Hartil tabs 5mg #28

Hartil instruction for use

You can buy Hartil tablets here

See also - Hartil-D

Composition

The drug as an active ingredient contains ramipril.
Additional components: sodium stearyl fumarate, pregelatinized starch 1500, iron oxide yellow, sodium bicarbonate, lactose monohydrate sodium croscarmellose. In addition, 5 mg tablets have iron oxide red in their composition.

Form of issue

This product is available in the form of tablets intended for oral use. Each blister contains 7 tablets.

pharmachologic effect

Antihypertensive drug.

Pharmacodynamics and pharmacokinetics

The main substance of the drug has an effect on the ACE, which circulates in the blood and is found in the tissues. This agent inhibits the action of ACE, resulting in an antihypertensive effect without compensatory increase in heart rate, angiotensin II and aldosterone levels decrease, and plasma renin activity increases.
Ramipril also reduces OPSS and pressure level in the pulmonary capillaries, increases exercise tolerance and cardiac output.
With a long course, the drug leads to the reverse development of myocardial hypertrophy in the case of hypertension. It also reduces the likelihood of arrhythmia in myocardial reperfusion, interferes with the decay of bradykinin, activates the blood supply of the ischemic myocardium, improves the formation of nitric oxide in the endothelium. With acute myocardial infarction, this drug prevents re-infarction and the development of necrosis, improves vital signs.
Hartil has cardioprotective and angioprotective action, activates the dissolution processes on the walls of blood vessels of blood clots and cholesterol plaques, causes an increase in the level of fibrinogen, reduces the aggregation of platelets.
The action of the drug begins 60-120 minutes after oral administration. The maximum concentration is observed after 4-5 hours and remains within 24 hours. Thus, with a regular intake, a high concentration of the active substance is maintained constantly. In patients with heart failure and liver function problems, the content of ramipril in the blood is higher.
The effectiveness of the drug does not depend on age. It is well absorbed from the digestive tract. Eating does not have a significant effect on bioavailability, but it can slow the absorption of the active substance. Bioavailability is about 50%.
The drug is biotransformed in the liver with the formation of metabolites. It is excreted in urine and feces in the form of metabolites and unchanged.

Indications for use

Indications for use of this tool are as follows:
    arterial hypertension;
    diabetic nephropathy;
    chronic diffuse kidney disease;
    the need to reduce the risk of myocardial infarction, "coronary death" in people with IHD;
    heart failure after acute myocardial infarction with stable hemodynamics;
    chronic heart failure;
    The need to reduce the risk of stroke in people with coronary artery disease.
In case of arterial hypertension, Hartil Amlo may also be used, if before the transition to this medicine the arterial pressure was controlled by the simultaneous use of ramipril and amlodipine at the same dosages as in the preparation.

Contraindications

This tool can not be used when:
    hypersensitivity to its components;
    systemic lupus erythematosus;
    renal failure;
    kidney transplantation;
    abnormal electrolyte blood balance;
    primary hyperaldosteronism;
    pregnancy;
    breastfeeding;
    Quincke's edema due to the use of ACE inhibitors;
    reduction of hematopoiesis in the bone marrow;
    stenosis of the renal arteries;
    severe violations of the liver;
    children under 15 years.
With caution Hartil should be taken to people with diabetes, as well as patients in old age.

Side effects

Adverse reactions with the use of this drug can be as follows:
    SSS - orthostatic hypotension, lowering blood pressure, tachycardia. With excessive decrease in blood pressure, cerebral ischemia and myocardial ischemia may occur;
    CNS - drowsiness, headache, weakness, nervous excitability, anxiety, muscle spasm, paresthesia, dizziness, tremor, changes in mood;
    digestive system - nausea, diarrhea, epigastric pain, thirst, stomatitis, pancreatitis, vomiting, constipation, dry mouth, blunting appetite, hypersensitivity or inflammation of the mucous membrane of the cheeks;
    allergies - rash, hives, photosensitivity, itching, conjunctivitis;
    genitourinary system - the severity of symptoms of proteinuria, a decrease in the volume of urine, kidney failure;
    sensory organs - impaired sense of smell, sight and other sensory organs, tinnitus, vestibular disturbances;
    respiratory system - "dry" cough, shortness of breath, rhinitis, bronchitis, bronchospasm, rhinorrhea, sinusitis;
    hematopoiesis - anemia, thrombocytopenia, neutropenia, pancytopenia, a decrease in the number of erythrocytes, leukocytopenia, a decrease in the concentration of hemoglobin and hematocrit, agranulocytosis, hemolytic anemia, bone marrow suppression;
    laboratory indicators - hypercreatininaemia, hyperkalemia, increased activity of "hepatic" transaminases, hyperbilirubinemia, increased urea nitrogen levels, hyponatremia;
    other - convulsions, hyperthermia, alopecia, increased sweating.
In rare cases, also possible: arrhythmia, impaired blood supply to organs due to narrowing of blood vessels, hepatitis, liver problems with the appearance of liver failure, cholestatic jaundice, Quincke's edema, arthralgia, multiforme erythema exudative, pemphigus, onycholysis, myositis, eosinophilia, exfoliative dermatitis, Lyell's syndrome, serositis, vasculitis, myalgia, arthritis, an increase in the antinuclear factor titer.

