سعر افيفابرل 5/12.5 مجم 21 قرص 2022

Ramipril 5 mg + hydrochlorothiazide 12.5 mg tablets, 21 tablets (3 strips); fixed-dose ACE inhibitor/thiazide diuretic combination for hypertension (Marcyrl Co. > ECCO Pharm, Egypt).

• Treatment of essential hypertension in patients for whom combination therapy is appropriate; not indicated for initial therapy.Population: AdultsBausch Health Canada (Valeant Canada LP)

• Most common in controlled clinical trials: headache (3.9%), dizziness (2.2%) and bronchitis (2.1%); others included neuralgia, infection and cough.International label, same formulation · Bausch Health Canada (Valeant Canada LP)

• Hypersensitivity to ramipril, other ACE inhibitors, hydrochlorothiazide, other thiazides or sulfonamide-derived drugs, or any excipient.International label, same formulation · Bausch Health Canada (Valeant Canada LP)
• History of angioedema (hereditary, idiopathic or with previous ACE inhibitor therapy).International label, same formulation · Bausch Health Canada (Valeant Canada LP)
• Pregnancy and breastfeeding.International label, same formulation · Bausch Health Canada (Valeant Canada LP)

• Boxed warning - fetal toxicity: when pregnancy is detected, discontinue as soon as possible; drugs acting on the renin-angiotensin system can cause injury and death to the developing fetus.International label, same formulation · Bausch Health Canada (Valeant Canada LP)
• Angioedema of the face, extremities, lips, tongue, glottis and/or larynx, including intestinal angioedema, may occur; risk is increased with mTOR inhibitors, DPP-IV inhibitors or neprilysin inhibitors; discontinue and treat promptly.International label, same formulation · Bausch Health Canada (Valeant Canada LP)
• Dual blockade of the renin-angiotensin system with ARBs or aliskiren is not recommended.International label, same formulation · Bausch Health Canada (Valeant Canada LP)

• LithiumIncreased serum lithium levels and toxicity; co-administration not recommended; if necessary, reduce the lithium dose by about 50% and monitor lithium levels closely.Bausch Health Canada (Valeant Canada LP)
• NSAIDs including acetylsalicylic acidMay reduce the antihypertensive and diuretic effect and increase the risk of renal impairment and hyperkalaemia; avoid or monitor serum creatinine and potassium.Bausch Health Canada (Valeant Canada LP)
• Aliskiren or angiotensin receptor blockersDual RAS blockade increases hypotension, hyperkalaemia and renal impairment; contraindicated in certain patients (diabetes, renal impairment) and generally not recommended.Bausch Health Canada (Valeant Canada LP)

• Contraindicated in pregnancy (boxed warning): drugs acting on the renin-angiotensin system can cause injury and death to the developing fetus; discontinue as soon as possible when pregnancy is detected.International label, same formulation · Bausch Health Canada (Valeant Canada LP)
• Contraindicated in nursing women: ACE inhibitors and thiazides are excreted in human milk.International label, same formulation · Bausch Health Canada (Valeant Canada LP)

• Ramipril: Prodrug hydrolysed to ramiprilat, which inhibits angiotensin-converting enzyme, reducing angiotensin II formation and aldosterone secretion and lowering blood pressure.
• Hydrochlorothiazide: Inhibits sodium and chloride reabsorption in the distal convoluted tubule, increasing their renal excretion and reducing plasma volume.