🐾 Vasotop R tablets 1.25 mg, 3 vials of 28 pcs.

Vasotop P is a hypotensive drug. The constituent of the drug, ramipril, is an angiotensin-converting enzyme (ACE) inhibitor which, by inhibiting angiotensin II synthesis, reduces its vasoconstrictor effect and stimulating effect on aldosterone secretion, and also inhibits bradykinin breakdown. Ramipril has no significant effect on renal blood flow (in some cases, it increases it) and on glomerular filtration rate. The drug does not cause development of compensatory tachycardia. The maximum hypotensive effect occurs 1 to 3 hours after taking the drug and lasts for 24 hours. At daily use of Vasotop P decrease in arterial pressure occurs gradually during 3 – 4 weeks and remains within physiological norm during the whole period of treatment. Abrupt withdrawal of the drug does not lead to a rapid increase in blood pressure. Vasotop P has cardioprotective effect due to ACE inhibition in myocardium and bradykinin accumulation, and also promotes the inverse development of myocardial hypertrophy in animals with arterial hypertension. After oral administration, ramipril is rapidly absorbed in an amount equal to at least 50-60% of the administered dose. Primary metabolism of ramipril occurs in liver. Ramipril derivative – ramiprilat – is formed. Ramiprilat is about 6 times more active inhibitor of ACE than ramipril. Binding to plasma proteins is 73% for ramipril and 56% for ramiprilat. After a daily single dose of Vasotop P, the steady-state plasma concentration of ramiprilat is reached by day 4. About 60% of the drug is excreted with urine and about 40% with feces (mainly as metabolites). With impaired renal function, excretion of ramipril and its metabolites slows down in proportion to the decrease in creatinine clearance. According to the degree of effect on the body of warm-blooded animals, Vasotop P is classified as a low-hazard substance.

Indications

Prescribed for dogs and cats in order to lower the pH level in the urine and remove crystals from the urinary tract due to the mild diuretic effect of the drug. Especially recommended for animals with an increased risk of disease – neutered, spayed, sedentary, obese.

Active ingredient

Ramipril

Composition

Vasotop P contains as an active ingredient ramipril and excipients: hypromellose, pregelatinized starch, microcrystalline cellulose, powdered beef flavoring, sodium stearyl fumarate, colloidal silicon anhydride and iron oxide.

Directions for use

Vasotop P is administered orally once a day, on an empty stomach. Initial therapeutic dose for dogs per day is 0.125 mg of the active substance ramipril per 1 kg of animal weight. Animals weighing more than 50 kg may be given a daily dose of the drug in two doses. After normalization of blood pressure the drug treatment shall be continued in half dose of the initial one. In animals with risk of hypovolemia, treatment with Vasotop R shall be started with half dose given during one week. Approximate calculation of the amount of the drug per animal:

If there is no reduction of blood pressure against the background of Vasotop P administration, simultaneous use of diuretics (except potassium-saving) in doses according to the instructions for use is allowed to enhance the therapeutic effect. In case of congestion in the lungs, two weeks after the start of the drug, the daily dose may be increased to 0.25 mg of ramipril per 1 kg of animal weight. The duration of the course of therapy shall be determined by the veterinarian.

Special Instructions

Animals with increased risk of developing excessive hypotension after the first dose, as well as after increasing the dose of the drug should be under close supervision of the veterinarian, especially during the first 2 weeks of treatment. If hypotension, ataxia, tachycardia, arrhythmia and angina develop, treatment with Vasotop R should be discontinued. Diuretics and diet with reduced sodium content enhance the effect of the drug, therefore, in order to avoid the development of severe hypotension accompanied by apathy, ataxia, fainting or acute renal failure, doses of diuretics should not be exceeded and diet with reduced sodium content should not be prescribed. Concomitant use with potassium-containing drugs is not recommended because it may lead to the development of hyperkalemia in the body.

Contraindications

Increased individual sensitivity to the drug components. Mitral valve stenosis, aortic stenosis, hypertensive cardiomyopathy, severe liver and kidney dysfunction. It is not recommended to use the drug in lactating and puppy animals.

Side effects

In some cases, against the background of the drug use the animal may experience side effects from the respiratory system (sinusitis, rhinitis, bronchospasm), gastrointestinal tract (nausea, dyspepsia, vomiting, diarrhea, constipation, dysphagia, loss of appetite), the nervous system (seizures, neuralgia, neuropathy, paresthesia, tremor). If side effects occur, use of Vasotop R should be discontinued and consult a veterinarian. Dosage in excess of 10 times (2.5 mg/kg animal weight) is normally tolerated by young animals. In rare cases there are signs of hypotension manifested as apathy and ataxia. If such symptoms occur, the prescribed treatment should be suspended until the animal’s condition stabilizes. After that the treatment is resumed in half dose. ACE inhibitor use in dogs with symptoms of hypovolemia and dehydration may lead to the development of acute hypotension. In such cases it is necessary to restore water-salt balance in the animal’s body and postpone use of Vasotop P until the condition stabilizes.