Arterial hypertension is a scourge of the modern population of the planet. A number of unfavorable external factors, poor ecology, persistent stress, poor-quality and irregular nutrition create prerequisites for the development of cardiovascular pathology and the emergence of this formidable disease.
Modern pharmacology seeks to create such medications that, if not cure the person of hypertension completely, then at least keep blood pressure under control, thereby minimizing the risk of myocardial infarction and strokes.
At the present time, antihypertensive medications such as "Hartil", analogues of this drug, which have been developed quite a lot, are in great demand among consumers.
The manufacturer of the drug "Hartil" is the Hungarian company EGIS Pharmaceuticals PLC. Consumers are presented three varieties of this medicine: "Hartil", "Hartil D" and "Hartil Amlo."
The main active ingredient of Hartil is the substance ramipril. The basic indications for using this medicine are the presence of such diseases as arterial hypertension, diabetic nephropathy, diffuse kidney diseases that are chronic. In addition, the "Hartil" instructions for use (the analogs in most cases will also have a positive effect) recommends that they be used to reduce the likelihood of myocardial infarction, "coronary death", strokes in people with IHD (coronary heart disease). It is also common practice to prescribe "Hartil" to those who suffer from a lack of cardiac activity in its chronic stage and developed after the patient suffered an acute myocardial infarction (an indispensable condition for applying "Hartil" - stable hemodynamic parameters).
The drug "Hartil D" (analogs to the available effects are available) consists of two active components - ramipril and hydrochlorothiazide. The first component reduces the elevated blood pressure, thereby reducing the burden on the heart. The second substance is a diuretic that stimulates the process of removing salts and water through the kidneys, and just like ramipril, lowers blood pressure. Thus, "Hartil D" is prescribed for the treatment of hypertension in cases when complex treatment with ACE inhibitors and diuretics is indicated.
The drug antihypertensive drug "Hartil Amlo" (analogues in composition and effect produced by modern pharmacy) contains two basic substances - ramipril and amlodipine. The purpose of this medication is practiced for the treatment of hypertension in those patients in whom the parallel administration of ramipril and amlodipine has a positive effect both individually and in combination.
The medicinal product "Ramipril-S3" is an analog of "Hartil" of Russian production. Produced in Moscow by the company "Northern Star". The main active ingredient is ramipril. As auxiliary magnesium stearate and lactose monohydrate act.
The medication is prescribed to people with such diagnoses as arterial hypertension, cardiac insufficiency (chronic form and developed after acute myocardial infarction).
With such diseases, a mandatory condition for the appointment of "Ramiplil-C3" - stable indicators of hemodynamics. Also, the indication for taking this analogue of the "Hartil" tablets is the patient's diabetic and nondiabetic nephropathy. With the expected good result, Ramipril-C3 is prescribed to people after surgery for transluminal coronary angioplasty and coronary artery bypass grafting (if the patient's clinical standing is stable).
As contraindications for taking this medication, individual hypersensitivity to the main or auxiliary components of the drug, the presence in the anamnesis of information about previously transferred angioedema, provoked by ACE inhibitor medications. Contraindicated "Ramipril-S3" patients who have not reached the age of 18, There is no information on its safety and effectiveness.
Antihypertensive medication "Dilaprel" is presented in the pharmaceutical market as a Russian analogue of "Hartil". The main active ingredient is ramipril. As auxiliary, calcium stearate and colloidal silicon dioxide are used.
Indication for the use of this medication: the presence of patients in such diseases as essential hypertension, cardiac insufficiency in the chronic stage (in combination with other medications, in particular, with diuretics).
Practice is the appointment of the drug with nephropathy (diabetic, nondiabetic), including when combined with proteinuria, hypertension. Prescribe for the reception of "Dilaprel" and in those cases when after a few days (2-9 days) after an acute myocardial infarction, cardiac insufficiency develops.
