Hydrohlorotyazyd | Ramazid N tablets 2.5mg + 12.5mg 30 pcs.
Special Price
$17.46
Regular Price
$26.00
In stock
SKU
BID825775
Release form
Tablets are white or almost white, flat, oval, with a notch on one side and marked 12.5.
Tablets are white or almost white, flat, oval, with a notch on one side and marked 12.5.
Release form
Tablets are white or almost white, flat, oval, with a notch on one side and marked 12.5.
Indications
Arterial hypertension (for patients which shows combination therapy).
Use during pregnancy and lactation
The drug is contraindicated during pregnancy and lactation.
Special instructions
Ramipril
At the beginning of treatment, renal function must be evaluated. It is necessary to carefully monitor renal function during treatment with ramipril, especially in patients with impaired renal function, with damage to the renal vessels (for example, clinically insignificant renal artery stenosis or hemodynamically significant stenosis of a single kidney artery) with heart failure.
The risk of hypersensitivity and allergic-like (anaphylactoid) reactions is increased in patients who are taking ACE inhibitors and undergoing hemodialysis using AN69 dialysis membranes. Similar reactions were detected during apheresis of low density lipoproteins using dextran sulfate, so when using ACE inhibitors, this method should be avoided.
During treatment with ramipril in patients with impaired renal function, especially with simultaneous treatment with diuretics, serum urea and creatinine levels may increase. In this case, treatment should be continued with lower doses of ramipril or discontinued. In patients with impaired renal function, the risk of hyperkalemia is increased.
In patients with impaired hepatic function, ramipril metabolism and the formation of an active metabolite may be slowed due to a decrease in the activity of “liver” enzymes. In this regard, the treatment of such patients should be started only under strict medical supervision.
Caution should be exercised when administering ramipril to patients on a low-salt or salt-free diet (increased risk of developing arterial hypotension). In patients with a reduced volume of circulating blood (as a result of diuretic therapy), during dialysis, with diarrhea and vomiting, symptomatic hypotension may develop.
Transient arterial hypotension is not a contraindication for continued treatment after stabilization of blood pressure. In case of repeated occurrence of severe arterial hypotension, the dose should be reduced or the drug should be discontinued.
In patients undergoing extensive surgery or receiving other hypotensive medication during general anesthesia, ramipril can cause blockade of the formation of angiotensin II due to the compensatory release of renin. If the doctor associates the development of arterial hypotension with the mechanism mentioned above, arterial hypotension can be corrected by an increase in blood plasma volume.
In rare cases, agranulocytosis, erythrocytopenia, thrombocytopenia, hemoglobinemia, or bone marrow suppression are observed during treatment with ACE inhibitors. At the beginning and during treatment, it is necessary to control the number of white blood cells to identify possible neutropenia / agranulocytosis. More frequent monitoring is recommended in patients with renal failure, with connective tissue diseases (e.g. systemic lupus erythematosus or scleroderma), and in patients taking medications that affect blood formation. The counting of blood cells should also be carried out when clinical signs of neutropenia / agranulocytosis and increased bleeding occur.
in patients with arterial hypertension treated with ramipril rarely increased serum potassium levels are observed. The risk of hyperkalemia increases with chronic heart failure, simultaneous treatment with potassium-sparing diuretics (spironolactone, amiloride, triamteren) and the appointment of potassium preparations.
When using ACE inhibitors during desensitizing therapy for aspen or bee venom, anaphylactoid reactions (e.g. arterial hypotension, shortness of breath, vomiting, skin rash) can occur, which can be life-threatening. Hypersensitivity reactions may occur with insect bites (e.g. bees or wasps). If it is necessary to carry out desensitizing treatment with bee or wasp venom, it is necessary to cancel ACE inhibitors and continue treatment with suitable drugs from other groups.
During treatment with Ramazide H, caution must be exercised when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions (dizziness is possible, especially after the initial dose of an ACE inhibitor in patients taking diuretic drugs). Patients are advised to refrain from driving and operating machinery until the response to treatment is clear.
Hydrochlorothiazide
To prevent K + and Mg2 + deficiency, potassium-sparing diuretics, K + and Mg2 + salts are prescribed. Regular monitoring of plasma potassium levels is required, glucose, uric acid, lipids and creatinine.
Composition
1 tab. - ramipril 2.5 mg, hydrochlorothiazide 12.5 mg.
Excipients: sodium carbonate, lactose monohydrate, croscarmellose sodium, pregelatinized corn starch, sodium stearyl fumarate.
