Charter

Description overdue on 10/16/2014

• Latin name: Hartil
• ATC code: C09AA05
• Active substance: Ramipril (Ramiprilum)
• Manufacturer: EGIS Pharmaceuticals PLC (Hungary)

Photos of the drug

Tweet

• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• Instructions for application of the Charter (method and dosage)
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Analogs
• Reviews
• Price, where to buy

Composition

The drug as an active constituent contains ramipril .

Additional components: sodium stearyl fumarate, pregelatinized starch 1500 yellow iron oxide, sodium hydrogen carbonate, lactose monohydrate, sodium Valium. In addition, 5 mg tablets are composed of iron oxide red.

Product form

This preparation is produced in the form of tablets for oral   use. Each blister contains 7 tablets.

Pharmacological action

Antihypertensive   medicine.

Pharmacodynamics and pharmacokinetics

The main substance of the preparation affects the ACE That circulates in the blood and stored in tissues. This means inhibits the action ACE , So that there hypotensive   effect without a compensatory increase Heart Rate , Reduced levels Angiotensin II   and aldosterone And increases plasma renin activity.

Ramipril   also reduces PR   and the level of pressure in the pulmonary capillaries, increases tolerance to stress and cardiac output.

In the long course of the drug leads to regress myocardial hypertrophy   when hypertension . It also reduces the likelihood of Arrhythmia   at myocardial reperfusion , Prevents decay bradykinin It activates blood circulation ischemic myocardium It improves the formation of nitric oxide endothelium . In acute myocardial infarction   the tool prevents re heart attack   and Development Necrosis It improves vital signs.

Hart has cardioprotective   and angioprotective   action activates the processes of dissolving blood clots in the walls of blood vessels and cholesterol plaque causes an increase in the level of fibrinogen Decreases aggregation Platelet .

The action of the drug begins after 60-120 minutes oral   application. The maximum concentration observed after 4-5 hours and left for the day. Thus, when taken regularly high concentration of active substance is maintained constant. Thus in patients with Heart Failure   and problems in the liver content ramipril   Blood above.

Efficacy of the drug is not dependent on age. He is well absorbed   from the gastrointestinal tract. Eating does not have to bioavailability   significant effect, but it may slow the absorption of the active substance. Bioavailability   - About 50%.

The drug is biotransformed in the liver to form metabolites . Excreted in the urine and faeces in the form metabolites   and unchanged.

Indications

Indications for use of this tool are:

• arterial hypertension ;
• diabetic nephropathy ;
• diffuse chronic kidney disease;
• the need to reduce the risk of myocardial infarction " coronary death "People with CHD ;
• heart failure   after acute myocardial infarction   in stable hemodynamics ;
• chronic heart failure ;
• the need to reduce the risk of stroke   in people with CHD .

With hypertension   It may also be applied Hart Amlo When to go to the drug arterial pressure   controlled simultaneous use ramipril   and amlodipine   at the same doses as in the preparation.

Contraindications

This tool can not be used when:

• hypersensitivity to its components;
• systemic lupus erythematosus ;
• renal failure ;
• kidney transplantation;
• abnormal blood electrolyte balance;
• primary hyperaldosteronism ;
• pregnancy ;
• breast-feeding ;
• angioedema   at history   the use of ACE inhibitors ;
• of decreased hematopoiesis in bone marrow;
• renal artery stenosis ;
• severe violations of the liver;
• children under 15 years.

Be wary of the Charter should be people with diabetes As well as patients in the elderly.

Side effects

Adverse reactions in the use of the funds are as follows:

• CCC - orthostatic hypotension , Lowering blood pressure, tachycardia . Excessive decrease in blood pressure may occur Cerebral ischemia   and myocardial ischemia ;
• CNS - drowsiness . headache , Weakness, nervous excitability, anxiety , muscle spasm, paresthesia . dizziness . tremor Changes in mood;
• digestive system - nausea, diarrhea , Pain in the epigastric , Thirst, stomatitis . pancreatitis , Vomiting, constipation , Dry mouth, blunting appetite, hypersensitivity or inflammation buccal mucosa;
• allergy - rash, hives . photosensitization . itch . conjunctivitis ;
• urogenital system - symptoms proteinuria , Reduced urine volume, renal failure ;
• senses - a violation of smell, sight and other senses, tinnitus, vestibular disorders;
• respiratory system - the "dry" cough, shortness of breath, rhinitis . bronchitis . bronchospasm . rhinorrhea . sinusitis ;
• Forming Organs - anemia . thrombocytopenia . neutropenia . pancytopenia , Reduced erythrocyte . leukopenia , Reduction of the concentration Hemoglobin   and hematocrit . agranulocytosis . hemolytic anemia , Bone marrow depression;
• laboratory parameters - hypercreatininemia . hyperkalemia , Increased activity of "liver" transaminases . hyperbilirubinemia , Increased BUN, hyponatremia ;
• Other - convulsions, hyperthermia . alopecia , Increased sweating.