Good results are obtained by medication in those patients whose health condition is characterized by high cardiovascular risk (sudden development of acute myocardial infarction, stroke).
The basis for not prescribing this analogue ("Hartil" is characterized by almost the same contraindications) is the presence of a history of angioedema, hemodynamically significant stenosis of the renal arteries, stenosis of the aortic or mitral valves, arterial hypotension (low blood pressure), insufficiency Renal activity and the need for hemodialysis. "Dilaprel" is not acceptable for patients with cardiac failure in chronic form in the stage of decompilation ensatsii and in the presence of nephropathy. In the acute phase of a heart attack the drug is not prescribed for unstable angina, pulmonary heart and serious ventricular cardiac arrhythmias.
This analogue ("Hartil" has the same main active component - ramipril) has the following indications for use: hypertension (arterial, refractory, malignant, vasorenal), nephropathy (diabetic and developing against chronic diffuse kidney diseases).
It has a cardioprotective effect and significantly reduces platelet aggregation. The drug increases the sensitivity of tissues to insulin. Hypotensive effect is felt after an hour and a half after taking the medication, the maximum effect is achieved after 5-9 hours, the duration of exposure is up to 24 hours.
Of the main contraindications for the use of this drug can be identified hypersensitivity to the components (primary and secondary) drug or to some other ACE inhibitors, the presence in the anamnesis of information about the previously transferred angioedema, provoked by treatment with ACE inhibitors.
When pregnancy is contraindicated to take this remedy, as well as "Hartil." Instructions for use, reviews (analogues of "Hartil" containing in ramipril, can not be prescribed to pregnant women), health workers are advised before the beginning of treatment to be convinced of the absence of pregnancy. If the patient becomes pregnant during the period of therapy, it is necessary to immediately cancel the medicines with ramipril and choose some other method of treatment.
An ACE inhibitor such as Amprilan is also analogous to Hartil, both in composition and in terms of its effect. The main active substance of the medication is ramipril. In the form of auxiliary constituents are sodium hydrogencarbonate, lactose monohydrate, croscarmellose sodium, starch.
Indications for the appointment of this drug in general, are almost identical to the previously described "Vazolong", "Dilaprel", Ramipril-C3 ": hypertension, chronic heart failure, nephropathy, a decrease in the likelihood of developing cardiovascular pathology.
The list of contraindications for the use of this drug is quite extensive. "Amprilan" is practically not prescribed for patients suffering from such serious diseases as bilateral stenosis of the renal arteries in a hemodynamically significant form and stenosis of the artery of a single kidney, failure of renal activity, condition after kidney transplantation and hemodialysis. The drug is inadmissible to apply to patients with the following cardiac problems: aortic and / or mitral stenosis, chronic heart failure (decompensation stage), obstructive cardiomyopathy and hypertension.
Women are not allowed to take medication during the period of gestation and breastfeeding. Contraindication is the age of 18 years.
Analogues of the drug "Hartil" are now quite densely saturated the pharmaceutical market. Another well-known analogue is Ramicardia. The indications and contraindications for the medication are almost identical with the previously considered Amprilan.
Before starting treatment with this drug, experts strongly recommend to investigate the state of the kidneys, because depending on the condition of these organs, an individual dose is chosen for therapy (or the drug is discarded altogether). In the process of treatment, this tool, almost identical to the "Hartil" medication, instructions for use (analogues, almost all, can cause serious damage to the kidneys) recommends monitoring the state of the urinary system, electrolyte blood composition, the number of renal enzymes and the picture of peripheral blood.
Those patients who have a deficiency of fluid, sodium, before starting to take "Ramic", it is necessary to eliminate all water-electrolyte abnormalities. In the process of treatment with this drug, hemodialysis with polyacrylonitrile membranes is unacceptable. There is a risk of developing anaphylactic reactions.
The analogues of "Hartil" in Russia are widely spread. Another such medication is called "Ramigamma". The main active ingredient is ramipril. Indications and contraindications are similar to those that describe the above described drugs. Therapy with this remedy should be controlled by the treating doctor.