Dosage and Administration
Inside. the dose is selected individually. The usual dose for adults is 1 tab. Ramazide H2.5 mg / 12.5 mg per day. If necessary, it can be increased to 1 tab. Ramazide H 5 mg / 25 mg.
In case of mild or moderate renal impairment (CC greater than 30 ml / min, serum creatinine approximately 3 mg / dl or 265 ?mol / l), the usual dose of the drug is recommended. With creatinine clearance less than 30 ml / min, the drug is not recommended.
Side effects of
Ramipril
From the cardiovascular system: decreased blood pressure, orthostatic hypotension, orthostatic collapse, tachycardia, rarely - arrhythmia, angina pectoris, myocardial infarction. From the genitourinary system: development or worsening of the symptoms of renal failure, proteinuria, decreased urine volume, decreased libido.
From the side of the central nervous system: cerebral ischemia, stroke, dizziness, headache, weakness, drowsiness, paresthesia, nervous irritability, anxiety, tremor, muscle spasm, mood disorders, when used in high doses - insomnia, anxiety, depression, confusion, fainting.
On the part of the sensory organs: vestibular disturbances, disturbances in taste (for example, metallic taste), smell, hearing and vision, tinnitus.
From the digestive system: nausea, vomiting, diarrhea or constipation, epigastric pain, intestinal obstruction, pancreatitis, hepatitis, cholestatic jaundice, impaired liver function with development of liver failure, dry mouth, thirst, decreased appetite, stomatitis, glossitis.
From the respiratory system: "dry" cough, bronchospasm, shortness of breath, rhinorrhea, rhinitis, sinusitis, bronchitis.
Allergic reactions: skin rash, itching, urticaria, conjunctivitis, photosensitivity angioedema of the face, limbs, lips, tongue, pharynx and / or larynx, exfoliative dermatitis, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell syndrome), pemphigus, serositis, onycholysis, vasculitis , myositis, myalgia, arthralgia, arthritis, eosinophilia.
Other: convulsions, alopecia, hyperthermia, increased sweating.
Laboratory indicators: hypercreatininemia, an increase in urea nitrogen, an increase in the activity of hepatic transaminases, hyperbilirubinemia, hyperkalemia, hyponatremia, and the appearance of antinuclear antibodies.
Effect on the fetus: impaired fetal function, decreased blood pressure in the fetus and newborns, impaired renal function, hyperkalemia, cranial bony hypoplasia, oligohydramnios, limb contracture, deformation of the skull bones, hypoplasia of the lungs.
Hydrochlorothiazide
On the part of the water-electrolyte and acid-base balance: the development of hypokalemia and hypochloremic alkalosis (dry mouth, increased thirst, cardiac arrhythmias, changes in mood and psyche, muscle cramps or pains, nausea, vomiting, weakness with hypochromia alkalosis may develop hepatic encephalopathy or hepatic coma), hyponatremia (confusion, convulsions, apathy, slowing of the thinking process, fatigue, irritability), hypomagnesemia (arrhythmias).
From the hemopoietic system: agranulocytosis, thrombocytopenia, hemolytic and aplastic anemia, leukocytopenia.
From the cardiovascular system: arrhythmia, orthostatic hypotension, tachycardia.
From the digestive system: cholecystitis, pancreatitis, jaundice, diarrhea, sialadenitis, constipation, anorexia, epigastric pain.
From the side of metabolism: hyperglycemia, glucosuria, hyperuricemia, exacerbation of gout.
Allergic reactions: skin rash, purpura, necrotic vasculitis, Stevens-Johnson syndrome, respiratory distress (pneumonitis, non-cardiogenic pulmonary edema), photosensitivity anaphylactic reactions (up to life-threatening anaphylactic shock).
Drug Interactions
Ramipril
Enhances the inhibitory effect of ethanol on the central nervous system. Taking salt with food can reduce the antihypertensive effect of ramipril.
With the simultaneous use of ramipril and other blood pressure lowering drugs (e.g. diuretics, nitrates, tricyclic antidepressants, anesthetics) leads to an increase in the hypotensive effect of ramipril.
The simultaneous administration of ramipril and potassium preparations or potassium-sparing diuretitis, it is necessary to control the concentration of lithium in the blood serum - the risk of toxic effects. Ik can cause hyperkalemia.
Vasopressor sympathomimetics (epinephrine, norepinephrine) may reduce the hypotensive effect of ramipril. In this regard, with simultaneous treatment, the level of blood pressure should be carefully monitored.
The simultaneous administration of ramipril and allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics increases the likelihood of changes in the peripheral blood picture.
