Medine.co.uk

Ramipril 10 Mg Capsules

Informations for option: Ramipril 10 Mg Capsules, show other option
Document: leaflet MAH GENERIC_PL 04569-0536 change

PACKAGE LEAFLET: INFORMATION FOR THE USER

Ramipril 1.25 mg Capsules Ramipril 2.5 mg Capsules Ramipril 5 mg Capsules Ramipril 10 mg Capsules

(Ramipril)

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

•    Keep this leaflet. You may need to read it again.

•    If you have any further questions, ask your doctor, pharmacist or nurse.

•    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them

even if their symptoms are the same as yours.

•    If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible

side effects not listed in this leaflet.

In this leaflet:

1.    What Ramipril is and what it is used for

2.    What you need to know before you take Ramipril

3.    How to take Ramipril

4.    Possible side effects

5.    How to store Ramipril

6.    Contents of the pack and other information

1.    WHAT RAMIPRIL IS AND WHAT IT IS USED FOR

Ramipril contains a medicine called Ramipril. This belongs to a group of medicines called ACE inhibitors (Angiotensin Converting Enzyme Inhibitors).

Ramipril works by:

•    Decreasing your body’s production of substances that could raise your blood pressure

•    Making your blood vessels relax and widen

•    Making it easier for your heart to pump blood around your body.

Ramipril can be used:

•    To treat high blood pressure (hypertension)

•    To reduce the risk of you having a heart attack or stroke

•    To reduce the risk or delay the worsening of kidney problems (whether or not you have

diabetes)

•    To treat your heart when it cannot pump enough blood to the rest of your body (heart failure)

•    As treatment following heart attack (myocardial infarction) complicated with heart failure.

2.    WHAT YOU NEED TO KNOW BEFORE YOU TAKE RAMIPRIL

Do not take Ramipril:

• If you are allergic (hypersensitive) to ramipril, any other ACE inhibitor medicine or any of the ingredients of Ramipril listed in section 6.

Signs of an allergic reaction may include a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue

•    If you have ever had a serious allergic reaction called “angioedema”. The signs include itching,

hives (urticaria), red marks on the hands, feet and throat, swelling of the throat and tongue, swelling around the eyes and lips, difficulty breathing and swallowing

•    If you are having dialysis or any other type of blood filtration. Depending on the machine that is

used, Ramipril may not be suitable for you

•    If you have kidney problems where the blood supply to your kidney is reduced (renal artery

stenosis)

•    If you have diabetes or impaired kidney function and you are treated with a blood pressure

lowering medicine containing aliskiren.

•    During the last 6 months of pregnancy (see section below on “Pregnancy and breast-feeding”)

•    If your blood pressure is abnormally low or unstable. Your doctor will need to make this

assessment.

Do not take Ramipril if any of the above apply to you. If you are not sure, talk to your doctor before taking Ramipril.

Warnings and precautions

Talk to your doctor, pharmacist or nurse before taking Ramipril:

•    If you have heart, liver or kidney problems

•    If you have lost a lot of body salts or fluids (through being sick (vomiting), having diarrhoea,

sweating more than usual, being on a low salt diet, taking diuretics (water tablets) for a long time or having had dialysis)

•    If you are going to have treatment to reduce your allergy to bee or wasp stings (desensitization)

•    If you are going to receive an anaesthetic. This may be given for an operation or any dental

work. You may need to stop your Ramipril treatment one day beforehand; ask your doctor for advice

•    If you have high amounts of potassium in your blood (shown in blood test results)

•    If you have a collagen vascular disease such as scleroderma or systemic lupus erythematosus

•    If you are taking any of the following medicines used to treat high blood pressure:

-    an angiotensin II receptor blocker (ARBs) (also known as sartans - for example valsartan, telmisartan, irbesartan), in particular if you have diabetes-related kidney problems.

-    aliskiren

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Ramipril”.

You must tell your doctor if you think that you are (or might become) pregnant. Ramipril is not recommended in the first 3 months of pregnancy and may cause serious harm to your baby after 3 months of pregnancy, see section “Pregnancy and breast-feeding”.