After the first dose of "Ramigamma" is taken, or the dosage of the patient's diuretic is increased, the blood pressure should be measured as much as possible during the next 8 hours. This is necessary in order to prevent the development of an uncontrolled and rapid hypotensive reaction (drop in blood pressure). Close attention is required by patients suffering from serious kidney disease and cardiovascular system.
In the process of treatment, it is necessary to control the level of leukocytes, so as not to miss the moment of development of leukopenia.
"Hartil", analogues of this medication (including "Remigamma") can not be prescribed to those patients who at this time receive desensitizing treatment (to reduce allergic reactions to insect bites). Parallel use of ACE inhibitors and sensitizers can lead to the development of severe, life-threatening anaphylactic reaction of the body (respiratory depression, falling blood pressure, vomiting, etc.)
Every single well-known medicinal preparation is analogous to "Hartil" - "Cardipril". The active ingredient is ramipril. The main indications for the use of this medication are hypertension, congestive heart failure (as a component of complex therapy), nephropathy (its initial stages as well), cardiac failure after myocardial infarction.
Contraindications for the application of "Cardipril" are quite extensive. The medication can not be prescribed for admission in the presence of renal and hepatic insufficiency, with systemic lupus erythematosus, stenosis of the renal arteries, hyperkalemia and hyponatremia, and oppression of bone hemopoiesis. Do not prescribe the drug during pregnancy, during lactation and patients younger than 18 years of age.
With an overdose of Cardipril, it is possible to develop severe hypotension (a drop in blood pressure), kidney failure, serious electrolyte abnormalities, shock. To eliminate the consequences, it is necessary to conduct constant monitoring and subsequent support of the basic functions of the body. With a strong drop in pressure, an additional volume of sodium and liquid can be introduced. Hemodialysis does not have any significant effect.
What else has the equivalent of "Hartil"? Another well-known drug used by patients is Tritace. The medication is available in Germany and France. The main active ingredient is ramipril. Indications for use, as well as contraindications, are approximately similar to all previously described ACE inhibitor drugs. Treatment with Tritats usually takes a fairly long period, the duration of which in each case is determined by the attending physician.
Before you start therapy with this medication, you must be sure of the absence of such conditions as hyponatremia and hypovolemia. In the event that a patient has previously taken any diuretic drugs, they will have to be canceled or at least reduced their dosage 2-3 days before the start of treatment using Tritatse.
After taking the first dose or increasing the volume of diuretics taken, nurses should ensure that the patient's condition is carefully monitored for at least 8 hours. This is necessary in order to take appropriate measures at too rapid a drop in blood pressure.
If a patient has heart failure or a malignant form of hypertension, therapy with Tritatse is acceptable only in a hospital.
Throughout the period of treatment with this medication it is necessary to monitor the kidney function, the level of electrolyte concentration, hematological parameters (hemoglobin level, platelets, white blood cells, erythrocytes, leukocyte formula).
Opinion of specialists about the ACE inhibitors
As for any serious medication, which can be attributed "Hartil" and its best counterparts, the reviews of a cardiologist, a doctor of any other specialization or a patient can leave both a positive and a negative direction.
Most patients characterize "Hartil" itself and most of its analogues as very fast-acting drugs, effective even at very high blood pressure values. The duration of exposure to drugs in this group also reaches 24 hours. Although the prices for these drugs vary greatly, and not all medicines are available to a wide range of consumers.
There are, however, negative opinions about the drug "Hartil." Analogues, patients' reviews are also sometimes characterized from the negative side. The reason is that all these drugs can cause the development of a whole bunch of side effects, some of which are quite heavy. On this issue, medical experts are in solidarity with their patients. Although the vast majority of medical workers believe that such medicines saved hundreds of lives and are very necessary for people. The main thing is not to prescribe medicines of this level independently and strictly follow the recommendations of the doctor in charge.