Among the diseases that can significantly reduce life expectancy and affect its quality, arterial hypertension stands apart. It develops gradually and gradually affects the vessels, brain, kidneys and myocardium. In the initial stages, it is difficult for the patient to recognize the disease, because it manifests itself with almost no complaints.
Later they appear, and the patient notes that his blood pressure is much higher than normal. This situation requires the initiation of pharmacological therapy, which is possible with the use of 5 classes of drugs. And "Ramipril" is the most perfect of them, guaranteeing the result in monotherapy or as part of a combined multicomponent treatment.
Systemic characteristics of the drug
"Ramipril", analogues of the drug, as well as complex drugs are antihypertensive drugs. Ramipril itself is an active ingredient that is found in many drugs. It is an ACE inhibitor that can block the enzyme and lower blood pressure. It can significantly improve the prognosis of the course of the disease in the elderly.
In clinicalStudies have shown that ramiprilat, the active metabolite of Ramipril, inhibits the angiotensin-converting enzyme much more strongly. Because of this, Ramipril, analogues and complex drugs are the drugs of choice for difficult-to-control hypertension.
Analogues
Since the drug is able to strongly block ACE and helps control high blood pressure, the drug "Ramipril" analogues are numerous. All of them have been successfully used in the treatment of hypertension. Moreover, the original ramipril is the drug "Tritace". All the rest are its generics, the effectiveness of which should be compared with it. Marketing authorization must be supported by bioequivalence to Tritace.
At the moment, the list of analogues is as follows: "Amprilan", "Vazolong", "Dilaprel", "Korpril", "Pyramil", "Ramepress", "Ramigamma", "Ramicardia", "Tritatse", "Hartil ". Ramipril is also produced by the Russian companies TatkhimPharmPreparaty, Biokom and Severnaya Zvezda. The latter's products are called Ramipril SZ.
Standard dosages and complex preparations
The antihypertensive drug Ramipril is easy to dose and take. Its activity allows us to distinguish three standard dosages of the drug. These are 2.5 mg, 10 and 5 mg. Tablets of this mass are taken twice a day. There are also complex drugs containing ramipril and hydrochlorothiazide: Amprilan ND, Amprilan NL, Vasolong N, Remazid, Triapin, Tritace Plus, Hartil D, Egipress. Here, the amount of ramipril ranges from 2.5 mg to 10, and the dose of hydrochlorothiazide is from 12.5 to 25 mg in one tablet.
The second category of complex preparations is the combination of Ramipril and the calcium antagonist Amlodipine. An example of a drug is Egipress, which is available in two standard dosages: 10 mg of ramipril and 5 mg of amlodipine, as well as at a dose of 10/10 mg. In addition to this combination, there is another type of drug containing the ACE inhibitor Ramipril and the calcium antagonist Felodipine. This is Triapin, which contains 2.5 mg of ramipril and 2.5 mg of felodipine.
Provisions of instructions for use
In addition to the recommendations of the doctor, the patient should take into account the instructions for use. It contains information about indications, side effects, dosing and administration regimens, contraindications and precautions. Also attached to the drug "Ramipril" instructions for use explains the need to avoid alcohol in the treatment of hypertension.
Indications
"Ramipril", analogues of the drug and generics "Tritace" are shown at:
- essential hypertension;
- as part of complex multiclass therapy for chronicheart failure;
- diabetic and other clinical or subclinical nephropathy not associated with renal artery stenosis;
- with symptomatic arterial hypertension;
- for the prevention of myocardial infarction, reduction of mortality in patients with cardiac disease, and for the treatment of hypertension with a high total cardiovascular risk.
The main indication is arterial hypertension. This is the most common disease of middle and old age that requires correction. Also, the drug "Ramipril" or another ACE inhibitor should be prescribed to patients in the first 2-9 days from the most acute period of myocardial infarction. The dose of the drug should be the maximum tolerated even in the case when the patient does not suffer from hypertension. This is due to the powerful cardioprotective effects of ACE inhibitors.
