COMPOSITION :
Ramipril-1.25
Tablets
Each tablet contains……….Ramipril 1.25 mg
Ramipril-2.5
Tablets
Each tablet contains……….Ramipril 2.5 mg
Ramipril-5
Tablets
Each tablet contains……….Ramipril 5 mg
INDICATIONS
- Reduction in risk of myocardial infarction,
stroke and death from cardiovascular causes
- Hypertension
- Heart failure post myocardial infarction
DOSAGE AND ADMINISTRATION
Reduction in risk of myocardial infarction, stroke and death from
cardiovascular causes
Ramipril should be given at an
initial dose of 2.5 mg, once a day for 1 week, 5 mg, once a day
for the next 3 weeks and then increased as tolerated, to a
maintenance dose of 10 mg, once daily. If the patient is
hypertensive or recently post myocardial infarction, it can be
given as a divided dose.
Hypertension
The recommended initial dose of
Ramipril is 2.5 mg once daily in patients not
receiving a diuretic. Dosage should be adjusted according to the
blood pressure response. The usual maintenance dosage range is 2.5
to 20 mg/day administered as a single dose or in two equally
divided doses. If blood pressure is not controlled with ramipril
alone, a diuretic can be added.
Heart failure post myocardial
infarction
The recommended starting dose of
Ramipril is 2.5 mg twice daily. A patient who
becomes hypotensive at this dose may be switched to 1.25 mg twice
daily, and after one week at the starting dose, patients should be
titrated (if tolerated) toward a target dose of 5 mg twice daily,
with dosage increases being about 3 weeks apart. After the initial
dose of ramipril, the patient should be observed under medical
supervision for at least two hours and until blood pressure has
stabilized for at least an additional hour. If possible, the dose
of any concomitant diuretic should be reduced which may diminish
the likelihood of hypotension.
In patients who are currently being treated with
a diuretic, symptomatic hypotension occasionally can occur
following the initial dose of ramipril. To reduce the likelihood
of hypotension, the diuretic should, if possible, be discontinued
two to three days prior to beginning therapy with ramipril. Then,
if blood pressure is not controlled with ramipril alone, diuretic
therapy should be resumed. If the diuretic cannot be discontinued,
an initial dose of 1.25 mg ramipril should be used to avoid excess
hypotension.
Dosage in renal impairment
In patients with creatinine
clearance less than 40 mL/min/1.73m 2
(serum creatinine approximately more than 2.5 mg/dl) doses only
25% of those normally used should be expected to induce full
therapeutic levels of ramiprilat.
Hypertension
For patients with hypertension and
renal impairment, the recommended initial dose is 1.25 mg ramipril
once daily. Dosage may be titrated upward until blood pressure is
controlled or to a maximum total daily dose of 5 mg.
Heart failure post
myocardial infarction
For patients with heart failure and
renal impairment, the recommended initial dose is 1.25 mg ramipril
once daily. The dose may be increased to 1.25 mg twice daily and
up to a maximum dose of 2.5 mg twice daily depending upon clinical
response and tolerability.
CONTRAINDICATIONS
Hypersensitivity to ramipril or any other ACE inhibitor (e.g. a
patient who has experienced angioedema during therapy with any
other ACE inhibitor).
PACKAGING
INFORMATION :
Ramipril-1.25
..............Strip of 10 tablets
Ramipril-2.5 ................Strip of 10 tablets
Ramipril-5 ...................Strip of 10 tablets
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