Ramimed Combi (ramipril) tablets 5 mg/25 mg. №30


Ramimed Combi tablets are prescribed for the treatment of arterial hypertension, for patients who do not have adequate blood pressure control with ramipril or hydrochlorothiazide alone.



Composition and form of release
Ramimed Combi is produced in the form of capsule-like, flat, uncoated tablets, white or almost white, which are notched on one side and marked “25” on the other. The main elements in one tablet are ramipril 5 mg and hydrochlorothiazide 25 mg. As additional substances: corn starch, sodium bicarbonate, sodium stearyl fumarate, lactose monohydrate, sodium croscarmellose. One pack contains 3 blisters, each containing 10 tablets.

Pharmacological properties
Ramimed Kombi tablets are a combined drug that has antihypertensive and diuretic effects, helps to lower blood pressure, while not increasing the heart rate, as well as dilation of blood vessels. Increases the excretion of water, chlorine, sodium and potassium from the body.

Indications for use
Ramimed Combi tablets are prescribed for the treatment of arterial hypertension, for patients who do not have adequate blood pressure control with ramipril or hydrochlorothiazide alone.

Ramimed Kombi tablets are contraindicated for: renal stenosis, liver failure, arterial hypotension, diabetes mellitus, angioedema, hemodynamically unstable conditions, hypokalemia, anuria, hyponatremia, severe renal impairment, hypercalcemia, electrolyte imbalance. Contraindications when taking the drug are concomitant treatment with extracorporeal methods, when blood comes into contact with negatively charged surfaces, as well as with drugs that contain aliskiren. Personal intolerance to the constituent components and under the age of 18.

Application during pregnancy and lactation
The drug should not be used by women who are planning to have a child, as well as pregnant and breastfeeding women.

Method of administration and dosage
Treatment with Ramimed Combi for arterial hypertension begins with the lowest possible dose. If necessary, the dose is gradually increased until the blood pressure is normalized. The maximum daily dose is 10 mg ramipril and 25 mg hydrochlorothiazide.

  • Patients with kidney disease, provided that creatinine clearance is between 30 and 60 ml / min, take the lowest dose of a fixed combination of ramipril and hydrochlorothiazide. The maximum permissible daily dose for such patients is 5 mg of ramipril and 25 mg of hydrochlorothiazide.
  • For patients in old age, treatment begins with a minimum dose, in the future, dose titration should be carried out more gradually.
  • For patients with impaired liver function, the maximum daily dose is 2.5 mg of ramipril and 12.5 mg of hydrochlorothiazide, treatment should be carried out under the strict supervision of a physician.
  • In cases where the patient takes diuretics, it is necessary to stop taking diuretics or reduce the dose before starting treatment. The doctor selects and changes the dose for each patient individually.

The drug is taken at the same hour orally once a day, without chewing, drinking plenty of water, Ramizes Combi can be used before and after meals, as well as during meals. The dose of a fixed combination of ramipril and hydrochlorothiazide is selected for each patient personally, depending on the general condition of the patient and what kind of blood pressure the patient has.

In case of an overdose, the following are possible: arterial hypotension, bradycardia, shock, cardiac arrhythmias, nausea, coma, electrolyte imbalance, impaired consciousness, tachycardia, acute urinary retention, weakness, oliguria. Also, an overdose of the drug can cause: dizziness, muscle spasms, polyuriaanuria, vomiting, exhaustion, hypokalemia, hyponatremia, hypochloremia, paresthesia, thirst, alkalosis, epileptic seizures, renal failure and paresis. In case of intoxication with the drug, the patient needs to do a gastric lavage, take adsorbents to cleanse the body, take measures to restore stable hemodynamics. Conduct symptomatic and maintenance therapy.

Side effects
When taking, side effects may occur: myocardial ischemia, peripheral edema, tachycardia, arterial hypotension, arrhythmia, decreased blood pressure, a feeling of increased heart rate, fainting, hypoperfusion, Raynaud’s phenomenon, vasculitis, increased urination, vascular stenosis, impaired renal function, increased urea levels and creatinine, cough, sinusitis, nasal congestion, discomfort and pain in the stomach, bronchitis, indigestion, shortness of breath, dyspepsia, bronchospasm, diarrhea, dry mouth, pancreatitis, vomiting, angioedema, nausea, gastritis, constipation, glossitis, cholestat , stomatitis, hepatitis, liver failure.
Also possible: headache, paresthesia, dizziness, ageusia, tremor, dysgeusia, imbalance, visual impairment, impaired psychomotor functions, hearing impairment, burning sensation, cerebral ischemia, parosmia, conjunctivitis, toxic epidermal necrolysis, tinnitus, rash, hyperhidrosis, pruritus, exfoliative dermatitis, urticaria, onycholysis, dermatitis, photosensitivity reaction, erythema multiforme, pemphigus, Stevens Johnson syndrome, alopecia.
The use of the drug can cause muscle spasms, an increase in the level of potassium in the blood, myalgia, anorexia, loss of appetite, arthralgia, pancytopenia, a decrease in the level of sodium in the blood, eosinophilia, a decrease in the level of hemoglobin, a decrease in the number of leukocytes, erythrocytes, platelets, hemolytic anemia, decreased libido, decreased mood, gynecomastia, anxiety, anxiety, pyrexia, nervousness, sleep disturbances, confusion, drowsiness, asthenia, fatigue.

Storage conditions and periods
The drug should be stored in a place with a temperature regime of up to + 30 ° C, in its original packaging, out of the field of vision of children. After 2 years from the date of manufacture, the drug cannot be used.