{"id":59124,"date":"2024-02-28T05:42:52","date_gmt":"2024-02-28T05:42:52","guid":{"rendered":"https:\/\/medsname.com\/rami-race\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"rami-race","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/rami-race\/","title":{"rendered":"Rami Race"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 R\u0103spuns rapid \u2014 Ce este Rami Race?<\/h3>\n<p style=\"margin:0;\"><strong>Rami Race<\/strong> este un <strong>Comprimat de ramipril 10 mg<\/strong> de la Torrent Pharmaceuticals \u2014 un <strong>inhibitor al enzimei de conversie a angiotensinei (ECA)<\/strong>. Inhibitorii ECA sunt <strong>terapie antihipertensiv\u0103 de prim\u0103 inten\u021bie<\/strong> \u00een majoritatea ghidurilor interna\u021bionale (NICE, AHA\/ACC, ESC\/ESH), \u00een special pentru pacien\u021bii sub 55 de ani \u0219i pentru diabetici, pacien\u021bi cu insuficien\u021b\u0103 cardiac\u0103, pacien\u021bi post-IM, \u0219i cei cu boli renale proteinurice. Ramiprilul este <strong>prodrog<\/strong> convertit de esterazele hepatice \u00een ramiprilat (inhibitorul activ al ECA) cu o timp de \u00eenjum\u0103t\u0103\u021bire efectiv de 13-17 ore (ramiprilat) \u2014 permite administrarea o dat\u0103 pe zi. Doza tipic\u0103 pentru hipertensiune: <strong>\u00eencepe\u021bi cu 1,25-2,5 mg o dat\u0103 pe zi, ajusta\u021bi la 2,5-10 mg o dat\u0103 pe zi<\/strong>. Efect secundar principal: <strong>tuse uscat\u0103 persistent\u0103<\/strong> (p\u00e2n\u0103 la 20% dintre utilizatori, efect de clas\u0103; dac\u0103 este intolerabil, trece\u021bi la un ARB precum <a href=\"https:\/\/medsbase.com\/ro\/losar\/\">losartan<\/a> sau <a href=\"https:\/\/medsbase.com\/ro\/telmaheal\/\">telmisartan<\/a>). Alte efecte de clas\u0103: hiperkaliemie, hipotensiune la prima doz\u0103, cre\u0219tere reversibil\u0103 a creatinei la \u00eenceput. <strong>Contraindica\u021bie absolut\u0103 \u00een sarcin\u0103<\/strong> (toate trimestrele \u2014 provoac\u0103 agenezie renal\u0103 fetal\u0103, oligohidramnios, hipoplazie pulmonar\u0103, defecte craniene), stenoz\u0103 bilateral\u0103 a arterei renale \u0219i istoric de angioedem indus de inhibitori ECA.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<h2 class=\"wp-block-heading\">Ce este Rami Race?<\/h2>\n<p>Rami Race este un comprimat oral de ramipril 10 mg de la Torrent Pharmaceuticals, furnizat \u00een cutii de 30-180 comprimate. Introdus \u00een 1989 (Hoechst \/ acum Sanofi) ca <strong>Altace \/ Tritace<\/strong>. Cel mai prescris inhibitor al enzimei de conversie a angiotensinei (ECA) la nivel mondial.<\/p>\n<p>Ramiprilul este un <strong>prodrog<\/strong> convertit de esterazele hepatice \u00een ramiprilat (inhibitorul activ al ECA), cu o semi-vie\u021b\u0103 efectiv\u0103 de 13-17 ore (ramiprilat) \u2014 permite administrarea o dat\u0103 pe zi.