The concomitant use of ramipril and lithium preparations leads to a decrease in excretion l
ACE inhibitors can enhance the effect of hypoglycemic agents (e.g. insulin or sulfonylurea derivatives), which in some cases can cause hypoglycemia. In this regard, the blood sugar level should be carefully monitored, especially at the beginning of joint use.
The simultaneous use of ramipril and non-steroidal anti-inflammatory drugs (eg, acetylsalicylic acid and indomethacin) can weaken the hypotensive effect of ramipril. Additionally, concurrent use can cause hyperkalemia and increase the risk of impaired renal function.
Concurrent use of heparin and ramipril can cause hyperkalemia.
Anaphylactic and anaphylactoid reactions to stinging venom insects (possibly other allergens) are more pronounced during treatment with ACE inhibitors.
Hydrochlorothiazide
The simultaneous use of digitalis glycosides with thiazide diuretics increases the likelihood of toxic effects of glycosides (including increased ventricular irritability) due to the possible development of hypokalemia and hypomagnesemia.
Drugs that intensively bind to proteins (indirect anticoagulants, clofibrate, NSAIDs) enhance the diuretic effect of hydrochlorothiazide.
The antihypertensive effect of hydrochlorothiazide is enhanced by vasodilators, beta-blockers, barbiturates, phenothiazines, tricyclic antidepressants, ethanol. Hydrochlorothiazide enhances the neurotoxicity of salicylates, weakens the effects of oral hypoglycemic drugs, norepinephrine, epinephrine and anti-gout drugs, enhances the cardiotoxic and neurotoxic effects of lithium preparations, the action of peripheral muscle relaxants, reduces the excretion of quinidine. With the simultaneous administration of methyldopa, hemolysis may develop. Colestyramine reduces the absorption of hydrochlorothiazide.
Hydrochlorothiazide reduces the effect of oral contraceptives.
Overdose
Symptoms: marked decrease in blood pressure, bradycardia, shock, imbalance in water-electrolyte, acute renal failure, stupor, dry mouth, weakness, drowsiness.
Treatment: give the patient a horizontal position with raised legs, in mild cases of overdose - gastric lavage, the introduction of adsorbents and sodium sulfate (it is advisable to carry out activities within the first 30 minutes after taking the drug). With a decrease in blood pressure - the on / in the introduction of catecholamines, angiotensin II with bradycardia - the use of a pacemaker. The drug is not excreted during hemodialysis.
Storage Conditions
At a temperature not exceeding 25 РC. Keep out of reach of children!
The Expiration of
is 3 years. The drug should not be used after the expiry date stated on the package.
conditions granted through pharmacies
In retseptu
Tablets are white or almost white, flat, oval, with a notch on one side and marked 12.5.
Indications
Arterial hypertension (for patients which shows combination therapy).
Use during pregnancy and lactation
The drug is contraindicated during pregnancy and lactation.
Special instructions
Ramipril
At the beginning of treatment, renal function must be evaluated. It is necessary to carefully monitor renal function during treatment with ramipril, especially in patients with impaired renal function, with damage to the renal vessels (for example, clinically insignificant renal artery stenosis or hemodynamically significant stenosis of a single kidney artery) with heart failure.
The risk of hypersensitivity and allergic-like (anaphylactoid) reactions is increased in patients who are taking ACE inhibitors and undergoing hemodialysis using AN69 dialysis membranes. Similar reactions were detected during apheresis of low density lipoproteins using dextran sulfate, so when using ACE inhibitors, this method should be avoided.
During treatment with ramipril in patients with impaired renal function, especially with simultaneous treatment with diuretics, serum urea and creatinine levels may increase. In this case, treatment should be continued with lower doses of ramipril or discontinued. In patients with impaired renal function, the risk of hyperkalemia is increased.
In patients with impaired hepatic function, ramipril metabolism and the formation of an active metabolite may be slowed due to a decrease in the activity of “liver” enzymes. In this regard, the treatment of such patients should be started only under strict medical supervision.
Caution should be exercised when administering ramipril to patients on a low-salt or salt-free diet (increased risk of developing arterial hypotension). In patients with a reduced volume of circulating blood (as a result of diuretic therapy), during dialysis, with diarrhea and vomiting, symptomatic hypotension may develop.
Transient arterial hypotension is not a contraindication for continued treatment after stabilization of blood pressure. In case of repeated occurrence of severe arterial hypotension, the dose should be reduced or the drug should be discontinued.
In patients undergoing extensive surgery or receiving other hypotensive medication during general anesthesia, ramipril can cause blockade of the formation of angiotensin II due to the compensatory release of renin. If the doctor associates the development of arterial hypotension with the mechanism mentioned above, arterial hypotension can be corrected by an increase in blood plasma volume.