In rare cases are possible: arrhythmia , Circulatory disorders of organs due to narrowing of blood vessels, hepatitis Problems in the liver with the advent hepatic insufficiency . cholestatic jaundice . angioedema . arthralgia , Multiforme exudative erythema . pemphigus . oniholizis . myositis . eosinophilia . e ksfoliativny dermatitis . Lyell's syndrome . serositis . vasculitis . myalgia . arthritis Increase antinuclear factor .

Instructions for application of the Charter (method and dosage)

For those who are appointed pills Hart, instructions for use reported that they should be taken regardless of meals. It is advisable to drink some of the water means, with the swallow follows not liquid. Time of therapy and dose are selected for each patient individually specialist.

Generally, depending on the diagnosis assigned the following dosage schedule:

• congestive heart failure   - At the beginning of the dosage rate is usually 1 to 25 mg once a day, then every 2-3 weeks, it is possible to gradually increase;
• arterial hypertension   - Accepted dosage of 2, 5 mg once a day, then it can be gradually increased every 2-3 weeks by observing the condition of the patient, until the desired therapeutic effect. Maintenance dose is usually 2, 5-5 mg / day. If you need more than 5 mg, better complement other course Hart antihypertensive drug as might otherwise develop undesirable side reactions. The medicament often combine with calcium channel blockers   or diuretics ;
• heart failure   after Acute myocardial infarction   - Take 1, 25-2, 5 mg 2 times a day, then it may be necessary to increase at 5 mg 2 times during a day. The course is better to start no earlier than the day after Acute myocardial infarction ;
• the need to prevent myocardial infarction   and stroke   - Accepted dosage 2 mg for 5 days a week and then it can be doubled, and after 3 weeks to reach 10 mg;
• Diabetic   and non-diabetic nephropathy   - Take 1, 25 mg / day, then it is possible to increase every 2-3 weeks until the desired therapeutic effect. But it is not desirable to take more than 5 mg / day;
• need to prevent circulatory disturbances - supporting dose of 10 mg per day.

Instructions for application of the Charter specifies that for any diagnosis of maximum daily dose should not exceed 10 mg. But in the case of   renal failure   the maximum dose - 5 mg, and for people with severely impaired liver function - 2, 5 mg.

When combined with diuretics   initial dose in most cases 1, 25 mg, as the need for ramipril   below.

Overdose

When used in high doses, the drug can: acute renal failure , A significant decrease in blood pressure, bradycardia , Disruption of water and electrolyte balance, a state of shock.

In the case of mild overdose administered gastric lavage, and the use of sodium sulfate and adsorbents .

At the use of the drug in dosage, significantly higher than the norm, it is necessary to conduct monitoring and maintenance of vital functions of the body in the intensive care. In the event of a significant reduction in blood pressure is necessary to enter catecholamines   and Angiotensin II . The patient should lie on sppine with the sublime position of the legs. Possibly additional introduction of fluid and sodium.

Cooperation

Diuretics And the means oppressive central nervous system, and antihypertensive   drugs increase antihypertensive effect   Hart.

Antihypertensive   action of the tool is reduced when combined with nonsteroidal   anti-inflammatory drugs, the funds available as part of Estrogens . NSAIDs   and kitchen salt. If such interaction inevitably requires strict monitoring of the patient by a specialist.

At the use of drugs that increase the levels of potassium in the blood, as well as Cyclosporine   and milk together with the possible emergence of Hartilom hyperkalemia . And in case of the combination of this agent with myelosuppressive   The drug increases the chance of developing neutropenia   and agranulocytosis , Possibly fatal.

In addition, the Charter increases levels of lithium in blood in the joint use of a lithium-containing medicines and reduces the level of glucose in the blood when combined with hypoglycemic   means.

When applying this medication with Alopurinolom . Procainamide . immunosuppressants   and cytostatics   It increases the likelihood of leukopenia . In conjunction with ethyl alcohol ramipril   increases its depressing effect on the central nervous system.

Terms of sale

The preparation is available in pharmacies by prescription only specialist.

Storage conditions

Charter should be kept at room temperature in a dry place.

Shelf life

Two years from the date of manufacture.

Analogs Hart

Match code ATC 4th level:

• Monopril
• Renitek
• Fozikard
• Amprilan
• Ramipril
• Perindopril
• Prestarium
• Perineva
• Capoten
• Berlipril
• Akkupro
• Diroton
• Enap
• Enalapril

Analogs of the Charter in the pharmacies you can find the following:

• AMF ;
• Angira ;
• Evroramipril 10 ;
• Evroramipril 5 ;
• Ramag ;
• Rami Sandoz ;
• Ramigeksal ;
• Ramizes ;
• Ramimed ;
• Ramira ;
• Tritatse .

All of them have different costs. Price analogues varies depending on the manufacturer and the form of drugs. As a rule, the cost is somewhat lower than for the dosage form and release Hartilu. Is more expensive only AMF Producing in Slovenia.

Reviews Hartile

Reviews Hartile forums mostly positive. Patients say his performance. They write that this tool is effective even at very high blood pressure.

Price Hart, where to buy

Charter Price may vary depending on the release form. Thus, the cost of tablets of 10 mg on average - about 350 rubles. And the price of the Charter in tablets of 5 mg - about 270 rubles.

Get the best price and buy