<\/p>\n<h2 class=\"wp-block-heading\">Cum Ramiprilul Scade Tensiunea Arterial\u0103<\/h2>\n<p>Inhibitorii ECA blocheaz\u0103 <strong>enzima de conversie a angiotensinei<\/strong>, care catalizeaz\u0103 conversia angiotensinei I inactive \u00een angiotensina II activ\u0103. Angiotensina II este un puternic vasoconstrictor \u0219i principalul stimul pentru eliberarea aldosteronului de la nivelul suprarenalelor. Blocarea form\u0103rii acesteia produce:<\/p>\n<ul>\n<li><strong>Vasodilata\u021bie arterial\u0103 direct\u0103<\/strong> \u2014 reducerea rezisten\u021bei vasculare sistemice = sc\u0103derea tensiunii arteriale<\/li>\n<li><strong>Secre\u021bie redus\u0103 de aldosteron<\/strong> \u2014 mai pu\u021bin\u0103 reten\u021bie renal\u0103 de sodiu \u0219i ap\u0103<\/li>\n<li><strong>Reducerea pre\u00eenc\u0103rc\u0103rii<\/strong> (desc\u0103rcare venoas\u0103 + modest\u0103 ventricular\u0103) \u2014 deosebit de important\u0103 \u00een insuficien\u021ba cardiac\u0103<\/li>\n<li><strong>Acumulare de bradikinin\u0103<\/strong> \u2014 ACE degradeaz\u0103 \u0219i bradikinina; blocarea ACE cre\u0219te nivelurile de bradikinina, ceea ce poten\u021beaz\u0103 vasodilata\u021bia (\u0219i provoac\u0103 efectul secundar de tuse uscat\u0103 la ~20% dintre utilizatori)<\/li>\n<li><strong>Reducerea activ\u0103rii sistemului nervos simpatic<\/strong><\/li>\n<li><strong>\u00cembun\u0103t\u0103\u021birea func\u021biei endoteliale<\/strong> \u0219i reducerea remodel\u0103rii ventriculare \u2014 responsabile pentru efectele vasoprotectoare observate \u00een studii (HOPE, EUROPA) care dep\u0103\u0219esc simpla sc\u0103dere a tensiunii arteriale<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Utiliz\u0103ri aprobate \u0219i bazate pe dovezi<\/h2>\n<ul>\n<li><strong>Hipertensiune arterial\u0103<\/strong> \u2014 indica\u021bie primar\u0103, de prim\u0103 inten\u021bie conform ghidurilor NICE, ESC\/ESH \u0219i AHA\/ACC pentru majoritatea adul\u021bilor sub 55 de ani \u0219i pentru toate v\u00e2rstele cu diabet, boli renale cronice sau insuficien\u021b\u0103 cardiac\u0103<\/li>\n<li><strong>Reducerea riscului cardiovascular<\/strong> la pacien\u021bii cu ateroscleroz\u0103 stabilit\u0103, infarct miocardic anterior, accident vascular cerebral, boal\u0103 vascular\u0103 periferic\u0103 sau diabet + un factor de risc suplimentar (dovezile din studiul HOPE)<\/li>\n<li><strong>Insuficien\u021b\u0103 cardiac\u0103 cu frac\u021bie de ejec\u021bie redus\u0103 (IC-FER)<\/strong> \u2014 studiul AIRE<\/li>\n<li><strong>Disfunc\u021bia ventricular\u0103 st\u00e2ng\u0103 post-infarct<\/strong><\/li>\n<li><strong>Nefropatia diabetic\u0103<\/strong> \u2014 \u00eencetine\u0219te progresia albuminuriei \u0219i declinul func\u021biei renale<\/li>\n<li><strong>BPC nefropatic proteinuric non-diabetic<\/strong><\/li>\n<\/ul>\n<p><strong>Dovezile din studiile pivotale:<\/strong> Studiul HOPE (2000) \u2014 ramipril 10 mg\/zi a redus mortalitatea cardiovascular\u0103, infarctul miocardic \u0219i accidentul vascular cerebral cu 22% la pacien\u021bii cu boli vasculare stabilite sau diabet plus un factor de risc. Studiul AIRE \u2014 reducere a mortalit\u0103\u021bii cu 27% la pacien\u021bii cu insuficien\u021b\u0103 cardiac\u0103 post-IM. Aceste studii au stabilit inhibitorii ACE ca agen\u021bi protectori vasculari, nu doar ca medicamente antihpertensive.