Children and adolescents

Ramipril is not recommended for use in children and adolescents below 18 years of age because safety and efficacy of Ramipril in children has not yet been established.

If any of the above apply to you (or you are not sure), talk to your doctor before taking Ramipril. Other medicines and Ramipril

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription (including herbal medicines).

This is because Ramipril can affect the way some other medicines work. Also some medicines can affect the way Ramipril works. Your doctor may need to change your dose and/or to take other precautions.

Please tell your doctor if you are taking any of the following medicines. They can make Ramipril work less well:

•    Medicines used to relieve pain and inflammation (e.g. Non-Steroidal Anti-Inflammatory Drugs

(NSAIDs) such as ibuprofen or indomethacin and aspirin)

•    Medicines used for the treatment of low blood pressure, shock, cardiac failure, asthma or

allergies such as ephedrine, noradrenaline or adrenaline. Your doctor will need to check your blood pressure.

Please tell your doctor if you are taking any of the following medicines. They can increase the chance of getting side effects if you take them with Ramipril:

•    Medicines used to relieve pain and inflammation (e.g. Non-Steroidal Anti-Inflammatory Drugs

(NSAIDs) such as ibuprofen or indometacin and aspirin)

•    Medicines for cancer (chemotherapy)

•    Medicines to stop the rejection of organs after a transplant such as ciclosporin

•    Diuretics (water tablets) such as furosemide

•    Medicines which can increase the amount of potassium in your blood such as spironolactone,

triamterene, amiloride, potassium salts and heparin (for thinning blood)

•    Steroid medicines for inflammation such as prednisolone

•    Allopurinol (used to lower the uric acid in your blood)

•    Procainamide (for heart rhythm problems).

•    An angiotensin II receptor blocker (ARB) or aliskiren (see information under the headings “Do

not take Ramipril” and “Warnings and precautions”)

Please tell your doctor if you are taking any of the following medicines. They may be affected by Ramipril:

•    Medicines for diabetes such as oral glucose lowering medicines and insulin. Ramipril may

lower your blood sugar amounts. Check your blood sugar amounts closely while taking Ramipril

•    Lithium (for mental health problems). Ramipril may increase the amount of lithium in your

blood. Your lithium amount will need to be closely checked by your doctor.

If any of the above apply to you (or you are not sure), talk to your doctor before taking Ramipril. Ramipril with food, drink and alcohol

Drinking alcohol with Ramipril may make you feel dizzy or light-headed. If you are concerned about how much you can drink while you are taking Ramipril, discuss this with your doctor as medicines used to reduce blood pressure and alcohol can have additive effects.

Ramipril may be taken with or without food.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

You should not take Ramipril in the first 12 weeks of pregnancy, and you must not take them at all after the 13th week as their use during pregnancy may possibly be harmful to the baby.

If you become pregnant while on Ramipril, tell your doctor immediately. A switch to a suitable alternative treatment should be carried out in advance of a planned pregnancy.

You should not take Ramipril if you are breast-feeding.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

You may feel dizzy, while taking Ramipril. This is more likely to happen when you start taking Ramipril or start taking a higher dose. If this happens, do not drive or use any tools or machines.

3. HOW TO TAKE RAMIPRIL

Always take Ramipril exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Taking this medicine

•    Take this medicine by mouth at the same time of the day each day.

•    Swallow the capsules whole with liquid.

•    Do not crush or chew the capsules.

How much to take

Treatment of high blood pressure

   The usual starting dose is 1.25 mg or 2.5 mg once daily.

•    Your doctor will adjust the amount you take until your blood pressure is controlled.

•    The maximum dose is 10 mg once daily.

•    If you are already taking diuretics (water tablets), your doctor may stop or reduce the amount of

the diuretic you take before beginning treatment with Ramipril.

To reduce the risk of you having a heart attack or stroke

   The usual starting dose is 2.5 mg once daily.

•    Your doctor may then decide to increase the amount you take.

