Ramizes

Medpreparat refer to the pharmacological series of cardiovascular drugs aimed at regulating blood pressure.

This effect is achieved through the action of the active component of ramipril on the renin-angiotensin system.

Ramizes is produced by the Ukrainian pharmaceutical company OAO Farmak.

Ramizes medication is dispensed in the pharmacy network if prescription is confirmed by the doctor.

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Indications Ramizes

Ramises are prescribed as an independent drug, or in combination with other drugs that stabilize blood pressure, improve cardiac activity (especially in the post-infarction period).

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

Indication for use is considered preventive therapy of strokes and heart attacks, as well as deaths from cardiovascular pathology. The medicine can be prescribed for IHD, peripheral vascular system diseases, hypertension, high cholesterol in the blood, and a small number of high-density lipoproteins.

[2], [3], [4]

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 rounded shape, a notch for dosing. Can include small dotted elements on the surface. The color of the tablet reflects its dosage:

1.25 mg white;

- 2.5 mg - pale yellow;

- 5 mg - pale pink;

- 10 mg - cream white.

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

Pharmacodynamics

Ramizes is a drug designed to stabilize blood pressure. Belongs to the group of drugs that inhibit the angiotensin-converting enzyme. The key ingredient is ramipril, which, entering the body, undergoes changes to the active substance of ramiprilata.

The active component is able to inhibit the angiotensin-converting enzyme, which causes 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 inhibited.

In the treatment of Ramizes, patients note a decrease in the degree of resistance of the vascular walls, relaxation of the walls of the vessels, which leads to a gradual decrease in blood pressure without increasing the burden on the heart. On the contrary, the drug can reduce the load on the heart muscle, thereby positively affecting the patients' well-being, especially in post-infarction and post-stroke states.

The decrease in blood pressure is observed after 60-120 minutes after the use of Ramises and continues throughout the day. Peak efficacy occurs after 14-20 days of continuous treatment. The medicine does not need to be canceled gradually: there is no withdrawal syndrome.

[5], [6],

Pharmacokinetics

The main metabolic processes of the drug occur in the liver, resulting in the formation of ramiprilate. Ramipril is converted to the ether of diketopiperazine.

Ramiprilate becomes bioavailable when taken orally and can be approximately 45%. The substance is rapidly absorbed into the digestive system (at least 56% of the amount). The degree of absorption is not dependent on simultaneous ingestion. The peak plasma content is observed 60 minutes after the drug is used.

The half-life is also 60 minutes.

Limit level of ramiprilata in the bloodstream is found after 120-240 minutes after drug use.

The final stage of excretion of the drug is quite long: for example, after a single use of the drug at a dosage of 2.5 mg or more, the organism returns to its basal state after 4 days. At the course of treatment, the half-life can be from 13 to 17 hours.

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

Pharmacokinetic properties of Ramizes are not dependent on the age of the patient. Cumulation in the body does not occur.

Dosing and administration

The medication is used for internal reception. It is not recommended to chew and grind tablets.

The daily dosage is divided into one, less often by two doses. You can eat tablets before or after meals.

The length of the course of treatment and dosage is selected by the doctor.

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

In case of insufficient cardiac activity, Ramises is taken in the amount of 1.25 mg per day. If the resulting therapeutic effect is insufficient, the dosage can be doubled every 7-14 days. The limiting 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 times 2.5 mg per reception. It is necessary to monitor the patient's condition and, if necessary, to revise the dosage in one direction or another. Increase the dosage is carried out gradually, every three days. The limiting dosage is 10 mg per day.

In severe form of heart failure, the drug is used with caution, starting with as few tablets as possible.

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

Patients with nephropathy (related or not associated with diabetes) take 1.25 mg of the drug per day. It is not recommended to use such patients more than 5 mg Ramizes per day.

Elderly patients with a disorder of renal function (with creatinine clearance of 20-50 ml per minute) take Ramizez at a trial dosage of 1.25 mg per day. The limiting dose for such patients can not be more than 5 mg per day.

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

Do not initially take high doses of patients with persistent hypertension, disorders of water-salt metabolism, pathologies of peripheral circulation.

