Ramizes

The drug belongs to the pharmacological series of cardiovascular agents aimed at regulating blood pressure.

This effect is achieved due to the effect of the active component of ramipril on the renin-angiotensin system.

Ramizes is produced by the Ukrainian pharmaceutical company JSC Farmak.

The drug Ramizes is available in pharmacies with a doctor's prescription.

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Indications Ramizes

Ramizes is prescribed as an independent drug, or in combination with other drugs that stabilize blood pressure and improve cardiac function (especially in the post-infarction period).

The drug can be used in the treatment regimen for patients with nephropathy (diabetic or other etiology).

The indication for use is considered to be preventive therapy of strokes and heart attacks, as well as fatal outcomes from cardiovascular pathology. The drug can be prescribed for coronary heart disease, diseases of the peripheral vascular system, hypertension, increased cholesterol in the blood, a small amount of high-density lipoproteins.

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Release form

Ramizes is produced in tablet form. One cardboard package contains one or three blisters of 10 tablets each.

The tablet has a flat round shape, a notch for dosage. It may include minor dotted elements on the surface. The color of the tablet reflects its dosage:

- 1.25 mg – white color;

- 2.5 mg – pale yellow;

- 5 mg – pale pink;

- 10 mg – creamy white.

The active component of the medicine is ramipril. There are also a number of additional ingredients: lactose, starch, magnesium stearate, etc.

Pharmacodynamics

Ramizes is a medicine intended to stabilize blood pressure. It belongs to a group of drugs that inhibit angiotensin-converting enzyme. The key ingredient is ramipril, which, when it enters the body, undergoes changes to the active substance ramiprilat.

The active component is capable of inhibiting angiotensin-converting enzyme, which provokes a decrease in the amount of angiotensin II in the blood serum and a decrease in aldosterone production. In addition, the action of renin in the blood is stimulated and the decomposition of bradykinin is slowed down.

When treated with Ramizes, patients note a decrease in the degree of resistance of the vascular walls, relaxation of the vessel walls, which leads to a gradual decrease in blood pressure without increasing the load on the heart. On the contrary, the drug is able to reduce the load on the heart muscle, thereby positively affecting the well-being of patients, especially in post-infarction and post-stroke conditions.

A decrease in blood pressure is observed already 60-120 minutes after taking Ramizes and continues throughout the day. Peak efficiency occurs after 14-20 days of continuous treatment. The drug does not have to be discontinued gradually: withdrawal syndrome does not occur.

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Pharmacokinetics

The main processes of drug metabolism occur in the liver, resulting in the formation of ramiprilat. Ramipril is converted into diketopiperazine ether.

Ramiprilat becomes biologically available when taken orally and can be approximately 45%. The substance is rapidly absorbed in the digestive system (at least 56% of the amount). The degree of absorption does not depend on the simultaneous intake of food. Peak plasma levels are observed 60 minutes after taking the drug.

The half-life is also 60 minutes.

The peak level of ramiprilat in the bloodstream is detected 120-240 minutes after taking the drug.

The final stage of drug elimination is quite long: for example, after a single dose of 2.5 mg or more, the body returns to its base state after 4 days. With a course of treatment, the half-life can be from 13 to 17 hours.

The binding of the active component and its metabolite to plasma proteins can be 70-56%.

The pharmacokinetic properties of Ramizes are not dependent on the patient's age. No accumulation occurs in the body.

Dosing and administration

The medicine is used for internal use. It is not recommended to chew or crush the tablets.

The daily dosage is divided into one, less often into two doses. Tablets can be taken both before and after meals.

The duration of the course of treatment and dosage are selected by the doctor.

To treat high blood pressure, take 2.5 mg of Ramizes per day. If the dynamics of pressure stabilization is insufficient, then after 14-20 days the dosage is reviewed and doubled. The optimal stationary dosage of the drug can be 2.5-5 mg per day. The maximum amount of the drug is 10 mg per day. In order to speed up the process of normalizing pressure, it is allowed to use auxiliary drugs, such as diuretics and calcium antagonists.

In case of insufficient cardiac activity, take Ramizes in the amount of 1.25 mg per day. If the therapeutic effect is insufficient, the dosage can be doubled every 7-14 days. The maximum dosage is unchanged - 10 mg per day.

In the post-infarction period, the recommended dosage is 5 mg per day. This dosage can be divided into two doses of 2.5 mg per dose. It is necessary to monitor the patient's condition and, if necessary, revise the dosage in one direction or another. The dosage is increased gradually, every three days. The maximum dosage is 10 mg per day.

In severe cases of heart failure, the drug is used with caution, starting with the smallest possible number of tablets.

To prevent possible heart attack, stroke or death due to cardiovascular complications, Ramizes is taken 2.5 mg in the morning and evening. After a week from the start of therapy, the dosage can be gradually increased.

Patients with nephropathy (diabetic or non-diabetic) take 1.25 mg of the drug per day. It is not recommended for such patients to use more than 5 mg of Ramizes per day.

