Arterial hypertension is the scourge of the modern population of the planet. A number of adverse external factors, poor ecology, constant stress, poor quality and irregular nutrition create the preconditions for the development of cardiovascular pathology and the emergence of this formidable disease.
Modern pharmacy seeks to create drugs that, if they do not completely cure a person of hypertension, then at least keep blood pressure under control, thereby minimizing the risk of developing myocardial infarctions and strokes.
At present, antihypertensive drugs such as Hartil, analogues of this drug, which have been developed quite a lot, are in great demand among consumers.
Khartil
The manufacturer of the drug "Hartil" is the Hungarian company EGIS Pharmaceuticals PLC. Consumers are presented with three varieties of this medication: Hartil, Hartil D and Hartil Amlo.
The main active ingredient of "Hartil" is the substance ramipril. The fundamental indications for the use of this drug is the presence in a person of such diseases as arterial hypertension, diabetic nephropathy, diffuse kidney diseases of a chronic nature. In addition, "Hartil" instructions for use (analogs in most cases will also give a positive effect) recommends using to reduce the likelihood of developing myocardial infarction, "coronary death", strokes in people suffering from coronary artery disease (ischemic heart disease). It is also practiced to prescribe "Hartil" to those who suffer from cardiac insufficiency in its chronic stage and developed after the patient has suffered an acute myocardial infarction (a prerequisite for using "Hartil" - stable hemodynamic parameters).
The drug "Khartil D" (analogues for the effects are available) consists of two active ingredients - ramipril and hydrochlorothiazide. The first component reduces elevated blood pressure, thereby reducing the load on the heart. The second substance is a diuretic that stimulates the process of excretion of s alts and water through the kidneys, and, like ramipril, lowers blood pressure. Thus, Hartil D is prescribed for the treatment of hypertension in cases where complex treatment with ACE inhibitors and diuretics is indicated.
The antihypertensive drug "Hartil Amlo" (analogues in composition and effect are produced by modern pharmacy) contains two main substances - ramipril and amlodipine. The appointment of this medication is practiced for the treatment of arterial hypertension in those patients in whom the parallel administration of ramipril and amlodipine has a positive effect both individually and in combination.
Ramipril-C3
The drug "Ramipril-C3" is an analogue of "Khartil" of Russian production. Produced in Moscow by the company "Northern Star". The main active ingredient is ramipril. The excipients are magnesium stearate and lactose monohydrate.
The drug is prescribed for people with diagnoses such as arterial hypertension, heart failure (chronic form and developed after acute myocardial infarction).
In such diseases, a prerequisite for the appointment of "Ramiplil-C3" is stable hemodynamic parameters. Also an indication for taking this analogue of Hartil tablets is the presence of diabetic and non-diabetic nephropathy in the patient. With the expected good result, "Ramipril-C3" is prescribed to people after surgery for transluminal coronary angioplasty and coronary artery bypass grafting (if the patient's clinical condition is stable).
As contraindications for taking this medication are individual hypersensitivity to the main or auxiliary components of the drug, a history of information about previously transferred angioedema, provoked by ACE inhibitor medications. Ramipril-C3 is contraindicated in patients who have not reached18 years of age, because there is no information about its safety and effectiveness.
Dilaprel
The antihypertensive drug "Dilaprel" is presented on the pharmaceutical market as the Russian analogue of "Khartil". The main active ingredient is ramipril. Auxiliaries are calcium stearate and colloidal silicon dioxide.
Indications for the use of this medication: patients with diseases such as essential hypertension, chronic heart failure (in combination with other medicines, in particular diuretics).
The practice of prescribing the drug for nephropathy (diabetic, non-diabetic), including when combined with proteinuria, hypertension. Prescribed to receive "Dilaprel" and in cases where a few days (2-9 days) after acute myocardial infarction develops cardiac failure.
The medicine gives good results in those patients whose he alth condition is characterized by a high cardiovascular risk (sudden development of acute myocardial infarction, stroke).