•    The usual dose is 10 mg once daily.

Treatment to reduce or delay the worsening of kidney problems

   You may be started on a dose of 1.25 mg or 2.5 mg once daily.

•    Your doctor will adjust the amount you are taking.

•    The usual dose is 5 mg or 10 mg once daily.

Treatment of heart failure

•    The usual starting dose is 1.25 mg once daily.

•    Your doctor will adjust the amount you take.

•    The maximum dose is 10 mg daily. Two administrations per day are preferable.

Treatment after you have had a heart attack

•    The usual starting dose is 1.25 mg once daily to 2.5 mg twice daily.

•    Your doctor will adjust the amount you take.

•    The usual dose is 10 mg daily. Two administrations per day are preferable.

Elderly

Your doctor will reduce the initial dose and adjust your treatment more slowly.

If you take more Ramipril than you should

Tell a doctor or go to the nearest hospital casualty department straight away. Do not drive to the hospital, get somebody else to take you or call for an ambulance. Take the medicine pack with you. This is so the doctor knows what you have taken.

If you forget to take Ramipril

•    If you miss a dose, take your normal dose when it is next due.

•    Do not take a double dose to make up for a forgotten capsule.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS

Like all medicines, Ramipril can cause side effects, although not everybody gets them.

Stop taking Ramipril and see a doctor straight away, if you notice any of the following serious side effects - you may need urgent medical treatment:

•    Swelling of the face, lips or throat which make it difficult to swallow or breathe, as well as

itching and rashes. This could be a sign of a severe allergic reaction to Ramipril

•    Severe skin reactions including rash, ulcers in your mouth, worsening of a pre-existing skin

disease, reddening, blistering or detachment of skin (such as Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme).

Tell your doctor immediately if you experience:

•    Faster heart rate, uneven or forceful heartbeat (palpitations), chest pain, tightness in your chest

or more serious problems including heart attack and stroke

•    Shortness of breath or a cough. These could be signs of lung problems

•    Bruising more easily, bleeding for longer than normal, any sign of bleeding (e.g. bleeding from

the gums), purple spots blotching on the skin or getting infections more easily than usual, sore throat and fever, feeling tired, faint, dizzy or having pale skin. These can be signs of blood or bone marrow problems

•    Severe stomach pain which may reach through to your back. This could be a sign of pancreatitis

(inflammation of the pancreas) which can be fatal.

•    Fever, chills, tiredness, loss of appetite, stomach pain, feeling sick, yellowing of your skin or

eyes (jaundice). These can be signs of liver problems such as hepatitis (inflammation of the liver) or liver damage and/or liver failure.

Other side effects include:

Please tell your doctor if any of the following gets serious or lasts longer than a few days.

Common (affects less than 1 in 10 people)

•    Headache or feeling tired

•    Feeling dizzy. This is more likely to happen when you start taking Ramipril or start taking a

higher dose

•    Fainting, hypotension (abnormally low blood pressure), especially when you stand or sit up

quickly

•    Dry tickly cough, inflammation of your sinuses (sinusitis) or bronchitis, shortness of breath

•    Stomach or gut pain, diarrhoea, indigestion, feeling or being sick

•    Skin rash with or without raised area

•    Chest pain

•    Cramps or pain in your muscles

•    Blood tests showing more potassium than usual in your blood.

Uncommon (affects less than 1 in 100 people)

•    Balance problems (vertigo)

•    Itching and unusual skin sensations such as numbness, tingling, pricking, burning or creeping

on your skin (paraesthesia)

•    Loss or change in the way things taste

•    Sleep problems

•    Feeling depressed, anxious, more nervous than usual or restless

•    Blocked nose, difficulty breathing or worsening of asthma

•    A swelling in your gut called “intestinal angioedema” presenting with symptoms like abdominal

pain, vomiting and diarrhea

•    Heartburn, constipation or dry mouth

•    Passing more water (urine) than usual over the day

•    kidney disease where you pass little or no urine

•    Sweating more than usual

•    Loss or decrease of appetite (anorexia)

•    Increased or irregular heartbeats. Swollen arms and legs. This may be a sign of your body

holding onto more water than usual

•    Flushing

•    Blurred vision

•    Pain in your joints

•    Fever

•    Sexual inability in men, reduced sexual desire in men or women

•    An increased number of certain white blood cells (eosinophilia) found during a blood test

•    Blood tests showing changes in the way your liver, pancreas or kidneys are working.

