INDICATION AND USE
1. Mild to severe hypertension, where it may be used alone or in
combination with thiazide diuretics
2. Congestive heart failure
3. To reduce the risk of stroke, myocardial infarction and death from
cardiovascular events in patients with a history of cardiovascular
diseases
4. Proteinuric non-diabetic nephropathy
CONTRAINDICATION
Ramipril is contraindicated in patients who are hypersensitive to any
component of this product and in patients with a history of angioedema
related to previous treatment with a ACE inhibitor.
SIDE EFFECT
Ramipril is generally well tolerated. Dizziness, headache, fatigue and
asthenia are commonly reported side effects. Other side effects occurring
less frequently include symptomatic hypotension, cough, nausea, vomiting,
diarrhoea, rash, urticaria, oliguria, anxiety, amnesia, etc. Angioneurotic
edema, anaphylactic reactions and hyperkalemia have also been reported
rarely.
Warnings : Ramipril should be used with caution in patients with impaired
PREPARATIONS
renal function, hyperkalemia, hypotension, surgery/anesthesia and impaired
hepatic function.
DRUG INTERACTIONS
With Diuretics : Patients on diuretics, especially those in whom diuretic
therapy was recently instituted, may occasionally experience an excessive
reduction of blood pressure after initiation of therapy with ramipril. The
possibility of hypotensive effects with ramipril can be minimized by either
discontinuing the diuretic or increasing the salt intake prior to initiation of
treatment with ramipril. If this is not possible, the starting dose should be
reduced.
With Potassium Supplements and Potassium-sparing Diuretics : Ramipril can
attenuate potassium loss caused by thiazide diuretics. Potassium-sparing
diuretics (spironolactone, amiloride, triamterene, and others) or potassium
supplements can increase the risk of hyperkalemia. Therefore, if
concomitant use of such agents is indicated, they should be given with
caution, and the patient’s serum potassium should be monitored frequently.
With Lithium : Increased serum lithium levels and symptoms of lithium
toxicity have been reported in patients receiving ACE inhibitors during
therapy with lithium.
USE IN PREGNANCY
Pregnancy should be excluded before start of treatment with ramipril and
avoided during treatment. However, if pregnancy is detected, ramipril should
be discontinued as early as possible unless continued use is considered life
saving.
USE IN LACTATION
Ramipril should not be used during lactation.
USE IN PEDIATRIC PATIENTS
Safely and effectiveness in pediatric patients have not been established.
STORAGE CONDITION
Store at cool & dry place, Protect from light and moisture
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