Ramimed

Ramide is a cardiovascular remedy aimed at regulating the blood pressure level. Refers to agents that affect the renin-angiotensin system.

Produced by the pharmaceutical companies Actavis Ltd and Medochemie Ltd.

Ramemed is a prescription medication, so you should consult a doctor before taking it. 

Indications Ramimed

• Preventive measures to prevent heart attack in patients with coronary heart disease.
• Increase in blood pressure.
• Chronic course of heart failure, among other things, after a heart attack in history.
• Nephropathy (all stages that depend or are not dependent on diabetes).

[1], [2], [3]

Release form

Ramide is produced in tablet form according to 1.25 mg, 2.5 mg, 5 mg and 10 mg, 30 pieces per pack.

Each tablet is an active component of ramipril, as well as additional substances: pregelatinized starch, sodium hydrogencarbonate, lactose, croscarmellose sodium, stearyl sodium fumarate, gelatin with dyes. 

[4], [5], [6], [7], [8]

Pharmacodynamics

An agent that stabilizes blood pressure, which inhibits ACE. The active component of the drug is able to inhibit the action of ACE, which indicates an increase in the vascular clearance and a decrease in pressure. The inhibition of ACE stimulates the activity of renin in the bloodstream, reduces the amount of angiotensin II and aldosterone. The action aimed at reducing the pressure is observed with a large and small level of renin in the bloodstream. The active ingredient has the property of inhibiting metabolic processes involving bradykinin.

Decrease in pressure is observed 1-2 hours after the use of the dose of the drug. The maximum effect is observed after 3-6 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.

Rapid cancellation of Ramide does not lead to a sudden and sudden increase in pressure indicators. 

[9], [10]

Pharmacokinetics

After ingestion, the active ingredient is well absorbed in the digestive tract: the peak amount of the drug in the blood is detected during the first hour. The average degree of absorption is determined in 56%, and this index is unchanged even in the presence of food masses in the stomach. The limiting amount of the active ingredient in the plasma is observed about 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 preparation.

With a single use of Ramemed, the active ingredient was not detected in the composition of breast milk. The degree of penetration into milk with regular use of tablets has not been studied. 

[11], [12], [13], [14], [15], [16], [17], [18],

Dosing and administration

The administration of Ramemed is carried out daily through the same periods of time. The tablet is swallowed in a whole state, without crushing or chewing, with a sufficient amount of liquid. Simultaneous eating does not affect the assimilation of the medication: 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 Ramide can be prescribed as an independent drug, or in combination with other antihypertensive drugs. The standard initial dosage assumes the use of 0.0025 g once a day. If necessary, the dosage is increased, doubling it once every 14-28 days. Alternatively, additional use of diuretics and calcium channel blocking agents 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, Ramemed'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. Further dosage is adjusted, taking into account the possible development of adverse events.

[27], [28], [29], [30]

Use Ramimed during pregnancy

The use of Ramemed in pregnancy is not recommended, due to the lack of reliable information about the effect of the drug on fetal development 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 Ramemed may include:

• excessive sensitivity to the active component of the drug, or to other ACE inhibitors;
• Quincke's edema in the anamnesis;
• arterial narrowing in one or two kidneys;
• complicated kidney failure or dysfunction;
• primary overestimated production of aldosterone;
• pregnancy and breastfeeding;
• childhood;
• tendency to low pressure;
• instability of hemodynamic parameters.

[19], [20], [21], [22], [23]

Side effects Ramimed

 Side effects Ramimed - not uncommon. They can manifest themselves with the following symptoms:

• an increase in the antinuclear factor, anaphylaxis;
• signs of arterial collapse, hypotonic fainting, ischemia of the heart muscle, violation of the heart rhythm, swelling of the limbs, weakening of perfusion pressure, inflammation and spasms of the vessels;
• in the analysis of the blood, signs of eosinophilia, neutropenia, agranulocytosis, lowering of hemoglobin and platelet counts;
• pain in the head, changes in the sensitivity of the limbs, dizziness, vestibular disorders, psychomotor disorders;
• mood instability, anxiety, sleep disorders, irritability;
• loss of vision clarity, inflammation of the conjunctiva;
• decreased auditory functions, tinnitus;
• dry cough, sinusitis, bronchospasm;
• inflammatory processes of the mucous membranes of the mouth and digestive tract, dyspeptic disorders, pancreatitis;
• changes in 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 symptoms, excessive sweating, dermatitis;
• pain and spasms in the muscles, tenderness of the joints;
• pain in the chest, a sense of fatigue.

[24], [25], [26]

Overdose

The symptomatology of Ramid's overdose is most often manifested in the excessive expansion and relaxation of peripheral vessels, which can be expressed in the following symptoms:

• hypotensive state, up to arterial collapse;
• slowing the frequency of cardiac activity;
• electrolyte exchange disorders;
• kidney dysfunction.

The condition of an overdose requires constant monitoring by a doctor. Use symptomatic and maintenance therapy: it is important to rinse the stomach in a timely manner, prescribe sorbents (activated charcoal, sorbex), funds for normalizing hemodynamics. Hemodialysis in this case is ineffective.

[31], [32], [33]

Interactions with other drugs

The combined use of antihypertensive, diuretics, opium preparations, anesthetics, tricyclics and antipsychotic medications can lead to an increase in hypotensive effect.

Combined reception 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.

Combined intake with potassium-containing drugs can lead to a marked increase in potassium levels in the blood serum.

It is not recommended to take Ramideed with lithium-containing products: this can increase the toxic effect of lithium.

If joint therapy with antidiabetic medications (including insulin) is carried out, then this may provoke an increase in hypoglycemic action.

Combined use with cytostatics, immunosuppressants, corticosteroid agents increases the risk of developing leukopenia.

Ramemed increases the effect of alcohol. 

[34], [35]

Storage conditions

Ramide is recommended to be stored in factory packaging at a temperature of +18 to + 25 ° C.

It is necessary to protect the medicine from direct UV radiation.

Keep medicines out of the reach of children. 

[36], [37]

Shelf life

Shelf life - up to 2 years.

[38], [39], [40], [41]