Hartil, tablets 5 mg 28 pcs

Hartil is an antihypertensive drug, an ACE inhibitor. As a result of suppression of ACE activity (regardless of plasma renin activity), a hypotensive effect is developed (in the prone and standing position) without a compensatory increase in HR. Suppression of ACE activity increases plasma renin activity and decreases angiotensin II and aldosterone levels. Ramipril acts on ACE circulating in blood and in tissues, including the vascular wall. It decreases OPPS (post-load), pulmonary capillary pressure (preload), increases cardiac output and increases exercise tolerance.

Indications

Hypertension (high blood pressure), Heart failure, Edema, Prevention of heart attacks and strokes, Kidney disease, Shortness of breath – Arterial hypertension.
– Chronic heart failure.
– Chronic heart failure after acute myocardial infarction in patients with stable hemodynamics.
– Diabetic nephropathy and chronic diffuse kidney diseases (nondiabetic nephropathy).
– In order to reduce the risk of myocardial infarction, stroke or coronary death in patients with high cardiovascular risk with CHD, including patients who had myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass surgery.

Active ingredient

Ramipril

How to take, the dosage

Tablets should be taken orally, swallowed whole, without chewing, with plenty of fluid (about 1 cup). Tablets can be taken regardless of the time of meals. The dose is set individually, taking into account the therapeutic effect and tolerability.

Interaction

Simultaneous use of Hartil with allopurinol, corticosteroids, procainamide, cytostatics and other substances that cause changes in the blood increases the risk of disorders of the hematopoietic system.

Special Instructions

Regular medical monitoring is necessary during treatment with Hartil. After the first dose, as well as when increasing the dose of diuretic and/or Hartil, patients should be under medical supervision for 8 hours to avoid the development of uncontrolled hypotensive reaction; repeated measurement of BP is recommended. If possible, dehydration, hypovolemia, decreased red blood cell count should be corrected before starting the drug. If these disorders are severe, ramipril should not be started or continued until measures to prevent an excessive drop in BP and impaired renal function are taken.

Contraindications

– History of angioedema, including that associated with prior therapy with ACE inhibitors.
– Hemodynamically significant bilateral stenosis of the renal arteries or stenosis of the artery of the single kidney.
– Arterial hypotension or unstable hemodynamics.
– Pregnancy.
– Lactation period (breastfeeding).
– Primary hyperaldosteronism.
– Renal insufficiency (CK – Hypersensitivity to ramipril or any other component of the drug.
Caution is used in:
– Hemodynamically significant aortic or mitral stenosis (risk of excessive BP reduction with subsequent renal dysfunction).
– Severe primary malignant arterial hypertension.
– Severe coronary and cerebral artery lesions (risk of decreased blood flow with excessive BP reduction).
– Unstable angina.
– Severe ventricular rhythm disorders.
– Terminal stage of CHF.
– Decompensated pulmonary heart.
– In diseases that require prescription of GCS and immunosuppressants (no clinical experience) – Including systemic connective tissue diseases.
– Severe renal and/or hepatic insufficiency.
– Hyperkalemia.
– Hyponatremia (including against the background of diuretics and sodium-restricted diet.)
– Initial or expressed manifestations of fluid and electrolyte deficiency, states accompanied by decreased blood circulation (including diarrhea and vomiting), diabetes.
– Inhibition of bone marrow hematopoiesis.
– The state after kidney transplantation.
– In elderly patients.
– In children and adolescents under the age of 18 years (efficacy and safety has not been established).
There is only limited experience with ramipril in patients on dialysis.

Side effects

Cardiovascular system: BP decrease, orthostatic hypotension, tachycardia; rarely – arrhythmia, increased blood supply disorders of organs caused by blood vessel narrowing. In excessive BP reduction, mainly in patients with CHD and clinically significant cerebral vasoconstriction, myocardial ischemia (angina or myocardial infarction) and cerebral ischemia (possibly with dynamic cerebral circulation disorder or stroke) may develop.

Urogenital system disorders: development or exacerbation of renal failure, exacerbation of existing proteinuria, decrease in urine volume (at the beginning of the drug).

CNS disorders: dizziness, headache, weakness, somnolence, paresthesias, nervous excitability, restlessness, tremor, muscle spasm, mood disorders; when used in high doses – insomnia, anxiety, depression, confusion, fainting.

Sensory organs: vestibular disorders, disorders of taste (e.g. metallic taste), smell, hearing and vision, tinnitus.

Digestive system disorders: nausea, vomiting, diarrhea or constipation, epigastric pain, dry mouth, thirst, decreased appetite, stomatitis, hypersensitivity or mucous membrane inflammation of the cheeks, pancreatitis; rarely – hepatitis, cholestatic jaundice, liver function disorders with development of acute liver failure.

Respiratory system disorders: “dry” cough, bronchospasm (in patients with increased cough reflex), shortness of breath, rhinorrhea, rhinitis, sinusitis, bronchitis.

Allergic reactions: skin rash, pruritus, urticaria, conjunctivitis, photosensitization; rarely – angioedema of the face, extremities, lips, tongue, pharynx or larynx, exfoliative dermatitis, erythema multiforme exudative (including Stevens-Johnson syndrome).Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), pemphigus, serositis, onycholysis, vasculitis, myositis, myalgia, arthralgia, arthritis, eosinophilia.

Hematopoietic organs: anemia, decreased hemoglobin and hematocrit concentrations, thrombocytopenia, leukocytopenia, neutropenia, agranulocytosis, pancytopenia, hemolytic anemia; decrease of erythrocyte number, bone marrow depression is possible.

Overdose

Symptoms: marked BP decrease, bradycardia, shock, water-electrolyte imbalance, acute renal failure.

Similarities

Tritace, Amprilan, Ramipril, Vazosan, Vazotop R – vet.