Jeninpril 5 mg Tablet (Ramipril)

Adult dose

1. Hypertension ① Adults not receiving diuretics: The initial dose of ramipril is 2.5㎎ once daily, taken orally during or after a meal with plenty of water. Depending on the patient’s response, the dose may be increased at intervals of 2‐3 weeks, initially to 5㎎ daily and thereafter to a maximum of 10㎎ daily; a diuretic may be administered concomitantly. ② Adults receiving diuretics: Since an undesirable excessive decrease in blood pressure may occur after the first dose, discontinue the diuretic 2‐3 days before starting treatment, if possible. If this is not possible, administer an initial dose of 1.25㎎ once daily and adjust appropriately as needed. ③ Patients with renal impairment 1) Creatinine clearance of 50㎖/min or higher (serum creatinine below 1.5㎎/㎗): No dose adjustment is necessary. 2) Creatinine clearance of 20~50㎖/min (serum creatinine 1.5‐3㎎/㎗): Administer an initial dose of 1.25㎎ once daily; the dose may be increased to a maximum of 5㎎ once daily. 3) Creatinine clearance below 20㎖/min (serum creatinine 3㎎/㎗ or higher): Administer an initial dose of 1.25㎎ every other day; the maintenance dose should not exceed 2.5㎎ once daily. ④ Patients with hepatic impairment: Administer under careful medical supervision and do not exceed 2.5㎎ daily. 2. Heart failure after myocardial infarction ① Patients not receiving diuretics: The recommended initial dose is 2.5mg twice daily. For patients who develop symptoms of hypotension at this dose, the dose may be changed to 1.25mg twice daily; however, all patients should have their dose gradually increased to the target dose of 5mg twice daily. Patients should be monitored closely for at least 2 hours after the first dose of this drug and for at least an additional 1 hour until their blood pressure has stabilized. If hypotension occurs after the first dose, treat the hypotension appropriately and then adjust the dose of this drug cautiously. ② Patients receiving diuretics: Symptomatic hypotension may occur after the first dose of this drug in patients who have been taking diuretics. To reduce the possibility of hypotension, discontinue the diuretic 2~3 days before starting this drug, if possible. Thereafter, if blood pressure is not controlled with this drug alone, resume diuretic treatment. If the diuretic cannot be discontinued, administer an initial dose of 1.25mg of this drug to avoid excessive hypotension. Reduce the dose of the concomitantly administered diuretic as much as possible to reduce the possibility of hypotension. ③ Patients with heart failure accompanied by renal failure The recommended initial dose is 1.25mg once daily. Depending on the clinical response and tolerability, the dose may be increased to 1.25mg twice daily and up to a maximum of 2.5mg twice daily. 3. Reduction in the risk of death due to myocardial infarction, stroke, or cardiovascular disease, or in the need for revascularization ① The initial dose is 2.5mg once daily, and the dose is increased gradually according to tolerability. Accordingly, increase the dose to 5mg daily after one week and to 10mg daily after 3 weeks. The usual maintenance dose is 10mg once daily. Patients stabilized on a lower dose for another indication should be adjusted to 10mg once daily. ② Patients with renal impairment: No dose adjustment is necessary in patients with creatinine clearance of 30ml/min( plasma creatinine<165 μmol/l) or higher. In patients with creatinine clearance below 30ml/min( plasma creatinine>165 μmol/l), the initial dose is 1.25mg once daily and the maximum dose is 5mg once daily. In patients with severe renal impairment (creatinine clearance of 10ml/min or less and plasma creatinine of 400~650 μmol/l), the initial dose is 1.25mg once daily and should not exceed 2.5mg daily. ③ Patients with hepatic impairment: In patients with hepatic impairment, decreased esterase activity in the liver reduces the metabolism of the parent compound ramipril and the subsequent formation of its biologically active metabolite ramiprilat, ultimately increasing plasma ramipril levels. Therefore, Tritace treatment should be initiated at a dose of 1.25mg under close medical supervision. 4. Nephropathy ① Patients not receiving diuretics The recommended initial dose is 1.25㎎ once daily. Increase the dose according to the patient’s tolerability. When increasing the dose, double it at intervals of 2‐3 weeks; the maximum daily dose is 5㎎. ② Patients receiving diuretics Consider whether the diuretic should be discontinued or at least reduced 2‐3 days before starting this drug. In general, the initial dose of this drug in patients receiving diuretics is 1.25㎎ once daily. ③ Patients with hepatic impairment: Increase or decrease the dose according to the patient’s response. Therefore, treatment with this drug should be initiated carefully according to the physician’s instructions, and the maximum daily dose is 2.5㎎. Adjust the dose appropriately according to age and symptoms.

