Ramoril PLUS 525mg+5mg

Hydrochlorothiazide + Ramipril is a medicine used to treat hypertension (high blood pressure). It is a combination of two medicines that helps to control blood pressure when a single medication is not effective. It helps to reduce the chances of any future heart attack and stroke. Hydrochlorothiazide + Ramipril is taken with or without food, preferably in the morning to avoid frequent urination at night. Keep taking it for as long as advised by your doctor. Even if you feel well, do not stop this medicine on your own because high blood pressure often has no symptoms. If you stop taking it, your condition may get worse. Keeping active with regular exercise, reducing your weight and eating a healthy diet will also help control your blood pressure. Follow your doctor's advice while taking this medicine. Nausea, indigestion, taste change, and diarrhea are some common side effects of this medicine. Consult your doctor If any of these bother you, or get worse, or do not go away. Let your doctor know about cough or throat irritation that does not go away. Drink plenty of fluids while taking medicine to overcome muscle weakness, dry mouth, and extreme thirst. Dizziness may occur due to low blood pressure but this gets better with time. Before taking it, let your doctor know if you have any liver or kidney problems. Pregnant or breastfeeding women should also consult their doctor for advice before taking this medicine. You also need to tell your doctor what other medicines you are taking especially those used to treat high blood pressure or heart conditions. You should have your blood pressure, kidney function and the levels of salts such as potassium checked regularly to make sure that this medicine is working properly. Hydrochlorothiazide + Ramipril is a combination of two medicines: Ramipril and hydrochlorothiazide which lower blood pressure effectively. Ramipril is an angiotensin-converting enzyme (ACE) inhibitor. It works by reducing stress on the heart and relaxing blood vessels so that blood flows more smoothly and the heart can pump blood more efficiently. Hydrochlorothiazide is a diuretic that removes extra water and certain electrolytes from the body. Over time it also relaxes blood vessels and improves blood flow.

• Hypertension (high blood pressure)

Ramipril is a long-acting ACE inhibitor which is metabolised into the active metabolite ramiprilat. Supine and standing blood pressures (BP) are reduced witho reflex tachycardia. Ventricular hypertrophy is reversed and renal blood flow increased. In CHF (CHF), pulmonary artery pressure and pulmonary capillary wedge pressure are reduced. Cardiac function is improved. Hydrochlorothiazide is a thiazide diuretic. It increases excretion of Na and chloride in approx equiv amounts. Natriuresis may be accompanied by some loss of K and bicarbonate. The rationale behind this combination is that these have a synergistic effect in lowering BP and offer an advantage of once-daily dosing convenience.

Adult Dose: Oral Essential hypertension Adult: Per tablet contains ramipril 2.5 mg and hydrochlorthiazide 12.5 mg: 1 tablet daily up to a max of 4 tablets daily.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Hydrochlorothiazide + Ramipril may be taken with or without food, but it is better to take it at a fixed time.

Common: • Nausea • Indigestion • Taste change • Diarrhea • Stomach pain • Headache • Dizziness • Weakness • Glucose intolerance • Increased uric acid level in blood • Increased blood lipid level • Electrolyte imbalance • Cough • Decreased blood pressure

[UNSAFE] Hydrochlorothiazide + Ramipril may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur. You have been prescribed Hydrochlorothiazide + Ramipril for the treatment of high blood pressure. It also lowers your risk of stroke and heart attack. Take it in the morning with breakfast, to avoid getting up at night to urinate. Hydrochlorothiazide + Ramipril may cause dizziness or sleepiness. Don't drive or do anything requiring concentration until you know how it affects you. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Inform you doctor about any cough, or throat irritation that doesn't go away. Hydrochlorothiazide + Ramipril may cause dehydration. Drink plenty of fluids and Inform your doctor if you develop extreme thirst, muscle weakness or very dry mouth. Your doctor may regularly monitor your blood pressure, kidney function and the levels of salts such as potassium in your blood while you are taking this medicine. Do not take Hydrochlorothiazide + Ramipril if you’re pregnant or planning pregnancy. It can cause birth defects or be fatal to your unborn baby.

Anuria, hypersensitivity, history of angioedema, bilateral renal artery stenosis, unilateral renal artery stenosis

Hydrochlorthiazide in combination with alcohol, barbiturates, or narcotics potentiates orthostatic hypotension. When coadministered with other antihypertensive gives additive effect. Absorption is reduced with cholestyramine and colestipol resins. Hypokalemia is observed with corticosteroids, tubocurarine responsiveness to the muscle relaxant is increased. It decreases the renal clearance of lithium and increases the risk of lithium toxicity. Non-steroidal anti-inflammatory agents can reduce the diuretic and natriuretic effect of hydrochlorthiazide. Ramipril with potassium-sparing diuretics results in severe hyperkaelemia. May increase serum lithium concentration, NSAIDs may reduce the effect of the drug and cause deterioration of renal function.

[UNSAFE] Hydrochlorothiazide + Ramipril may cause excessive drowsiness with alcohol.

[CONSULT YOUR DOCTOR] Hydrochlorothiazide + Ramipril is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[SAFE IF PRESCRIBED] Hydrochlorothiazide + Ramipril is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[CAUTION] Hydrochlorothiazide + Ramipril should be used with caution in patients with kidney disease. Dose adjustment of Hydrochlorothiazide + Ramipril may be needed. Please consult your doctor. Regular monitoring of blood pressure is recommended for dose adjustment. [CAUTION] Hydrochlorothiazide + Ramipril should be used with caution in patients with liver disease. Dose adjustment of Hydrochlorothiazide + Ramipril may be needed. Please consult your doctor.

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