Instructions for the use of Hartil (Method and dosage)

For those who are prescribed Hartil tablets, the instructions for use indicate that they should be taken regardless of meals. It is advisable to drink the remedy with some water, while swallowing should be done without chewing. The time of therapy and dosage is selected for each patient by a specialist individually.
As a rule, depending on the diagnosis, the following regimens are prescribed:
    congestive heart failure - dosage at the beginning of the course, as a rule, 1.25 mg once a day, then every 2-3 weeks it can be step-by-step raised;
    arterial hypertension - a dosage of 2.5 mg once a day is taken, then it can be gradually increased every 2-3 weeks, observing the patient's condition, before the desired therapeutic effect. The maintenance dosage is usually 2.5-5 mg / day. If you need more than 5 mg, it is better to supplement the course of Hartil with another antihypertensive drug, because otherwise unwanted side reactions may develop. This drug is often combined with calcium channel blockers or diuretics;
    heart failure after acute myocardial infarction - taken at 1.25-2.5 mg 2 times during the day, then it can be increased if necessary to 5 mg 2 times during the day. The course should be started no earlier than on the second day after an acute myocardial infarction;
    the need to prevent myocardial infarction and stroke - taking a dosage of 2.5 mg during the day, then it can be doubled in a week, and after 3 weeks it can be increased to 10 mg;
    diabetic and nondiabetic nephropathy - taken at 1.25 mg / day, then it can be increased every 2-3 weeks until the desired therapeutic effect. But it is not desirable to take more than 5 mg / day;
    the need for prevention of circulatory disorders - a maintenance dosage of 10 mg per day.
Instructions for use Hartil indicates that for any diagnosis the maximum daily dosage should not be more than 10 mg. But in the case of renal failure, the maximum dose is 5 mg, and for people with severe liver disorders 2.5 mg.
When combined with diuretics, the initial dose in most cases is 1.25 mg, since the need for ramipril is lower.

Overdose

When the drug is used in high doses, acute renal failure, a significant decrease in blood pressure, a bradycardia, a violation of the water-electrolyte balance, a shock state are possible.
In the case of an easy overdose, gastric lavage is prescribed, as well as the use of sodium sulfate and adsorbents.
When you use the drug in a dosage significantly exceeding the norm, you need to monitor and maintain the vital functions of the body in an intensive care unit. In the case of a significant reduction in blood pressure, it is necessary to introduce catecholamines and angiotensin II. The patient should lie on a spine with an elevated position of the legs. Possible additional administration of liquid and sodium.

Interaction

Diuretics, as well as drugs that depress the central nervous system, and hypotensive drugs increase the antihypertensive effect of Hartil.
The hypotensive effect of this drug is reduced when combined with non-steroidal anti-inflammatory drugs, with agents containing estrogens, NSAIDs, and salt. If such interaction is inevitable, strict monitoring of the patient's condition by a specialist is necessary.
With the use of drugs that increase the level of potassium in the blood, as well as Cyclosporine and milk together with Hartil, there may be hyperkalemia. And in the case of a combination of this drug with mielosupressivnyh drugs increases the likelihood of developing neutropenia and agranulocytosis, a possible fatal outcome.
In addition, Hartil increases the level of lithium in the blood when used together with lithium-containing medicines and reduces the level of glucose in the blood when combined with hypoglycemic agents.
When using this drug with Alopurinol, Procainamide, immunosuppressants and cytostatics increases the likelihood of occurrence of leukopenia. In combination with ethyl alcohol, ramipril increases its inhibitory effect on the central nervous system.

Terms of sale

You don't need a prescription to buy Hartil online.

Storage conditions

Hartil should be kept at room temperature in a dry place.
Shelf life - two years from the date of manufacture.

Reviews of Hartil

Reviews about Hartil on the forums are mostly positive. Patients note its speed. They write about the fact that this remedy is effective even at very high blood pressure.