In rare cases, agranulocytosis, erythrocytopenia, thrombocytopenia, hemoglobinemia, or bone marrow suppression are observed during treatment with ACE inhibitors. At the beginning and during treatment, it is necessary to control the number of white blood cells to identify possible neutropenia / agranulocytosis. More frequent monitoring is recommended in patients with renal failure, with connective tissue diseases (e.g. systemic lupus erythematosus or scleroderma), and in patients taking medications that affect blood formation. The counting of blood cells should also be carried out when clinical signs of neutropenia / agranulocytosis and increased bleeding occur.
in patients with arterial hypertension treated with ramipril rarely increased serum potassium levels are observed. The risk of hyperkalemia increases with chronic heart failure, simultaneous treatment with potassium-sparing diuretics (spironolactone, amiloride, triamteren) and the appointment of potassium preparations.
When using ACE inhibitors during desensitizing therapy for aspen or bee venom, anaphylactoid reactions (e.g. arterial hypotension, shortness of breath, vomiting, skin rash) can occur, which can be life-threatening. Hypersensitivity reactions may occur with insect bites (e.g. bees or wasps). If it is necessary to carry out desensitizing treatment with bee or wasp venom, it is necessary to cancel ACE inhibitors and continue treatment with suitable drugs from other groups.
During treatment with Ramazide H, caution must be exercised when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions (dizziness is possible, especially after the initial dose of an ACE inhibitor in patients taking diuretic drugs). Patients are advised to refrain from driving and operating machinery until the response to treatment is clear.
Hydrochlorothiazide
To prevent K + and Mg2 + deficiency, potassium-sparing diuretics, K + and Mg2 + salts are prescribed. Regular monitoring of plasma potassium levels is required, glucose, uric acid, lipids and creatinine.
Composition
1 tab. - ramipril 2.5 mg, hydrochlorothiazide 12.5 mg.
Excipients: sodium carbonate, lactose monohydrate, croscarmellose sodium, pregelatinized corn starch, sodium stearyl fumarate.
Dosage and Administration
Inside. the dose is selected individually. The usual dose for adults is 1 tab. Ramazide H2.5 mg / 12.5 mg per day. If necessary, it can be increased to 1 tab. Ramazide H 5 mg / 25 mg.
In case of mild or moderate renal impairment (CC greater than 30 ml / min, serum creatinine approximately 3 mg / dl or 265 ?mol / l), the usual dose of the drug is recommended. With creatinine clearance less than 30 ml / min, the drug is not recommended.
Side effects of
Ramipril
From the cardiovascular system: decreased blood pressure, orthostatic hypotension, orthostatic collapse, tachycardia, rarely - arrhythmia, angina pectoris, myocardial infarction. From the genitourinary system: development or worsening of the symptoms of renal failure, proteinuria, decreased urine volume, decreased libido.
From the side of the central nervous system: cerebral ischemia, stroke, dizziness, headache, weakness, drowsiness, paresthesia, nervous irritability, anxiety, tremor, muscle spasm, mood disorders, when used in high doses - insomnia, anxiety, depression, confusion, fainting.
On the part of the sensory organs: vestibular disturbances, disturbances in taste (for example, metallic taste), smell, hearing and vision, tinnitus.
From the digestive system: nausea, vomiting, diarrhea or constipation, epigastric pain, intestinal obstruction, pancreatitis, hepatitis, cholestatic jaundice, impaired liver function with development of liver failure, dry mouth, thirst, decreased appetite, stomatitis, glossitis.
From the respiratory system: "dry" cough, bronchospasm, shortness of breath, rhinorrhea, rhinitis, sinusitis, bronchitis.
Allergic reactions: skin rash, itching, urticaria, conjunctivitis, photosensitivity angioedema of the face, limbs, lips, tongue, pharynx and / or larynx, exfoliative dermatitis, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell syndrome), pemphigus, serositis, onycholysis, vasculitis , myositis, myalgia, arthralgia, arthritis, eosinophilia.
Other: convulsions, alopecia, hyperthermia, increased sweating.
Laboratory indicators: hypercreatininemia, an increase in urea nitrogen, an increase in the activity of hepatic transaminases, hyperbilirubinemia, hyperkalemia, hyponatremia, and the appearance of antinuclear antibodies.
Effect on the fetus: impaired fetal function, decreased blood pressure in the fetus and newborns, impaired renal function, hyperkalemia, cranial bony hypoplasia, oligohydramnios, limb contracture, deformation of the skull bones, hypoplasia of the lungs.
