Heartpril Protect Tablets (Ramipril)

Adult dose

1. Hypertension ① Adults not receiving diuretics: The initial dose of ramipril is 2.5㎎ once daily, administered orally with plenty of water during or after a meal. However, depending on the patient's response, the dose may be increased at intervals of 2‐3 weeks, initially up to 5㎎ daily and then up to a maximum of 10㎎ daily; a diuretic may be administered concomitantly. ② Adults receiving diuretics: Since an undesirable excessive reduction 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, then adjust appropriately as needed. ③ Patients with renal impairment 1) Creatinine clearance of 50㎖/min or greater (serum creatinine less than 1.5㎎/㎗): No dosage 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 greater): 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 with 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 carefully observed for at least 2 hours after the initial dose of this drug and for at least an additional 1 hour until blood pressure has stabilized. If hypotension occurs after the initial dose, appropriately manage the hypotension and carefully adjust the dose of this drug. ② Patients receiving diuretics: Symptomatic hypotension may occur after the first dose of this drug in patients taking diuretics. To reduce the likelihood 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 the diuretic. 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 concomitant diuretic as much as possible to reduce the likelihood of hypotension. ③ Patients with heart failure accompanied by renal failure The recommended initial dose is 1.25mg once daily. Depending on 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 myocardial infarction, stroke, or death due to cardiovascular disease, or the need for revascularization ① The initial dose is 2.5mg once daily, and the dose is gradually increased according to tolerability. Therefore, increase the dose to 5mg daily after one week and to 10mg daily after 3 weeks. The usual maintenance dose is 10mg once daily. Adjust patients stabilized on lower doses for other indications to 10mg once daily. ② Patients with renal impairment: No dosage adjustment is necessary in patients with creatinine clearance of 30ml/min (plasma creatinine<165 μmol/l) or greater. 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, reduced esterase activity in the liver decreases the metabolism of the parent compound ramipril and, consequently, the formation of its biologically active metabolite ramiprilat, ultimately increasing plasma ramipril levels. Therefore, treatment with Tritace 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 to discontinue the diuretic or at least reduce the dose of the diuretic being taken 2‐3 days before starting this drug. In general, the initial dose of this drug for 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 as directed by a physician, 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 and protect heart and kidney function. However, sudden swelling in areas such as the face, lips, tongue, larynx, etc. may occur, so if these symptoms appear, you must inform a doctor immediately. Such swelling can be life-threatening, so you should stop taking the medication and seek emergency treatment. Vascular swelling may also occur in the intestines, leading to symptoms such as abdominal pain, nausea, and vomiting, so caution is advised. It can cause serious damage to the fetus during pregnancy, particularly in the second and third trimesters, so if pregnancy is confirmed, you should stop taking the medication immediately. There is insufficient information about the safety of this medication in patients with severely impaired kidney function or those on dialysis, and its use is not recommended in children. If you have allergies to this medication or a history of angioedema, or if you have certain heart valve diseases or are pregnant, you should not take it. Patients with very low blood pressure or issues with renal blood vessels, as well as those with hyperkalemia, may be at risk, so caution is required. When using along with other antihypertensives or diuretics, frequent monitoring of blood pressure, kidney function, and electrolyte levels is required, and sudden drops in blood pressure may occur, so caution is needed. Patients with impaired liver function should use the medication cautiously as its metabolism and effectiveness may change. Blood tests and kidney function tests should be conducted regularly while taking this medication, and careful monitoring of blood potassium and sodium levels and white blood cell counts should be done. Initially, symptoms such as headaches, dizziness, and dry cough may occur, and in severe cases, you should consult a doctor. This medication can interact with other medications, so if you are taking any other drugs, you must inform your doctor or pharmacist. When driving or operating machinery, caution is needed, as dizziness or light-headedness may occur. In case of overdose, blood pressure may drop too low and heart rate may slow, requiring immediate hospitalization and emergency treatment. Finally, store this medication out of the 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, erythrocytopenia, decreased hemoglobin levels, thrombocytopenia, bone marrow failure, pancytopenia, hemolytic anemia, headache, dizziness, vertigo, sensory disturbances, ageusia, dysgeusia, tremor, balance disorders, ischemic stroke, transient ischemic attack, psychomotor dysfunction, flushing, olfactory disturbance, blurred vision, visual impairment, conjunctivitis, hearing impairment, tinnitus, itchy dry cough, bronchitis, sinusitis, dyspnea, bronchospasm, congestion, gastrointestinal inflammatory response, dyspepsia, abdominal discomfort, indigestion, diarrhea, nausea, vomiting, pancreatitis, increased pancreatic enzymes, small bowel angioedema, gastritis, epigastric pain, constipation, dry mouth, glossitis, aphthous stomatitis, acute renal failure, renal 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, bullous pemphigoid, lichenoid eruptions, alopecia, muscle spasms, myalgia, arthralgia, inappropriate secretion of antidiuretic hormone syndrome, increased blood potassium, anorexia, decreased appetite, decreased blood sodium, hypotension, orthostatic hypotension, syncope, flushing, vascular stenosis, decreased perfusion, vasculitis, Raynaud's phenomenon, chest pain, fatigue, fever, weakness, anaphylaxis, anaphylactoid reaction, increased antinuclear antibodies, elevated liver enzymes, increased bilirubin polymers, cholestatic jaundice, liver cell damage, acute liver failure, cholestasis, cytolytic hepatitis, transient erectile dysfunction, decreased libido, gynecomastia, mood disturbances, anxiety, irritability, restlessness, drowsiness, sleep disorders, confusion, attention deficit disorder, cough, hyperkalemia, increased blood creatinine, elevated blood urea nitrogen, peripheral edema, renal dysfunction, acute renal failure, constipation, urticaria, rash, upper respiratory tract infection

This medication should be stored in a tightly sealed container to prevent air ingress, and it is best kept at room temperature between 1°C and 30°C. This way, the efficacy of the medication can be well maintained.

Appearance

Oblong white tablet

Package unit

30 tablets/bottle, 100 tablets/bottle