Patients who undergo hemodialysis should take the medicine 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 are not prescribed to women in the period of gestation. Moreover, before prescribing the medicine, the doctor must make sure that the patient does not have a pregnancy. During the course of treatment, patients are recommended to use contraceptives.

If a woman is planning a pregnancy, or she has already started, Ramisez treatment should be canceled, or replaced with another approved drug.

Ramisez active ingredient is found in breast milk, therefore, when prescribing the drug, breastfeeding should be stopped.

Contraindications

Ramizes are not used in the following cases:

• with a tendency to allergy to any of the components of the drug, as well as to drugs that inhibit the angiotensin-converting enzyme;
• with lactase deficiency and glucose-galactose malabsorption syndrome;
• with Quincke's edema in the past;
• with a narrowing of the arteries of the kidneys, with an imbalance of hemodynamics, with a lowered blood pressure;
• with hyperaldosteronism (primary form);
• during pregnancy and lactation;
• for the treatment of children;
• with severe kidney disease.

 The drug is administered with caution under the following conditions:

• hypertensive crisis;
• complicated CHD;
• narrowing of the aortic lumen;
• narrowing of the mitral valve;
• hypertrophic cardiomyopathy;
• disturbance of water-salt metabolism;
• 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 lowering of blood pressure;
• ischemia of the heart muscle, heart rhythm disorders, edema of the extremities, inflammatory processes in the vessels, vasospasms;
• renal function impairment, arthritis, diuresis, protein in the urine, high levels of creatinine and urea in the blood;
• dry "scratching" cough, inflammation of the bronchi, sinusitis, bronchospasm, asthma relapse;
• inflammatory processes of the oral mucosa, throat, digestive system;
• Dyspeptic phenomena, disorders of the stool, disorders of taste and olfactory sensations, impaired liver function;
• pain in the head, visual and auditory dysfunction, anxiety, sleep disorders, vestibular disorders, trembling in the limbs, inflammation of the conjunctiva, cerebral circulation and psychomotor reactions, reduced concentration of attention;
• allergic manifestations (rashes, itching of the skin, puffiness);
• increased sweating, increased sensitivity to ultraviolet rays, exacerbation of skin diseases, alopecia;
• cramps, pain in the muscles or joints;
• disorders of metabolic processes, emaciation, loss of appetite;
• eosinophilia, anemia, neutropenia, agranulocytosis, low hemoglobin and platelet count;
• chest pain, fatigue, apathy;
• decreased sexual desire, erectile dysfunction;
• swelling of mammary glands.

Overdose

Taking large amounts of Drugs can lead to excessive vasodilation, which will trigger a sharp drop in blood pressure until the collapse develops. Among other things, an overdose can cause a slowdown in heart rate, impaired kidney function and a water-salt metabolism disorder.

A special drug that neutralizes the effects of ramipril does not exist. When using large doses of the medicine, the stomach cavity is washed, after which sorbents (activated charcoal) are prescribed. In the disturbance of water-salt metabolism and a decrease in the volume of circulating blood, infusion solutions are added drip to replenish fluid in the body.

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

Do not use in an overdose of hemodialysis or forced diuresis, because of their questionable effectiveness in this situation.

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Interactions with other drugs

Therapeutic effect Ramizes can become more pronounced when combined with other pressure-reducing drugs, for example, with diuretics, antidepressants of the tricyclic structure, as well as preparations for anesthesia.

With the simultaneous treatment of Ramises and diuretics, there is a need to control the amount of sodium in the blood.

Sympathomimetics with vasoconstrictor properties when used together with Ramises lower the effect of the latter. When combined enrollment of listed medicines, it is important to monitor the blood pressure readings.

The probability of a hematologic reaction increases with combined administration of Ramises and immunosuppressants, cytostatics, glucocorticosteroids.

It is not recommended to use Ramises and lithium-containing agents, in view of the increased toxicity of the latter.

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

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Storage conditions

Remizes is recommended to be stored in darkened places with a temperature of no more than + 25 ° C, outside the children's access zone.

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Shelf life

Shelf life Ramises is indicated on the package to the drug and is one and a half years for tablets at a dosage of 1.25 mg, or 2 years for tablets of other dosages.