Reasons for not prescribing this analogue ("Hartil" is characterized by almost the same contraindications) are considered to be a history of angioedema, hemodynamically significant stenosis of the renal arteries, stenosis of the aortic or mitral valves, arterial hypotension (low blood pressure), renal insufficiency and the need for hemodialysis. Dilaprel is not allowed to be taken by patients withinsufficiency of cardiac activity in a chronic form in the stage of decompensation and in the presence of nephropathy. In the acute stage of a heart attack, the drug is not prescribed for unstable angina pectoris, cor pulmonale, and for serious ventricular arrhythmias.
Vazolong
This analogue ("Hartil" has the same main active ingredient - ramipril) has the following indications for use: hypertension (arterial, refractory, malignant, vasorenal), nephropathy (diabetic and developing on the background of chronic diffuse renal diseases).
Has a cardioprotective effect and significantly reduces platelet aggregation. The drug increases the sensitivity of tissues to insulin. The hypotensive effect is felt one and a half hours after taking the medication, the maximum effect is achieved after 5-9 hours, the duration of exposure is up to 24 hours.
From the main contraindications for the use of this drug, one can single out hypersensitivity to the components (main and auxiliary) of the drug or to any other ACE inhibitors, the presence in the anamnesis of information about previously transferred angioedema, provoked by treatment with ACE inhibitors.
During pregnancy, it is contraindicated to take this remedy, as well as Hartil. Instructions for use, reviews (analogues of "Khartil", containing ramipril, cannot be prescribed to pregnant women), he alth workers are recommended to make sure that there is no pregnancy before starting treatment. If the patient becomes pregnant during therapy, the medication with ramipril should be immediately discontinued and some other method of treatment should be selected.
Amprilan
Amprilan, an ACE inhibitor, is also an analogue of Hartil, both in composition and in terms of its effect. The main active ingredient of the medication is ramipril. The auxiliary components are sodium bicarbonate, lactose monohydrate, croscarmellose sodium, starch.
Indications for the appointment of this drug in general are almost identical to the previously described "Vazolong", "Dilaprelu", Ramipril-C3 ": hypertension, chronic heart failure, nephropathy, a decrease in the likelihood of developing cardiovascular pathology.
The list of contraindications for the use of this drug is quite extensive. "Amprilan" is practically not prescribed to patients suffering from such serious diseases as bilateral renal artery stenosis in a hemodynamically significant form and stenosis of the artery of a single kidney, renal insufficiency, condition after kidney transplantation and hemodialysis. The drug should not be used in patients with the following heart problems: aortic and / or mitral stenosis, chronic heart failure (stage of decompensation), obstructive cardiomyopathy and arterial hypertension.
It is unacceptable for women to take medication during the period of bearing and breastfeeding. Contraindication is age under 18years.
Ramicardia
Analogues of the drug "Hartil" are currently quite tightly saturated the pharmaceutical market. Another well-known analogue is Ramicardia. Indications and contraindications for the drug are almost the same as those previously considered "Amprilan".
Before starting treatment with this drug, experts strongly recommend examining the condition of the kidneys, because depending on the state of these organs, an individual dose for therapy is selected (or the drug is completely abandoned). In the process of treatment with this remedy, which is almost identical to the Hartil medication, the instructions for use (analogues, almost all, can cause serious harm to the kidneys) recommend monitoring the state of the urinary system, electrolyte composition of the blood, the amount of renal enzymes and the picture of peripheral blood.
Those patients who have a deficiency of fluid, sodium, before starting to take "Ramicardia", it is necessary to eliminate all water and electrolyte abnormalities. During treatment with this drug, it is unacceptable to carry out hemodialysis using polyacrylonitrile membranes, because. there is a risk of developing anaphylactic reactions.
Ramigamma
Analogues of "Khartil" are widely used in Russia. Another such medication is called "Ramigamma". The main active ingredient is ramipril. Indications and contraindications are similar to those described above. Therapy with this remedy should be under the supervision of the attending physician.