<\/p>\n<h2 class=\"wp-block-heading\">Doza Rami Race<\/h2>\n<p><strong>Hipertensiune arterial\u0103:<\/strong><\/p>\n<ul>\n<li><strong>Doza ini\u021bial\u0103:<\/strong> 1,25-2,5 mg o dat\u0103 pe zi<\/li>\n<li><strong>Doza \u021bint\u0103:<\/strong> 2,5-10 mg o dat\u0103 pe zi<\/li>\n<li><strong>Maximum:<\/strong> 10 mg o dat\u0103 pe zi<\/li>\n<li>Titra\u021bi la fiecare 2-4 s\u0103pt\u0103m\u00e2ni \u00een func\u021bie de r\u0103spunsul tensional \u0219i tolerabilitate<\/li>\n<\/ul>\n<p><strong>Insuficien\u021b\u0103 cardiac\u0103 cu frac\u021bie de ejec\u021bie redus\u0103 (IC-FER):<\/strong> \u00cencepe\u021bi cu 1,25-2,5 mg de dou\u0103 ori pe zi; titra\u021bi p\u00e2n\u0103 la 5 mg de dou\u0103 ori pe zi (\u021bint\u0103 IC-FER)<\/p>\n<p><strong>Post-infarct miocardic:<\/strong> 5 mg de dou\u0103 ori pe zi, \u00eencep\u00e2nd cu 2-9 zile post-IM<\/p>\n<p><strong>Precau\u021bii la prima doz\u0103:<\/strong> hipotensiunea la prima doz\u0103 este mai probabil\u0103 la pacien\u021bii sub tratament cu diuretice \u00een doze mari, la pacien\u021bii deshidrata\u021bi, la cei cu insuficien\u021b\u0103 cardiac\u0103 \u0219i la pacien\u021bii \u00een v\u00e2rst\u0103. Administra\u021bi prima doz\u0103 la ora de culcare; monitoriza\u021bi TA; suspenda\u021bi diureticele 24-48 de ore \u00eenainte de \u00eenceperea tratamentului, dac\u0103 posibil.<\/p>\n<p><strong>Monitorizare:<\/strong><\/p>\n<ul>\n<li>La baz\u0103: uree, electroli\u021bi (\u00een special potasiu), creatinin\u0103, eTFG. M\u0103sura\u021bi tensiunea arterial\u0103 ini\u021bial\u0103.<\/li>\n<li>Dup\u0103 1-2 s\u0103pt\u0103m\u00e2ni: repeta\u021bi U&amp;E. Efecte a\u0219teptate: cre\u0219tere u\u0219oar\u0103 a creatininemiei (p\u00e2n\u0103 la 30% este acceptabil\u0103 \u0219i reflect\u0103 o modificare hemodinamic\u0103 intrarenal\u0103, nu nefrotoxicitate); cre\u0219tere u\u0219oar\u0103 a potasiemiei.<\/li>\n<li>Dup\u0103 cre\u0219terea dozei: repeta\u021bi analizele U&amp;E dup\u0103 1-2 s\u0103pt\u0103m\u00e2ni.<\/li>\n<li>Pe termen lung: analize U&amp;E anual odat\u0103 stabilizat.<\/li>\n<li><strong>Opri\u021bi \u0219i investiga\u021bi:<\/strong> cre\u0219terea creatininemiei &gt;30%, sc\u0103derea eGFR &gt;25%, potasiu &gt;5,5, hipotensiune sau ame\u021beli noi.<\/li>\n<\/ul>\n<p><strong>\u00centrerupere:<\/strong> reducerea treptat\u0103 a dozei nu este strict necesar\u0103 pentru inhibitorii ACE (spre deosebire de beta-blocante), dar \u00eentreruperea brusc\u0103 poate provoca revenirea tensiunii arteriale \u00een c\u00e2teva zile. Dac\u0103 se opre\u0219te tratamentul, reduce\u021bi doza progresiv pe 1-2 s\u0103pt\u0103m\u00e2ni \u0219i monitoriza\u021bi TA.<\/p>\n<h2 class=\"wp-block-heading\">Efecte Secundare<\/h2>\n<p><strong>Frecvente (&gt;5%):<\/strong><\/p>\n<ul>\n<li><strong>Tuse uscat\u0103 persistent\u0103<\/strong> (p\u00e2n\u0103 la 20% \u2014 efect de clas\u0103 datorat acumul\u0103rii de bradikinin\u0103). De obicei apare \u00een primele s\u0103pt\u0103m\u00e2ni de la \u00eenceperea terapiei; nu dispare cu timpul. Dac\u0103 este deranjant\u0103, trece\u021bi la un ARB (losartan, telmisartan, olmesartan, valsartan, irbesartan) \u2014 ARB nu provoac\u0103 tuse deoarece ac\u021bioneaz\u0103 \u00een aval de metabolismul bradikininet.