This medication is used to lower blood pressure by dilating blood vessels. During treatment, there may be sudden swelling in the face, lips, tongue, and larynx; if such symptoms occur, immediate contact with a physician is essential. Laryngeal edema can be very dangerous and requires prompt emergency treatment. Symptoms like abdominal pain, nausea, and vomiting may lead to intestinal swelling, and in such cases, it is important to consult a doctor. Taking this medication during pregnancy, especially in the second and third trimesters, can cause serious harm to the fetus; therefore, women who are pregnant or planning to become pregnant should not take this medication. The safety of this medication has not been adequately confirmed for patients with severely impaired kidney function or for children, and its use is not recommended in these cases. Patients with a known allergy to this medication, those with a history of angioedema, patients with certain cardiac valve diseases, and pregnant women should avoid taking this medication. Taking this medication with other blood pressure medications, diuretics, or potassium-sparing drugs may increase the risk of side effects, so it is essential to consult a physician. Patients should have regular blood tests and kidney function tests while on the medication, and blood pressure and electrolyte levels should be monitored closely. When starting this medication or changing dosages, there may be symptoms of hypotension (dizziness, fainting), so caution is needed. A dry cough may occur, and if this symptom persists, inform a doctor. This medication may impair concentration while driving or operating machinery, so caution is advised. Overdose may lead to severe hypotension, electrolyte abnormalities, and kidney damage; immediate emergency treatment is necessary. Store this medication out of reach of children and do not transfer it to another container.

Angioedema, abdominal pain, nausea, vomiting, angina, myocardial infarction, tachycardia, arrhythmia, palpitations, peripheral edema, eosinophilia, leukopenia, anemia, decreased hemoglobin levels, decreased platelet count, bone marrow failure, pancytopenia, hemolytic anemia, headache, dizziness, vertigo, sensory abnormalities, ageusia, dysgeusia, tremors, balance disorder, ischemic stroke, transient ischemic attack, psychomotor agitation, flushing, paresthesia, blurred vision, visual impairment, conjunctivitis, hearing impairment, tinnitus, itchy sore throat, dry cough, bronchitis, sinusitis, difficulty breathing, bronchospasm, congestion, gastrointestinal inflammatory response, digestive disorders, abdominal discomfort, dyspepsia, diarrhea, nausea, vomiting, pancreatitis, increased pancreatic enzymes, small bowel angioedema, gastritis, epigastric pain, constipation, dry mouth, glossitis, aphthous stomatitis, acute renal failure, kidney impairment, increased urine output, worsening of proteinuria, increased blood urea, increased blood creatinine, rash, angioedema, pruritus, hyperhidrosis, exfoliative dermatitis, urticaria, onycholysis, photosensitivity reaction, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, pemphigus, exacerbation of psoriasis, psoriatic dermatitis, alopecia, muscle spasm, myalgia, arthralgia, inappropriate antidiuretic hormone secretion syndrome, increased potassium levels, anorexia, decreased appetite, decreased sodium levels, hypotension, orthostatic hypotension, syncope, flushing, vascular stenosis, vasculitis, Raynaud's phenomenon, chest pain, fatigue, fever, weakness, anaphylaxis, anaphylactic reactions, increased antinuclear antibodies, elevated liver enzymes, increased bilirubin polymers, cholestatic jaundice, hepatocyte damage, acute liver failure, cholestasis, cytolytic hepatitis, temporary erectile dysfunction, decreased libido, gynecomastia, depression, anxiety, nervousness, restlessness, drowsiness, sleep disorders, confusion, attention deficit, cough

Store this medication in a tightly closed container to prevent air or moisture from entering, maintaining a temperature between 1 to 30 degrees Celsius. Proper storage helps maintain the effectiveness and safety of the medication.

Appearance

Pale red, oblong tablets

Package unit

30 tablets/bottle, 100 tablets/bottle