Contraindications
The drug "Ramipril SZ" should not be used if there is a history of angioedema to any analogue of the drug, as well as in case of any allergic reaction that has developed on its reception. The appointment is contraindicated in the presence of hemodynamically significant stenosis of the arteries on both sides. If the stenosis is unilateral and both kidneys function normally in the patient, then the appointment is allowed with caution and under the control of GFR.
The drug "Ramipril" (5 mg or offered in any other dosage) is not used for hypotension below 90 mm Hg. Art. Also, the drug should not be used for hemodynamicsignificant stenosis of the aortic or mitral valve, with obstructive hypertrophic cardiomyopathy, primary hyperaldosteronism, chronic renal failure with a creatinine clearance (GFR) less than 20 ml/min.
The instructions for use attached to the drug "Ramipril" (there are no analogues of this documentation) contain an indication of the impossibility of using the drug during pregnancy and lactation. It is also unacceptable to use medicine for children. Under 18 years of age, clinical experience is limited and cannot confirm safety.
Dosing regimens
The main dosage form of Ramipril is tablets. In capsules, it is less common. The recommended starting dose is 1.25 mg. The smallest dosage of the drug is 2.5 mg, which forces it to be divided in two. The presence of the line on the tablet makes it easy.
For any form of hypertension, the initial dose is 1.25 mg once a day. Then, with good tolerance, the dose is gradually doubled. Dose titration is carried out until the blood pressure indicator stabilizes. The criterion for effective treatment of hypertension is a constant blood pressure that rarely rises at rest.
Precautions
The drug should be taken under pressure control, especially when initially prescribed. It is important that systolic blood pressure falls below 90 mm. rt. Art. When blood pressure falls below this level, it is recommended to seek the help of medical staff. FROMin order to prevent falls in blood pressure, it is not recommended to use Ramipril together with nitrates, class I antiarrhythmics (Procainamide) and alpha-1 blockers (Alfuzosin, Tamsulosin).
The drug should be taken regularly and preferably at the same hour. This allows the adaptation of the renin-angiotensin-aldosterone system, which regulates blood pressure. Also, do not skip medications, which can be expressed in severe hypertensive crises. Abrupt withdrawal can cause strokes, the risks of which increase during this period.
Reviews of patients about the drug
Tritace and its generics are quality drugs that control blood pressure well. To date, this medicinal substance is the most powerful antihypertensive agent. Due to this, patient reviews about him are generally positive. They characterize it as a reliable and strong drug that controls blood pressure well. Reviews of those patients who have previously taken other drugs in this group are especially important.
Patients report a small number of adverse reactions associated with toxicity. A high degree of affinity for ACE, as well as a low dose of the drug, neutralize a number of metabolic effects that are potentially undesirable with constant use. It is important that the number of crises against the background of the constant use of "Ramipril" is significantly reduced. However, their complete elimination is not possible with monotherapy.
Reviews of doctors about the drug
Hypertension statistics are depressing. It confirms the importance of this disease for modern medicine. It is also important that pathology significantly reduces life expectancy. Hypertension develops due to overproduction of renin, which increases the amount of angiotensin in the blood. Inhibition of this enzyme leads to a decrease in pressure. This is necessary to prevent sclerosis of the vascular wall and the appearance of formidable complications of hypertension.
As shown in retrospective clinical studies, many atrial fibrillations and cases of coronary heart disease develop after the patient has had hypertension for some time. Therefore, the importance of its treatment is enormous. And more importantly, it is the ability to eliminate the disease thanks to the drugs of the ACE inhibitor group. Among them, Ramipril is the strongest and most effective so far.
Reviews of doctors about it prove its benefits. The drug is easy to use, has few side effects and is quite effective. However, despite these qualities, it may not be enough to treat severe hypertension. This is almost 40-50% of clinical cases.
They require a combination regimen consisting of an ACE inhibitor, a diuretic, a calcium antagonist and sometimes a beta blocker. As an angiotensin-converting enzyme inhibitor, Ramipril is well suited. Therefore, it can take its place in the treatment of hypertension whenever it is permissible. Although many patients will find it disadvantageous, its comparatively highcost.