Rare (affects less than 1 in 1,000 people)

•    Feeling shaky or confused

•    Red and swollen tongue

•    Severe flaking or peeling of the skin, itchy, lumpy rash

•    Nail problem (e.g. loosening or separation of a nail from its bed)

•    Skin rash or bruising

•    Blotches on your skin and cold extremities

•    Red, itchy, swollen or watery eyes

•    Disturbed hearing and ringing in your ears

•    Feeling weak

•    Blood tests showing a decrease in the number of red blood cells, white blood cells or platelets or

in the amount of haemoglobin.

Very rare (affects less than 1 in 10,000 people)

•    Being more sensitive to the sun than usual.

Other side effects reported:

Please tell your doctor if any of the following gets serious or lasts longer than a few days.

•    Difficulty concentrating

•    Swollen mouth

•    Blood tests showing too few blood cells in your blood

•    Blood tests showing less sodium than usual in your blood

•    Fingers and toes changing colour when you are cold and then tingling or feeling painful when

you warm up (Raynaud's phenomenon)

•    Breast enlargement in men

•    Slowed or impaired reactions

•    Burning sensation

•    Change in the way things smell

•    Hair loss.

If you get any side effects, talk to your doctor or , pharmacist or nurse. This includes any side effects not listed in this leaflet.

5. HOW TO STORE RAMIPRIL

Keep this medicine out of the reach and sight of children.

Do not use Ramipril after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.

Do not store above 25oC.

Store in the original package.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. CONTENTS OF THE PACK AND OTHER INFORMATION

What Ramipril contains

-    The active substance is Ramipril.

Ramipril 1.25 mg Capsules: each capsule contains 1.25 mg of Ramipril Ramipril 2.5 mg Capsules: each capsule contains 2.5 mg of Ramipril Ramipril 5 mg Capsules: each capsule contains 5 mg of Ramipril Ramipril 10 mg Capsules: each capsule contains 10 mg of Ramipril

-    The other ingredients are Pregelatinised starch (Starch 1500), Titanium Dioxide E171, Gelatin, Yellow Iron Oxide E172 (for the 1.25 mg and 2.5 mg capsules), Erythrosine E127 (for the 2.5 mg capsules), Acid Red 18 E124 (for the 5 mg and 10 mg capsules), Quinoline Yellow E104 (for the 5 mg capsules), FD&C Blue #2 E132 (for the 10 mg capsules) and Black Iron Oxide E172 (for the 10 mg capsules)

What Ramipril looks like and contents of the pack

1.25 mg capsule: A hard gelatin capsule with yellow opaque body and yellow opaque cap. The body has radially imprinted ‘G’ and the cap has radially imprinted ‘RM1.25’

2.5 mg capsule: A hard gelatin capsule with orange opaque body and orange opaque cap. The body has radially imprinted ‘G’ and the cap has radially imprinted ‘RM2.5’.

5 mg capsule: A hard gelatin capsue with red opaque body and red opaque cap. The body has radially imprinted ‘G’ and the cap has radially imprinted ‘RM5’.

10 mg capsule: A hard gelatin capsule with blue opaque body and blue opaque cap. The body has radially imprinted ‘G’ and the cap has radially imprinted ‘RM10’.

Ramipril capsules is available in bottles or in blister packs with the pack size of 7, 10, 14, 21, 28, 30, 32, 50, 100 capsules. Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Generics [UK] Ltd Station Close Potters Bar

Hertfordshire EN6 1TL England

This leaflet was last revised in September 2014.

This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor or pharmacist.

Page 8 of 8