After the first dose of "Ramigamma" is taken, or the dosage of the diuretic taken by the patient is increased, blood pressure should be measured as often as possible over the next 8 hours. This is necessary in order to prevent the development of an uncontrolled and rapid hypotensive reaction (drop in blood pressure). Patients suffering from serious diseases of the kidneys and the cardiovascular system require close attention.
In the process of treatment, it is necessary to control the level of leukocytes in order not to miss the moment of development of leukopenia.
"Hartil", analogues of this medication (including "Remigamma") should not be prescribed to those patients who are currently receiving desensitizing treatment (to reduce allergic manifestations to insect bites). Concurrent use of ACE inhibitors and sensitizers can cause a severe, life-threatening anaphylactic reaction of the body (respiratory failure, drop in blood pressure, vomiting, etc.)
Cardipril
Even one fairly well-known drug - an analogue of "Hartil" - "Kardipril". The active ingredient is ramipril. The main indications for the use of this medication are hypertension, congestive heart failure (as a component of complex therapy), nephropathy (including its initial stages), cardiac insufficiency after myocardial infarction.
Contraindications for the use of "Cardipril" are quite extensive. The medication should not be prescribed forthe presence of renal and hepatic insufficiency, with systemic lupus erythematosus, stenosis of the renal arteries, with hyperkalemia and hyponatremia, with oppression of bone hematopoiesis. Do not prescribe the drug during pregnancy, lactation and patients under 18 years of age.
With an overdose of Cardipril, severe hypotension (drop in blood pressure), renal failure, serious electrolyte abnormalities, and shock may develop. To eliminate the consequences, it is necessary to carry out constant monitoring and subsequent support of the main functions of the body. With a strong drop in pressure, you can enter an additional volume of sodium and fluid. Hemodialysis will not give any significant effect.
Tritatse
What else has an analogue of "Khartil"? Another drug widely known and used by patients is Tritace. The drug is produced in Germany and France. The main active ingredient is ramipril. Indications for use, as well as contraindications, are approximately similar to all previously described ACE inhibitor drugs. Treatment with Tritace usually takes a fairly long period, the duration of which is determined in each case by the attending physician.
Before you start therapy with this medication, you must make sure that there are no conditions such as hyponatremia and hypovolemia. In the event that the patient has previously taken any diuretic medications, they will have to be discontinued or at least reduced in their dosage 2-3 days before the start of treatment using Tritace.
After taking the first dose or increasing the volume of diuretics taken, medical staff must ensure that the patient's condition is carefully monitored for at least 8 hours. This is necessary in order to take appropriate measures in case of too rapid a drop in blood pressure.
If a patient has heart failure or a malignant form of arterial hypertension, it is permissible to start therapy using Tritace only in a hospital setting.
Throughout the entire period of treatment with this medication, it is necessary to monitor kidney function, the level of electrolyte concentration, hematological parameters (hemoglobin level, platelet count, leukocyte, erythrocyte count, leukocyte formula).
Expert opinion on ACE inhibitors
As with any serious drug, which can be attributed to Hartil and its best analogues, reviews by a cardiologist, a doctor of any other specialization or a patient can leave both positive and negative directions.
Most patients characterize Hartil itself and most of its analogues as very fast-acting drugs, effective even at very high blood pressure. The duration of exposure to drugs of this group also reaches 24 hours. Although prices for these drugs fluctuate greatly, not all drugs are available to a wide range of consumers.
There are, however, negative opinions about the drug"Hartil". Analogues, patient reviews are also sometimes characterized from the negative side. The reason is that all these drugs can cause the development of a whole bunch of side effects, some of which are quite severe. On this issue, medical professionals are in solidarity with their patients. Although the vast majority of medical professionals believe that such drugs have saved hundreds of lives and people really need them. The main thing is not to prescribe yourself medications of this level on your own and strictly follow the recommendations of your doctor.