Hydrochlorothiazide
On the part of the water-electrolyte and acid-base balance: the development of hypokalemia and hypochloremic alkalosis (dry mouth, increased thirst, cardiac arrhythmias, changes in mood and psyche, muscle cramps or pains, nausea, vomiting, weakness with hypochromia alkalosis may develop hepatic encephalopathy or hepatic coma), hyponatremia (confusion, convulsions, apathy, slowing of the thinking process, fatigue, irritability), hypomagnesemia (arrhythmias).
From the hemopoietic system: agranulocytosis, thrombocytopenia, hemolytic and aplastic anemia, leukocytopenia.
From the cardiovascular system: arrhythmia, orthostatic hypotension, tachycardia.
From the digestive system: cholecystitis, pancreatitis, jaundice, diarrhea, sialadenitis, constipation, anorexia, epigastric pain.
From the side of metabolism: hyperglycemia, glucosuria, hyperuricemia, exacerbation of gout.
Allergic reactions: skin rash, purpura, necrotic vasculitis, Stevens-Johnson syndrome, respiratory distress (pneumonitis, non-cardiogenic pulmonary edema), photosensitivity anaphylactic reactions (up to life-threatening anaphylactic shock).
Drug Interactions
Ramipril
Enhances the inhibitory effect of ethanol on the central nervous system. Taking salt with food can reduce the antihypertensive effect of ramipril.
With the simultaneous use of ramipril and other blood pressure lowering drugs (e.g. diuretics, nitrates, tricyclic antidepressants, anesthetics) leads to an increase in the hypotensive effect of ramipril.
The simultaneous administration of ramipril and potassium preparations or potassium-sparing diuretitis, it is necessary to control the concentration of lithium in the blood serum - the risk of toxic effects. Ik can cause hyperkalemia.
Vasopressor sympathomimetics (epinephrine, norepinephrine) may reduce the hypotensive effect of ramipril. In this regard, with simultaneous treatment, the level of blood pressure should be carefully monitored.
The simultaneous administration of ramipril and allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics increases the likelihood of changes in the peripheral blood picture.
The concomitant use of ramipril and lithium preparations leads to a decrease in excretion l
ACE inhibitors can enhance the effect of hypoglycemic agents (e.g. insulin or sulfonylurea derivatives), which in some cases can cause hypoglycemia. In this regard, the blood sugar level should be carefully monitored, especially at the beginning of joint use.
The simultaneous use of ramipril and non-steroidal anti-inflammatory drugs (eg, acetylsalicylic acid and indomethacin) can weaken the hypotensive effect of ramipril. Additionally, concurrent use can cause hyperkalemia and increase the risk of impaired renal function.
Concurrent use of heparin and ramipril can cause hyperkalemia.
Anaphylactic and anaphylactoid reactions to stinging venom insects (possibly other allergens) are more pronounced during treatment with ACE inhibitors.
Hydrochlorothiazide
The simultaneous use of digitalis glycosides with thiazide diuretics increases the likelihood of toxic effects of glycosides (including increased ventricular irritability) due to the possible development of hypokalemia and hypomagnesemia.
Drugs that intensively bind to proteins (indirect anticoagulants, clofibrate, NSAIDs) enhance the diuretic effect of hydrochlorothiazide.
The antihypertensive effect of hydrochlorothiazide is enhanced by vasodilators, beta-blockers, barbiturates, phenothiazines, tricyclic antidepressants, ethanol. Hydrochlorothiazide enhances the neurotoxicity of salicylates, weakens the effects of oral hypoglycemic drugs, norepinephrine, epinephrine and anti-gout drugs, enhances the cardiotoxic and neurotoxic effects of lithium preparations, the action of peripheral muscle relaxants, reduces the excretion of quinidine. With the simultaneous administration of methyldopa, hemolysis may develop. Colestyramine reduces the absorption of hydrochlorothiazide.
Hydrochlorothiazide reduces the effect of oral contraceptives.
Overdose
Symptoms: marked decrease in blood pressure, bradycardia, shock, imbalance in water-electrolyte, acute renal failure, stupor, dry mouth, weakness, drowsiness.
Treatment: give the patient a horizontal position with raised legs, in mild cases of overdose - gastric lavage, the introduction of adsorbents and sodium sulfate (it is advisable to carry out activities within the first 30 minutes after taking the drug). With a decrease in blood pressure - the on / in the introduction of catecholamines, angiotensin II with bradycardia - the use of a pacemaker. The drug is not excreted during hemodialysis.
Storage Conditions
At a temperature not exceeding 25 РC. Keep out of reach of children!
The Expiration of
is 3 years. The drug should not be used after the expiry date stated on the package.
conditions granted through pharmacies
In retseptu
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