Composition
Tab/Cap 1.25 mg/2.5 mg/5 mg/10 mg: Ramipril1.25 mg/2.5 mg/5 mg/10 mg.
Indications & Dosage
Hypertension: Adult: Initially 1.25-2.5 mg once daily, increased if necessary up to 10 mg once daily, increased at intervals of 2-4 weeks. Symptomatic heart failure (adjunct): Adult: Initially 1.25 mg once daily, increased if tolerated to 10 mg daily in 2 divided doses, increase dose gradually at intervals of 1-2 weeks. Prophylaxis after myocardial infarction in patients with clinical evidence of heart failure (started at least48 hours after infarction): Adult: Initially 2.5 mg twice daily for 3 days, then increased to 5 mg twice daily, if initial dose not tolerated then 1.25 mg twice daily for 2 days, then increased to 2.5 mg twice daily, then increased to 5 mg twice daily, withdraw treatment if dose cannot be increased to 2.5 mg twice daily. Prevention of cardiovascular events in patients with atherosclerotic cardiovascular disease or with diabetes mellitus and an additional risk factor for cardiovascular disease: Adult: Initially 2.5 mg once daily for 1-2 weeks, then increased to 5 mg once daily for a further 2-3 weeks, then increased to 10 mg once daily. Nephropathy: Adult: Initially 1.25 mg once daily for 2 weeks, then increased to 2.5 mg once daily for a further 2 weeks, then increased if tolerated to 5 mg once daily. Children: Not recommended.
Contraindications
History of angioneurotic oedema, aortic stenosis, outflow obstruction.
Precautions
Congestive heart failure; initiate therapy in hos-pital. Hepatic impairment; initiate therapy under close medical supervision, haemodialysis, renal impairment; reduce dose and assess renal function prior to and during treatment.
Interactions
Antihypertensive agents, K+ sparing diuretics or K+ supplements, lithium.
Pregnancy
Contraindicated in pregnancy.
Lactation
Not recommended.
Side Effects
Bronchitis, dyspnea, muscle cramps, stomatitis, syncope, angina, anxiety, arrhythmias, chest pain, depression, dry mouth, flushing, myocardial infarction, nervousness, palpitations, peripheral oedema, sweating, tachycardia, visual disturbances. Rare: Confusion, conjunctivitis, impaired hearing, onycholysis, tinnitus, tremor