<\/li>\n<li>Ame\u021beli, hipotensiune postural\u0103 (mai ales la \u00eenceputul terapiei)<\/li>\n<li>Hiperkaliemie u\u0219oar\u0103 (verifica\u021bi potasiul)<\/li>\n<li>Cre\u0219tere reversibil\u0103 a creatininemiei (p\u00e2n\u0103 la ~30% este a\u0219teptat\u0103 \u0219i acceptabil\u0103)<\/li>\n<li>Cefalee, oboseal\u0103<\/li>\n<li>Modificarea senza\u021biei gustative (disgeuzie)<\/li>\n<\/ul>\n<p><strong>Pu\u021bin frecvente, dar importante:<\/strong><\/p>\n<ul>\n<li><strong>Angioedem<\/strong> \u2014 tumefac\u021bie poten\u021bial letal\u0103 a buzelor, limbii sau c\u0103ilor respiratorii. Inciden\u021b\u0103 ~0,1-0,5%; mai frecvent\u0103 la pacien\u021bii de origine african\u0103. Poate ap\u0103rea dup\u0103 ani de utilizare f\u0103r\u0103 incidente. <strong>Opri\u021bi imediat<\/strong>, solicita\u021bi ajutor medical de urgen\u021b\u0103 \u0219i nu relua\u021bi niciun inhibitor ACE \u2014 de asemenea, ARB sunt contraindica\u021bi \u00een primele 4 s\u0103pt\u0103m\u00e2ni la pacien\u021bii cu antecedente de angioedem provocat de inhibitori ACE.<\/li>\n<li><strong>Leziune renal\u0103 acut\u0103 \u00een stenoz\u0103 bilateral\u0103 a arterei renale<\/strong> \u2014 inhibarea ACE elimin\u0103 constric\u021bia arteriolelor eferente dependente de angiotensin-II care men\u021bine GFR \u00een perfuzia renal\u0103 sever compromis\u0103. De obicei se manifest\u0103 prin cre\u0219terea creatinei cu &gt;30% \u00een c\u00e2teva zile de la \u00eenceperea tratamentului.<\/li>\n<li><strong>Hiperkaliemie sever\u0103<\/strong> \u2014 \u00een special cu suplimente de potasiu, diuretice care economisesc potasiu (spironolacton\u0103), AINS sau \u00een BCR<\/li>\n<li><strong>Neutropenie \u0219i agranulocitoz\u0103<\/strong> \u2014 foarte rar\u0103, \u00een principal o preocupare istoric\u0103 legat\u0103 de captopril<\/li>\n<li><strong>Disfunc\u021bie hepatic\u0103 \/ icter colestatic<\/strong> \u2014 foarte rar<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contraindica\u021bii<\/h2>\n<ul>\n<li><strong>Sarcina \u2014 CONTRAINDICA\u021aIE ABSOLUT\u0102 \u00een toate trimestrele.<\/strong> Inhibitorii ACE provoac\u0103 agenezie renal\u0103 fetal\u0103, oligohidramnios, hipoplazie pulmonar\u0103 \u0219i hipoplazie cranian\u0103. \u00centrerupe\u021bi imediat dac\u0103 apare sarcina. Femeile \u00een v\u00e2rst\u0103 fertil\u0103 ar trebui s\u0103 utilizeze metode contraceptive sigure sau s\u0103 treac\u0103 la un antihipertensiv sigur \u00een sarcin\u0103 (<a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a>, methyldopa, nifedipine, hidralazin\u0103) \u00eenainte de concep\u021bie.<\/li>\n<li><strong>Istoric de angioedem indus de inhibitori ACE<\/strong> \u2014 contraindicat absolut; chiar \u0219i un singur episod anterior face inhibitorii ACE contraindica\u021bi pe via\u021b\u0103<\/li>\n<li><strong>Stenoz\u0103 bilateral\u0103 a arterei renale<\/strong> sau stenoz\u0103 \u00eentr-un singur rinchi func\u021bional \u2014 risc de ARI<\/li>\n<li><strong>Angioedem ereditar sau idiopatic<\/strong><\/li>\n<li><strong>Stenoz\u0103 aortic\u0103 sever\u0103<\/strong> \u2014 relativ; poate precipita