Following is information on contraindications to the use of ramipril in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should Ramipril not be used?
Ramipril must not be used with
- Hypersensitivity to ramipril or other ACE inhibitor
- history of angioedema (angioneurotic edema), whether it is congenital (more common in black people), has no apparent cause, or is caused by the use of antihypertensive drugs derived from ACE inhibitors or AT1 receptor antagonists
- Blood scrub treatments that cause contact between blood and negatively charged surfaces
- diabetics or patients with impaired kidney function who receive the antidiabetic aliskiren
- Bilateral narrowing of the renal arteries or one-sided constriction in only one functional kidney
- Patients with low blood pressure or unstable circulatory conditions.
Only after careful consideration of the benefit and risk by the physician and under his control may Ramipril be used in all patients who have risk factors for sudden drop in blood pressure. Such risk factors are:
- higher age
- severe hypertension
- poorly treatable myocardial insufficiency
- obstruction of the left ventricle due to narrowing of the aortic or mitral valve
- two functional kidneys, but a one-sided narrowing of a renal artery
- subliminal or detectable fluid or salt deficiency (common in patients taking dessicants)
- Cirrhosis of the liver and / or water retention in the abdomen
- Operations and narcosis with medicines that lower blood pressure.
Patients with transient or existing cardiac insufficiency following myocardial infarction and those at risk of hypoperfusion of the heart or brain are at particular risk of sudden drop in blood pressure.
Furthermore, the physician should use caution when administering Ramipril in patients at risk of potassium excess in the blood. This is mainly
- renal dysfunction
- Persons over 70 years old
- not or insufficiently treated diabetics
- Patients who use potassium salts, potassium-sparing dehydrators, and other agents that increase blood potassium levels
- an acute disorder of heart function
- body acidity (metabolic acidosis).
Pathological changes in the blood count are especially common in patients with
- impaired kidney function
- concomitant connective tissue disorders such as lupus erythematosus or scleroderma
- concomitant treatment with other medicinal products that may cause changes in the blood count.
What should you watch out for during pregnancy and lactation?
The use of ramipril is strictly prohibited during pregnancy and lactation.
If pregnancy becomes apparent during treatment with the active substance, it must be immediately discontinued by the attending physician and replaced with another antihypertensive. Also, when planning a pregnancy, the therapy should be changed early.
During breastfeeding, the active ingredient passes into breast milk. If treatment with ramipril is urgently required at this time, the patient must breastfeed.
What should be considered in children?
Ramipril should not be used in children. In this age group, there is still insufficient experience with the active substance.
Warnings and Precautions
- Prior to the administration of the drug, kidney function should be monitored by a doctor.
- Diabetics who inject insulin need to be examined more frequently by the doctor.
- The drug can cause birth defects in the baby during pregnancy, therefore it is important to prevent pregnancy during therapy.
- Therapy should not be interrupted or stopped without medical advice.
- During therapy, physical activity should not be increased suddenly.
- Before beginning therapy, compensate for fluid or body salt deficiency.
- If angioneurotic edema occurs (swelling of the face, lips, tongue, larynx, mucosa, eyes), the therapy should be discontinued and changed over by a physician.
- If jaundice (icterus) develops or the liver enzymes increase significantly, the therapy should be stopped. Patients must be monitored by a doctor.
- If you experience dizziness, nausea, and weakness, lie down temporarily and lift your legs up.
- All important laboratory values (urea, creatinine, potassium, sodium, urine protein, bilirubin, liver enzymes) should be checked regularly by the doctor. This is especially true for older patients.
- Alcohol should be avoided during treatment as the drug strengthens its effects.
- The drug may affect your ability to react so far that driving a car, operating machinery or working without a secure grip is dangerous.
Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.