Hopace H Capsules (Ramipril + Hydrochlorothiazide)

• Composition :
  Each capsulecontains Ramipril 2.5/5mg + Hydrochlorothiazide 12.5mg.
• Indications :
  Mild to moderate hypertension in patient (in whom combination therapy is appropriate) who have been stabilized on the individual components given in the same proportion.
• Pharmacodynamics :
  Ramipril and hydrochlorothiazide(tablets) has antihypertensive and diuretic effects.Ramipril is a long-acting ACE inhibitor.Inhibition of ACE results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and to decreased aldosterone secretion. The effect of ramipril in hypertension resultsby reducing angiotensin II formation in tissue and plasma.Hydrochlorothiazide is a thiazide diuretic. It increases excretion of sodium and chloride, natriuretic may be accompanied by some loss of potassium and bicarbonate. Hydrochlorothiazide also normalizes the hyperkalemia caused by Ramipril by increasing its excretion.
• Dosage and administration :
  Initially once capsule, once daily. If necessary, the dose can be progressively increased to achieve target blood pressure; the maximum permitted doses are 10 mg of ramipril and 25 mg of hydrochlorothiazide daily.
• Contraindications :
  Anuria, hypersensitivity, history of angioedema, renal unilateral and bilateral renal artery stenosis, severe hepatic impairment, 2nd and 3rd trimester of pregnancy.
• Precautions and warnings :
  Angioedema, Cough,Aortic Stenosis, Symptomatic hypotension may occur, monitoring of patients undergoing surgery, liver disease and white blood cell counts should be considered.
• Use in pregnancy, lactation & pediatrics :
  Contraindicated in pregnancy.Not recommended for use in nursing mothers. Safety and effectiveness in pediatricpatients have not been established.
• Drug interactions :
  Monitoring of the alcohol, barbiturates, or narcotics,absorption is reduced with cholestyramine and colestipol resins,Non-steroidal anti-inflammatory agents can reduce the diuretic and natriuretic effect of hydrochlorothiazide. Ramipril with potassium-sparing diuretics results in severe hyperkalemia, increases serum lithium concentration, NSAIDs may reduce the effect of the drug and cause deterioration of renal function.
• Adverse reactions :
  The most common adverse events areheadache, dizziness, bronchitisandnon- productive cough.
• Therapy Area :
  Anti-Hypertensives