Ramacein 5 mg - 7 Tablet

Angiotensin-Converting Enzyme (ACE) Inhibitor used in the treatment of chronic hypertension, acute coronary syndrome, heart failure and proteinuric chronic kidney disease.

Administer with or without food.

-Increased blood urea nitrogen and increased serum creatinine, angioedema, a dry hacking-nonproductive cough that is typically associated with tickling or scratching in the throat and hyperkalemia. -Hypotension, cough, angina pectoris, orthostatic hypotension, syncope, hyperkalemia, diarrhea, nausea, vomiting, dizziness, fatigue, headache, vertigo, increased serum creatinine, renal insufficiency, edema, palpitations, symptomatic hypotension, diaphoresis, erythema multiforme, onycholysis, pemphigoid, pemphigus, skin photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, weight gain, abdominal pain, anorexia, constipation, dysgeusia, dyspepsia, dysphagia, gastroenteritis, pancreatitis, sialorrhea, xerostomia, impotence, decreased hematocrit, decreased hemoglobin, hemolytic anemia, pancytopenia, purpuric disease, thrombocytopenia, hepatic failure, hepatitis, jaundice, amnesia, anxiety, depression, drowsiness, insomnia, malaise, nervousness, neuralgia, neuropathy, paresthesia, seizure, arthralgia, arthritis, myalgia, tremor, visual disturbance, hearing loss, tinnitus, acute kidney injury, increased blood urea nitrogen, dyspnea and epistaxis.

-Should not be given to patients suffering from hypersensitivity to Ramipril. -Should not be given to patients suffering from hereditary/idiopathic angioedema or history of angioedema related to previous treatment with an ACE inhibitor. -If the creatinine clearance is <40 mL/minute: Administer 25% of normal dose. -May cause anemia because, ACE inhibitors can suppress the production of erythropoietin. This is more likely to occur in the presence of chronic kidney disease. -Anaphylactic reaction/nonimmune anaphylaxis can occur with ACE inhibitors. -Symptomatic hypotension with or without syncope can occur (usually with the first several doses); effects are most often observed in volume-depleted patients. -Use with caution in patients with severe aortic stenosis. -Avoid use in patients with ascites due to cirrhosis. -Use with caution in patients with collagen vascular disease. -Use with caution in patients with hepatic impairment. -Use with caution in patients with hypertrophic cardiomyopathy and left ventricular outflow tract obstruction. -Use with caution in patients with renal impairment. -The BP-lowering effects of ACE inhibitors may be less pronounced in black patients. -In case of over dose be ready to tell or show what was taken, how much and when it happened, and seek immediate medical attention. For additional information call us on 16676. Always tell your physician your detailed medical history.

-Store at room temperature. -Interactions (continue): -Potassium salts: May enhance the hyperkalemic effect of angiotensin-converting enzyme inhibitors. -Potassium-sparing diuretics: May enhance the hyperkalemic effect of angiotensin-converting enzyme inhibitors. -Pregabalin: Angiotensin-converting enzyme inhibitors may enhance the adverse/toxic effect of Pregabalin. -Sacubitril: Angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Sacubitril. -Salicylates: May enhance the nephrotoxic effect of Angiotensin-Converting Enzyme Inhibitors. -Telmisartan: May enhance the adverse/toxic effect of Ramipril. -Tizanidine: May enhance the hypotensive effect of Angiotensin-Converting Enzyme Inhibitors. -Trimethoprim: May enhance the hyperkalemic effect of Angiotensin-Converting Enzyme Inhibitors.

-Alfuzosin: May enhance the hypotensive effect of blood pressure lowering agents. -Allopurinol: Angiotensin-converting enzyme inhibitors may enhance the potential for allergic or hypersensitivity reactions to allopurinol. -Angiotensin II receptor blockers: May enhance the adverse/toxic effect of angiotensin-converting enzyme inhibitors. -Antipsychotic agents: blood pressure lowering agents may enhance the hypotensive effect of antipsychotic agents. -Azathioprine: Angiotensin-converting enzyme inhibitors may enhance the myelosuppressive effect of Azathioprine. -Dapoxetine: May enhance the orthostatic hypotensive effect of angiotensin-converting enzyme inhibitors. -Duloxetine: blood pressure lowering agents may enhance the hypotensive effect of Duloxetine. -Ferric Gluconate: Angiotensin-converting enzyme inhibitor may enhance the adverse/toxic effect of Ferric Gluconate. -Ferric Hydroxide Polymaltose Complex: Angiotensin-converting enzyme inhibitors may enhance the adverse/toxic effect of Ferric Hydroxide Polymaltose Complex. -Heparin: May enhance the hyperkalemic effect of angiotensin-converting enzyme inhibitors. -Iron Dextran Complex: Angiotensin-converting enzyme inhibitors may enhance the adverse/toxic effect of Iron Dextran Complex. -Levodopa-containing products: blood pressure lowering agents may enhance the hypotensive effect of Levodopa-containing products. -Lithium: Angiotensin-converting enzyme inhibitors may increase the serum concentration of Lithium. -Loop diuretics: May enhance the hypotensive effect of Angiotensin-converting enzyme inhibitors. -Nicorandil: May enhance the hyperkalemic effect of angiotensin-converting enzyme inhibitors. -Nonsteroidal Anti-Inflammatory Agents: Angiotensin-converting enzyme inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. -Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of blood pressure lowering agents. -For the rest of interactions refer to Storage.

-Drugs that act on the renin-angiotensin system can cause injury to the developing fetus. Ramipril crosses the placenta. Exposure to an angiotensin-converting enzyme (ACE) inhibitor during the first trimester of pregnancy may be associated with an increased risk of fetal malformations. Drugs that act on the renin-angiotensin system are associated with oligohydramnios, when treatment of hypertension in pregnancy is indicated, ACE inhibitors should generally be avoided due to their adverse fetal events; use in pregnant women should only be considered for cases of hypertension refractory to other medications. ACE inhibitors are not recommended for the treatment heart failure in pregnancy. -Ramipril and its metabolites were not detected in breast milk following a single oral dose of 10 mg. It is not known if multiple doses will produce detectable levels. Breastfeeding is not recommended during the treatment. -Ask your physician before taking any medication in pregnancy and lactation.

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