Ramipril belongs to the active ingredient class of ACE inhibitors (angiotensin converting enzyme) and is used as a hypotensive drug against arterial hypertension. Ramipril is also used to prevent heart attacks and other cardiac disorders, for example in heart failure. Although it can be successfully treated with the drug Ramipril hypertension, but it is not suitable for everyone due to the possible side effects. The dosage of ramipril is determined individually by the doctor.
Effect of Ramipril
The blood pressure is constantly adapted to the respective needs of the body. During stress or exercise, the hormone angiotensin-II is formed, which narrows the blood vessels and thus increases the blood pressure. In addition, angiotensin II stimulates the production of the blood pressure-increasing hormone aldosterone. The active substance Ramilpril inhibits the angiotensin converting enzyme (ACE), a protein that is responsible for the formation of angiotensin II. Therefore, Ramilpril produces less angiotensin II, which widens blood vessels and lowers blood pressure. This also relieves the heart, since it has to pump the blood against a lower resistance.
In addition, less aldosterone is secreted by the lower amount of angiotensin II. This hormone in the body ensures that less water is excreted through the kidneys, which increases the blood volume and thus the blood pressure. For example, Ramipril has an additional antihypertensive effect due to the reduced production of aldosterone. Since high blood pressure is one of the main risk factors for the development of arteriosclerosis, Ramipril can thus protect against serious sequelae such as stroke, angina pectoris, myocardial infarction and other diseases of the cardiovascular system.
possible side effects
Ramipril may cause several side effects, which may vary depending on the dose, duration, frequency of administration and dosage form of the active substance. Common side effects of ramipril are:
- blurred vision
- Weaknesses or dizziness
- Renal dysfunction
- Bronchitis or dry cough
- Disorders of the digestive tract and nausea
- a headache
- lack of concentration
- Tiredness or increased need for sleep
Side effects of ramipril include skin reactions such as hives and rashes, itching, dyspnoea, asthma attacks, sore throat and hoarseness. The concentration of red blood pigment may be reduced. In addition, the blood composition may change. Occasionally, a sudden drop in blood pressure is one of the side effects.
The rare side effects of ramipril include fainting, rhinitis, decreased kidney performance, vascular swelling and shock. Patients should exclude potential risk factors before taking ramipril and pay attention to the package leaflet.
Dosage and interaction
The dosage of ramipril must always be individually adjusted by the doctor to the patient. This is especially true if other medicines are also taken, as a wrong dose of ramipril combined with the use of certain medications can cause severe interactions or side effects. This is the case, for example, with certain types of therapy for diabetes, lithium and certain medicines for gout, rheumatism, cardiac arrhythmias and cell growth disorders.
With the right dose of ramipril, it should also be noted that the active ingredient is more effective in the elderly - as the effect of alcohol is also stronger, it should be avoided while taking ramipril. Ramipril can not be taken during pregnancy because of the risk of severe birth defects and stillbirths. If Ramipril is combined with another active substance, such as HCT (Hydrochlorothiazide), the dosage should be fine-tuned.
Ramipril: contraindications and alternatives
The active substance ramipril should not be taken by children and adolescents under the age of 18 years. It is also unsuitable for people with constrictions of the renal arteries and heart valves as well as severe kidney and liver dysfunction. Furthermore, ramipril must not be used in hyperaldosteronism (excessive production of the hormone aldosterone). Due to the possible side effects of antihypertensive drugs, it is always necessary to decide on a case-by-case basis which remedy is most appropriate.
An alternative to ACE inhibitors are so-called AT1 antagonists. These drugs block a special "docking" (receptor) of angiotensin II, through which the hormone achieves the vasoconstrictive effect. Angiotensin II is thus still formed, only the hypertensive effect remains out. As a result, certain side effects such as irritating cough or shortness of breath, which can occur when taking ACE inhibitors, are less common. All drugs that act by blocking the AT1 receptors have the suffix "-sartan" in the drug name, for example, telmisartan.
In addition to ACE inhibitors and AT1 antagonists, there are also drugs against hypertension that act in other ways, such as the beta-blockers metoprolol and bisoprolol, or the calcium channel blocker amlodipine. Also, drugs based on any of these drugs are not free of side effects and contraindications and, like ramipril, may interact with other agents.