The simultaneous use of medicines containing aliskiren, or angiotensin II receptor antagonists, leading to a double blockade of the renin-angiotensin-aldosterone system (RAAS), hyperkalemia, hyponatremia (including on the background of diuretics durabolin price and diet with restriction of salt intake) diabetes (risk of hyperkalemia); chronic heart failure, especially heavy or about which other drugs are taken with the antihypertensive effect; severe coronary and cerebral arteries (risk reduction of blood flow in the excessive decrease in blood pressure); hemodynamically significant unilateral renal artery stenosis (if both kidneys); state, accompanied by a decrease in circulating blood volume (including diarrhea, vomiting), the simultaneous application of lithium drugs, immunosuppressants and saluretikov; connective tissue disease (including systemic lupus erythematosus, scleroderma – increased risk of neutropenia or agranulocytosis); desensitizing therapy, advanced age (over 65) (increased risk of associated liver dysfunction and / or kidney disease and congestive heart failure); condition after kidney transplantation, liver failure.
Application of pregnancy and during breastfeeding
Application of medication Pyramus ® during pregnancy and breastfeeding is contraindicated, since ramipril may have adverse effects on the fetus: fetal developmental disorder of the kidneys, lowering blood pressure of the fetus and newborn, renal dysfunction, hyperkalemia, hypoplasia of the skull bones, lung hypoplasia. Pyramus ® is not recommended for women planning pregnancy. In case of pregnancy during therapy with peers ® should, as soon as possible, stop taking the drug and to conduct monitoring of the fetus.
Women of childbearing age receiving treatment with ACE inhibitors should use effective contraceptive measures.
If the women of childbearing age with hypertension taking ACE inhibitors , you should be aware of the need in the case of pregnancy, the patient transfer to receiving antihypertensive drug from a different group. In all cases, a careful medical supervision.
There is no information about whether ramipril is released in breast milk.
Animal studies have shown that ramipril is released into the milk of lactating rats. Use of the drug Pyramus ® during breastfeeding is contraindicated. The appointment of the drug Pyramus ® nursing mother, you should decide the issue of termination of breastfeeding.
Dosing and durabolin price
Inside, regardless of meals, without chewing, with a sufficient amount (1/2 cup) of water.
The dose is selected depending on the therapeutic effect and tolerability of the drug by the patient. Hypertension The recommended initial dose of the drug Pyramus ® for patients without heart failure, not taking diuretics is 2.5 mg per day. The dose can be gradually increased every 2-3 weeks depending on the effect and tolerability. The maximum dose is 10 mg once a day. Typically, a maintenance dose of 2.5-5 mg once daily. In the absence of a satisfactory therapeutic effect when taking 10 mg per day of the drug peers ® recommended assignment combined medication. If the patient is taking diuretics, should finish taking them or reduce their dose for 2-3 days before starting treatment drug Pyramus ® . For these patients, the recommended starting dose is 1.25 mg (2.1, 2.5 mg tablets) once daily. Chronic heart failure recommended starting dose of the drug peers ® is 1.25 mg (2 tablets of 1.2, 5 mg) once per day. The dose can be gradually increased depending on the effect and tolerability, doubling its every 1-2 weeks. Doses of 2.5 mg per day and can be taken up in one or two steps. The maximum dose is 10 mg once a day. For patients taking high doses of diuretics should decrease their doses before treatment with peers ® , to minimize risk of symptomatic hypotension. to reduce the risk of myocardial infarction, stroke or cardiovascular death in patients at high cardiovascular risk recommended initial dose is 2.5 mg 1 time per day. Depending on tolerability, durabolin price the dose can be double after 1 week of treatment and during the following 3 weeks of treatment to increase its usual maintenance dose of 10 mg 1 time per day.Heart failure is due to acute myocardial infarction treatment is started 3-10 days after acute myocardial infarction . The starting dose of the drug peers ® is 5 mg per day (2.5 mg twice morning and evening) after two days increased to a dose of 5 mg twice a day. If poor tolerability initial dose of 2.5 mg twice a day, should be within two days designate dose of 1.25 mg (2.1, 2.5 mg tablets) twice daily, then increasing the dose to 2.5 mg and 5 mg twice a day. The maintenance dose of the drug Pyramus ® is 2.5-5 mg twice daily. The maximum daily dose is 10 mg. Diabetic and nondiabetic nephropathyRecommended initial dose of the drug Pyramus ® is 1.25 mg (1/2 tablets of 2.5 mg), 1 per day. Depending on the tolerability, the dose may be doubling intervals 2- . 3 weeks to a maximum dose of 5 mg per day if the patient is taking diuretics, you should finish taking them or reduce the dose for 2-3 days before starting treatment drug Pyramus ® ; In this case, the recommended initial dose of the drug Pyramus® is 1.25 mg (1/2 tablets of 2.5 mg) once a day. Patients with renal impairment For patients with renal impairment (creatinine clearance (CC) 20-50 ml / min / 1.73 m²), the recommended initial dose of drug peers ® is 1.25 mg (2.1, 2.5 mg tablets) once a day, and the maximum dose should not exceed 5 mg per day. In severe renal failure (creatinine clearance less than 20 mL / min / 1.73 m²), the recommended initial dose of drug peers ® is 1.25 mg (2.1, 2.5 mg tablets) once a day, if necessary, the dose may be increased to 2.5 mg per day. patients with impaired hepatic function in patients with impaired liver function may be observed as the strengthening and weakening of the therapeutic action of the drug Pyramus ® . Treatment should be initiated under the supervision of a physician with the appointment of a dose of 1.25 mg (1/2 tablets of 2.5 mg). The maximum dose should not exceed 2.5 mg per day. Elderly patients (over 65 years) should be careful in appointing a drug Pyramus ® in patients older age group if they have kidney or liver failure, and heart failure, and / or simultaneous administration of diuretics . The dose should be individualized depending on the desired durabolin price level of blood pressure. The initial dose is reduced to 1.25 mg per day.