Drug name: Hartil

Active Ingredients:

• Ramipril

Therapeutic effect Hartil: Ramipril is the active ingredient in Hartil and is a constituent of ACE inhibitors.

The main function of Ramipril is to regulate blood pressure. This is done in three distinct ways which are explained below:

• Blocking angiotensin II

Angiotensin II is an enzyme that has the capacity to bind with its receptors present on the blood vessels. When this happens, the vessels get constricted and hence the blood pressure increases within the vessel. Taking Ramipril inhibits the conversion of angiotensin II and keeps the blood pressure in check.

• Aldosterone intervention

By hindering the production of the enzyme aldosterone, blood volume in the body is reduced. This in turn also lowers the blood pressure.

• Influencing PG synthesis

There are some cardio protective properties attributed to Ramipril that disturb the cycle of PG synthesis and promote nitrogen oxide production in endotheliocytes.

In addition to the above, Hartil also increases the renal and coronary blood circulation and decreases the accumulation of thrombocytes.

Indications: People suffering from hypertension can benefit from Hartil consumption. Hartil is also prescribed in cases of heart failure and for individuals recuperating from heart attack. It can even be used by people who are at a high risk of contracting any kind of heart disease.

Precautions and Restrictions: You should not take Ramipril:

• if you are highly sensitive or allergic to ACE inhibitors
• if you have an angioedema (swelling beneath the skin) leading to swelling of the lips, face and tongue.
• Hypotension
• Condition in which the aortic valve does not open fully (Aortic stenosis)
• Mitral valve stenosis
• Ventricular outflow tract obstruction
• Pregnancy
• Lactation
• In children

Caution must be practiced before taking Ramipril if you fall under any of the below conditions:

• Old age
• Liver diseases
• Poor liver function (Liver cirrhosis)
• Kidney diseases
• Low blood volume
• Concomitant use of medicines that promote forrmation of urine (diuretics)
• Diseases that affect conjunctive tissue (scleroderma, systemic lupus erythematosus)
• Patients with kidney failure requiring a certain type of haemodialysis (high-flux membrane)
• Patients who receive therapy to remove certain types of fat from the blood using LDL apheresis

Side effects: Ramipril, like any other medicine, carries the risk of causing a few side effects that vary in nature from person to person. These side effects are not applicable in nature or severity to every individual consuming Ramipril.

• Problems related to the digestive system such as diarrhea, constipation, nausea, vomiting or stomach ache.
• Problems of the Central Nervous System such as cephalalgia, lightheadedness, dry mouth, change in taste perception, anxiety and restlessness, confusion, fatigue.
• Problems of the cardiovascular system such as hypotension, awareness of the heart beat (palpitations), abnormal heart beats (arrhythmias), chest pain (angina).
• Certain allergic reactions such as flushing, itching and rashes.
• Other side effects such as impotence, hyperkalaemia, angioedema, liver and kidney disorders.

The side effects are not limited to the above list. To get a detailed description of other possible risks, please refer to the information booklet that comes with Ramipril. Consult a physician or a pharmacist before starting the medication.

Interactions: Drugs produce different results when combined with other drugs. Before starting taking Ramipril it is very important to let your doctor know about any other medication you are taking even if it is only herbal remedies. Also, while taking Ramipril care must be taken on starting any other drug so that the combination is not harmful. Here are a few examples on how Ramipril taken in combination with other drugs can affect your body.

Calcium-channel blockers, alpha and b-blockers, clonidine, water pills and nitrates when combined with Ramipril tend to have an increased effect on lowering hypertension resulting in very low blood pressure. When taken along with potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes, ciclosporin or heparin, ramipril increases the risk of hyperkalaemia.

Anti-depressants and anti-psychotics interact with ramipril to alter the blood levels. Also, the number of white blood cells in the body is altered dangerously when Ramipril is taken along with immunosuppresants, allopurinol and azathioprine.

Additional Information: It is strongly advisable not to share Ramipril with anyone else as each person's condition varies. Ramipril must not be used for any other health condition. The medication, syringes and needles that may be used during the treatment must be kept out of reach of children.