Elderly patients with impaired renal function (with creatinine clearance of 20-50 ml per minute) take Ramizes in a trial dose of 1.25 mg per day. The maximum dose for such patients cannot exceed 5 mg per day.

Patients with insufficient liver function take the drug at 1.25 mg per day. The maximum permissible dosage for such patients is 2.5 mg per day.

Patients with persistent hypertension, water-salt metabolism disorders, and peripheral circulatory pathologies should not take high doses initially.

Patients undergoing hemodialysis should take the drug in an amount of 1.25 mg per day. The dose is taken 2-4 hours after the end of the procedure.

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Use Ramizes during pregnancy

Ramizes is not prescribed to women during pregnancy. Moreover, before prescribing the drug, the doctor must make sure that the patient is not pregnant. During the course of treatment, patients are recommended to use contraceptives.

If a woman is planning a pregnancy or has already become pregnant, treatment with Ramizes should be discontinued or replaced with another approved drug.

The active component of Ramizes is found in breast milk, so when prescribing the drug, breastfeeding should be stopped.

Contraindications

Ramizes is not used in the following cases:

• if you are prone to allergies to any of the components of the drug, as well as to drugs that inhibit angiotensin-converting enzyme;
• in case of lactase deficiency and glucose-galactose malabsorption syndrome;
• in case of Quincke's edema in the past;
• in case of narrowing of the renal artery, in case of hemodynamic imbalance, in case of low blood pressure;
• in hyperaldosteronism (primary form);
• during pregnancy and breastfeeding;
• for the treatment of children;
• in severe kidney diseases.

The medicine is prescribed with caution in the following conditions:

• hypertensive crisis;
• complicated coronary heart disease;
• narrowing of the aortic lumen;
• mitral valve stenosis;
• hypertrophic cardiomyopathy;
• water-salt metabolism disorder;
• severe liver disease;
• disorder of cardiac and cerebral circulation;
• collagenoses;
• decompensation of cardiac activity;
• old age.

Side effects Ramizes

When taking the medicine, some side effects may develop:

• excessive decrease in blood pressure;
• ischemia of the heart muscle, heart rhythm disorders, swelling of the extremities, inflammatory processes in the vessels, vascular spasms;
• renal dysfunction, acute renal failure, increased diuresis, protein in the urine, high levels of creatinine and urea in the blood;
• dry "scratching" cough, bronchitis, sinusitis, bronchospasm, asthmatic relapses;
• inflammatory processes of the mucous membrane of the mouth, throat, digestive system;
• dyspeptic symptoms, bowel disorders, taste and smell disturbances, liver dysfunction;
• headaches, visual and auditory dysfunctions, anxiety, sleep disorders, vestibular disorders, tremors in the limbs, inflammation of the conjunctiva, cerebrovascular accidents and psychomotor reactions, decreased concentration;
• allergic reactions (rashes, itchy skin, swelling);
• increased sweating, increased sensitivity to ultraviolet rays, exacerbation of skin diseases, alopecia;
• cramps, muscle or joint pain;
• metabolic disorders, weight loss, loss of appetite;
• eosinophilia, anemia, neutropenia, agranulocytosis, low hemoglobin and platelet levels;
• chest pain, increased fatigue, apathy;
• decreased sexual desire, erectile dysfunction;
• swelling of the mammary glands.

Overdose

Taking large amounts of the drug can cause excessive vasodilation, which will cause a sharp drop in blood pressure, even to the point of collapse. Among other things, an overdose can cause a slowing of the heart rate, deterioration of kidney function, and a disorder of water-salt metabolism.

There is no special drug that neutralizes the effect of ramipril. When using large doses of the drug, gastric lavage is performed, after which sorbents (activated carbon) are prescribed. In case of water-salt metabolism disorder and a decrease in the volume of circulating blood, infusion solutions are administered dropwise to replenish fluid in the body.

In case of excessive drop in blood pressure, cardiotonic hypertensive agents (dopamine, reserpine) may be prescribed.

In case of overdose, hemodialysis or forced diuresis are not used due to their questionable effectiveness in this situation.

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Interactions with other drugs

The therapeutic effect of Ramizes may become more pronounced when used in combination with other drugs that lower blood pressure, such as diuretics, tricyclic antidepressants, and anesthetics.

When treating with Ramizes and diuretics simultaneously, there is a need to monitor the amount of sodium in the blood.

Sympathomimetics with vasoconstrictor properties when used together with Ramizes reduce the effect of the latter. When taking the listed drugs in combination, it is important to monitor blood pressure readings.

The likelihood of a hematological reaction increases with the combined use of Ramizes and immunosuppressants, cytostatics, and glucocorticosteroids.

It is not recommended to use Ramizes and lithium-containing products, due to the increased toxicity of the latter.

When using Ramizes and antidiabetic drugs, it is necessary to monitor blood sugar levels.

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Storage conditions

It is recommended to store the medicinal product Ramizes in dark places with a temperature of no more than +25°C, out of reach of children.

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Shelf life

The expiration date of Ramizes is indicated on the packaging of the drug and is one and a half years for tablets in a dosage of 1.25 mg, or 2 years for tablets of other dosages.