE inhibitor.

The active component of the drug is Ramipril.

Produced by the German pharmaceutical company Salutas Pharma GmbH.

The drug Ramigexal is sold in pharmacies upon presentation of a prescription, therefore the drug is prescribed only by a specialist if there are clear indications for its use.

Indications Ramigexal

Ramigexal is used:

• for hypertension;
• in chronic heart failure;
• in the rehabilitation period of post-infarction and post-stroke conditions;
• in diabetes-associated nephropathy.

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Release form

The medicine is produced in tablet form. Content per tablet: ramipril 2.5 or 5 mg. Additional components are sodium bicarbonate, MCC, hypromellose, pregelatinized starch, sodium stearyl.

Pharmacodynamics

A drug for stabilizing high blood pressure that inhibits ACE. Suppresses ACE, which causes relaxation of the vascular walls and a decrease in blood pressure. As a result of ACE inhibition, the activity of renin is stimulated - a component of the renin-angiotensin system, which normalizes blood pressure.

In case of significant nephropathy (with or without diabetes mellitus) Ramigexal slows down the progression of renal disorders. In patients at risk of renal damage, the severity of albuminuria decreases.

Ramigexal has virtually no effect on blood circulation in the kidneys and the rate of urine formation (URF).

Patients with high blood pressure note a decrease in blood pressure regardless of changes in body position. In most patients, a decrease in pressure begins 1-2 hours after taking the pill. The maximum effect can be observed after 3 to 6 hours: it continues throughout the day.

Stable blood pressure readings are established after about a month of continuous use of Ramigexal.

Long-term use of the drug does not cause addiction and does not affect the degree of the drug's effect.

Abrupt discontinuation of Ramigexal does not result in a simultaneous increase in blood pressure readings.

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Pharmacokinetics

Ramigexal is well absorbed when taken orally. Food taken at the same time does not affect the absorption and assimilation of the drug. Metabolism occurs to a greater extent in the liver, where active and inactive intermediate metabolic products are formed. The active metabolic product is ramiprilat. Its activity is more than 5 times greater than the activity of the active substance of the drug ramipril.

The peak concentration of the active component in the bloodstream is observed after 2 to 4 hours after oral administration. The connection with plasma proteins can be about 56%. The half-life is 14-16 hours after taking a repeated dose of Ramigexal. Most of the active component leaves the body through the urinary system, about 40% - with feces.

In case of kidney dysfunction, the active component tends to accumulate inside the body.

When liver function is impaired, there is a failure in the process of transforming the active component into ramiprilat.

The patient's age does not affect the pharmacokinetic properties of the drug.

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Dosing and administration

Ramigexal is taken orally, regardless of meal time. The tablet is swallowed without chewing or crushing. If necessary, it can be divided into 2 parts.

In case of high blood pressure, Ramigexal is started with 2.5 mg once a day. As a rule, the same dosage is used for further therapy. If the doctor deems it appropriate, the amount of the drug used can be increased over 14-20 days to 5 mg. The maximum daily dosage of the drug is 10 mg. Sometimes Ramigexal is combined with diuretics.

In chronic heart failure, treatment begins with 1.25 mg of Ramigexal per day. The doctor monitors the patient and, if necessary, increases the amount of the drug over 7-14 days.

For the treatment of post-infarction conditions, Ramigexal is prescribed from the 4th-5th day after the infarction, provided that the patient's hemodynamics are stable. The dosage is selected by the doctor strictly individually.

In case of insufficient renal function, with creatinine clearance of 50 ml per minute, Ramigexal is taken in a standard dosage. If clearance is ≤50 ml per minute, the drug is prescribed at 1.25 mg once a day. Maximum - 5 mg once a day.

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Use Ramigexal during pregnancy

Ramigexal is not used during pregnancy and breastfeeding.

Contraindications

Before use, carefully read the list of contraindications to taking the medicine:

• tendency to allergy to the active or any of the additional components of the drug;
• allergic sensitivity to other drugs that inhibit ACE;
• previous history of Quincke's edema;
• narrowing of the lumen of the renal arterial vessels, kidney transplant;
• aortic spasm, mitral stenosis;
• cardiac muscle hypertrophy;
• primary increased production of aldosterone;
• insufficient liver function;
• performing hemodialysis.

The medicine is not prescribed to women during pregnancy and breastfeeding, as well as to children.

Ramigexal is contraindicated in severe forms of cardiac insufficiency, orthostatic imbalance, exacerbation of coronary heart disease, severe cardiac arrhythmias, and pulmonary heart disease.

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Side effects Ramigexal

What are the possible side effects of Ramigexal:

• decreased blood pressure (including critical), myocardial ischemia, chest pain, heart rhythm disturbances, tachycardia;
• anemia, decreased platelet count in the blood, inflammation of the vascular walls;
• dyspepsia, bowel disorders, epigastric pain, inflammation of the digestive tract, liver dysfunction, cholestasis;
• headaches, memory and sleep disorders, sensory disturbances in the extremities, hand tremors, hearing and visual impairments;
• dry cough, inflammatory processes in the nasal sinuses, nasopharynx, bronchi and trachea;
• deterioration of kidney function, swelling, decrease in daily urine volume, protein in the urine;
• allergic dermatoses, sensitivity to ultraviolet radiation;
• weight loss, joint and muscle pain, fever, etc.

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Overdose

Overdose of Ramigexal can be expressed in a critical decrease in pressure, up to a state of shock. In some cases, an imbalance of electrolyte metabolism and kidney dysfunction occur.

To help with an overdose, general measures are used to detoxify the body: wash the stomach, give a sorbent drug (for example, activated carbon). Physiological solution and catecholamines are administered intravenously.

The use of hemodialysis in case of Ramigexal overdose is not advisable.

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Interactions with other drugs

The combined use of drugs aimed at lowering blood pressure, as well as diuretics, opium-based analgesics, and anesthetics may enhance the hypotensive properties of Ramigexal.

The combined use of non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, etc.), sympathomimetic agents and foods rich in table salt may reduce the effect of Ramigexal.

Concomitant use of potassium-containing drugs, potassium-sparing diuretics and Ramigexal may result in a significant increase in the level of potassium in the bloodstream.

Simultaneous use of Ramigexal with lithium-containing drugs may provoke an increase in the level of lithium in the bloodstream. Taking these drugs is possible only under constant monitoring of the amount of lithium in the blood.

The combined use of Ramigexal with drugs for the treatment of diabetes may enhance the degree of the hypoglycemic effect.

Concomitant use of cytostatics, immunosuppressants, and allopurinol can provoke the development of leukopenia.

The use of Ramigexal together with alcohol potentiates the action of the latter.

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Storage conditions

Ramigexal is recommended to be stored at temperatures up to +25°C. The medicine should not be frozen or exposed to direct ultraviolet radiation.

Ramigexal must be stored in the original packaging, in a specially designated place where children have limited access.

Shelf life

The expiration date of Ramigexal is indicated on the packaging of the drug and is no more than 2 years from the date of manufacture. If the expiration date has expired, it is recommended to throw the medicine away.