"Ramipril": analogues, reviews and instructions. Ramipril-C3

Among the diseases that can significantly reduce life expectancy and affect its quality, arterial hypertension alone stands apart. It develops gradually and gradually afflicts the vessels, the brain, the kidneys and the myocardium. At the initial stages the patient is difficult to recognize the disease, because it manifests itself practically without complaints.

Later they appear, and the patient notes that his blood pressure is much higher than normal. This situation requires the beginning 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 with monotherapy or as part of a combined multicomponent treatment.

System characteristics of the preparation

"Ramipril", analogues of the drug, as well as complex drugs are antihypertensive drugs. Ramipril itself is an active substance found in many drugs. It is an ACE inhibitor that can block an enzyme and lower blood pressure. It allows to significantly improve the prognosis of the course of the disease in the elderly.

In clinical studies, it has been proven that ramiprilate, the active metabolite of Ramipril, inhibits the angiotensin-converting enzyme much more strongly. Because of this, "Ramipril", analogs and complex preparations are the means of choice for difficultly controlled hypertension.

Analogues

Since the drug can strongly block ACE and helps control high blood pressure, Ramipril has many analogues. All of them are successfully used in the treatment of hypertension. And the original ramipril is the drug Tritace. All the rest - his generics, the effectiveness of which should be compared with him. Admission to sale must be confirmed by bioequivalence to the drug Tritace.

At the moment the list of analogs is as follows: Amprilan, Vazolong, Dilaprel, Korpil, Piramil, Rampepress, Ramigamma, Ramikardia, Tritats, Hartil. Ramipril is also produced by Russian companies TatkhimParmPreparaty, Biokom and Severnaya Zvezda. The production of the latter is called "Ramipril SZ".

Standard dosages and complex preparations

Anti-hypertensive medicine "Ramipril" is easy to dose and take. Its activity allows us to distinguish three standard dosages of the drug. This is 2.5 mg, 10 and 5 mg. Tablets of such mass are taken twice a day. There are also complex medicines containing ramipril and hydrochlorothiazide: Amprilan ND, Amprilan NL, Vazolong 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 ranges from 12.5 to 25 mg in one tablet.

The second category of complex preparations is a combination of Ramipril and a calcium antagonist - Amlodipine. An example of a medicine is "Egipress", which is available in two standard dosages: 10 mg of ramipril and 5 mg of amlodipine, and also at a dose of 10/10 mg. In addition to this combination, there is another type of drug that contains ACE inhibitor Ramipril and calcium antagonist Felodipine. This "Triapin", which contains 2.5 mg of ramipril and 2.5 mg of felodipine.

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, dosage and reception regimens, contraindications and precautions. Also attached to the preparation "Ramipril" instructions for use explains the need to refrain from drinking alcohol in the treatment of hypertension.

Indications

"Ramipril", analogues of the drug and generics "Tritace" are shown when:

• Essential hypertension ;
• In the complex multiclass therapy of chronic heart failure;
• Diabetic and other nephropathy at the clinical or subclinical stage, not associated with stenosis of the renal arteries ;
• With symptomatic arterial hypertension;
• For the prevention of myocardial infarction, to reduce the mortality of patients with cardiac diseases, as well as 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, requiring correction. Also, the drug "Ramipril" or another ACE inhibitor should be given to patients in the first 2-9 days from the acute period of myocardial infarction. The dose of the drug should be as tolerated as possible, even when the patient is not hypertensive. This is due to the potent cardioprotective effects of ACE inhibitors.

Contraindications

The drug "Ramipril SZ" should not be used in the presence of a history of angioedema in any analogue of the drug, as well as with any allergic reaction that has developed at its reception. Contraindicated appointment in the presence of hemodynamically significant stenosis of the arteries on both sides. If the stenosis is unilateral and the patient normally has both kidneys functioning, then the appointment is allowed with caution and under the control of the GFR.

The drug "Ramipril" (5 mg or suggested in any other dosage) is not used for arterial hypotension below 90 mm Hg. Art. Also, the drug should not be used for hemodynamically significant stenoses 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.

Attached to the preparation "Ramipril" instructions for use (analogues of this documentation are not available) contains an indication of the impossibility of using the drug in pregnancy and lactation. It is also unacceptable to use a medicine for children. Under the age of 18, experience in clinical use is inadequate and can not confirm safety.

Dosing Modes

The main medicinal form of the drug "Ramipril" is pills. In capsules, it is less common. The recommended initial dose is 1.25 mg. The smallest dosage of the drug is 2.5 mg, which makes it necessary to divide it in two. Having a line on the tablet makes it easy.

In any of the forms of hypertension, the initial dose is 1.25 mg once daily. Then, with good tolerability, the dose gradually doubles. Titration of the dose is carried out until the moment when the blood pressure index stabilizes. The criterion for the effective treatment of hypertension is a constant BP, which rarely rises at rest.

Precautionary measures

The drug should be taken under pressure control, especially with the primary purpose. It is important that systolic blood pressure should not drop below 90 mm. Gt; Art. If the blood pressure drops below this level, it is recommended that you seek help from medical personnel. In order to prevent BP falls, 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 you to adapt the renin-angiotensin-aldosterone system, which regulates blood pressure. Do not skip the medications, which can be expressed by severe hypertensive crises. Sharp refusal of admission can cause strokes, the risks of occurrence of which increase in this period.

Patients' comments about the drug

Tritace and its generics are quality drugs that control blood pressure well. To date, this drug is the most powerful antihypertensive drug. Due to this, the patients' reviews about him are generally positive. They characterize it as a reliable and strong drug that controls BP well. Especially important are the reviews of those patients who previously took other medications of this group.

Patients noted a small number of adverse reactions associated with toxicity. A high degree of affinity for ACE, as well as a small dose of the drug level a number of metabolic effects, potentially unwanted with constant use. It is important that the number of crises against the background of the continuous use of "Ramipril" is significantly reduced. However, their complete elimination is impossible with monotherapy.

Reviews of doctors about the drug

The statistics of hypertension is depressing. It confirms the significance of this disease for modern medicine. It is also important that pathology significantly reduces life expectancy. Hypertension develops due to hyperproduction of renin, which increases the amount of angiotensin of the blood. Inhibition of this enzyme leads to a decrease in pressure. This is necessary to prevent sclerosis of the vessel wall and the appearance of formidable complications of hypertension.

As retrospective clinical studies show, many atrial fibrillations and cases of coronary heart disease develop after the patient has had hypertension for some time. Therefore the importance of her treatment is enormous. And more importantly, it is the availability of the opportunity to eliminate the ailment due to the preparations of the ACEI group. Among them, "Ramipril" is still the strongest and most effective.

The doctors' comments about him prove its advantages. The drug is convenient in use, has few adverse reactions 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.

For their therapy, a combined regimen consisting of ACE inhibitors, a diuretic, a calcium antagonist, and sometimes a beta-blocker is required. As an inhibitor of the angiotensin-converting enzyme, "Ramipril" is well suited. Therefore, he can always take his place in the therapy of hypertension, whenever this is permissible. Although many patients will find it disadvantageous for its relatively high cost.