hipotensiune<\/li>\n<li><strong>Hiperkaliemie &gt;5,5 mmol\/L<\/strong> la evaluarea ini\u021bial\u0103 (corecta\u021bi \u00eent\u00e2i)<\/li>\n<li><strong>Administrare concomitent\u0103 cu sacubitril\/valsartan (Entresto)<\/strong> \u2014 nu combina\u021bi; este necesar\u0103 o perioad\u0103 de eliminare de 36 de ore<\/li>\n<li><strong>Administrare concomitent\u0103 cu aliskiren \u00een diabet sau BCR<\/strong> (inhibitor direct al reninei)<\/li>\n<li>Hipersensibilitate la ramipril<\/li>\n<\/ul>\n<p><strong>Al\u0103ptarea:<\/strong> enalaprilul \u0219i captoprilul sunt considerate compatibile (cantit\u0103\u021bi mici \u00een laptele matern); datele pentru ramipril sunt limitate \u2014 evita\u021bi \u00een primele s\u0103pt\u0103m\u00e2ni dup\u0103 na\u0219terea unui copil prematur; \u00een general acceptabil dup\u0103 aceea.<\/p>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>Diuretice economisitoare de potasiu<\/strong> (spironolacton\u0103, eplerenon\u0103, amilorid\u0103, triamteren\u0103) \u2014 hiperkaliemie aditiv\u0103; monitoriza\u021bi K \u00eendeaproape. Combina\u021bia este utilizat\u0103 clinic \u00een IC-FER dar necesit\u0103 monitorizare atent\u0103.<sup>+<\/sup> Suplimente de potasiu.<\/li>\n<li><strong>\u0219i \u00eenlocuitori de sare care con\u021bin potasiu \u2014 risc de hiperkaliemie<\/strong> (ibuprofen, diclofenac, naproxen) \u2014 reduc efectul antihipertensiv al inhibitorilor ACE \u0218I cresc riscul de leziune renal\u0103 acut\u0103 (\u201etriplu impact\u201d = inhibitor ACE + diuretic + AINS). Evita\u021bi combina\u021bia cronic\u0103.<\/li>\n<li><strong>AINS<\/strong> \u2014 inhibitorii ACE reduc clearance-renal de litiu; monitoriza\u021bi nivelurile de litiu \u00eendeaproape.<\/li>\n<li><strong>Litiu<\/strong> \u2014 de obicei complementare; monitoriza\u021bi TA<\/li>\n<li><strong>Alte antihipertensive<\/strong> Sacubitril\/valsartan (Entresto)<\/li>\n<li><strong>\u2014 nu combina\u021bi; este necesar\u0103 o perioad\u0103 de eliminare de 36 de ore pentru a evita riscul de angioedem<\/strong> \u2014 rapoarte rare de hipersensibilitate crescut\u0103; minor din punct de vedere clinic<\/li>\n<li><strong>Allopurinol<\/strong> Aliskiren<\/li>\n<li><strong>\u2014 evita\u021bi combina\u021bia \u00een diabet \u0219i BCR (studiul ALTITUDE oprit prematur din cauza riscului)<\/strong> Clasa inhibitorilor ACE pe scurt<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Inhibitor ACE<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">ACE Inhibitor<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Activare<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Cel mai bun pentru \/ studiu cheie<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/ramcor\/\">Ramipril (Ramcor, Rami Race, Ramgee, Ramisave)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prodrog (metabolizat \u00een ficat \u2192 ramiprilat)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Protec\u021bie vascular\u0103 (HOPE); post-IM (AIRE)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/enapril\/\">Enalapril (Enapril)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prodrog (metabolizat \u00een ficat \u2192 enalaprilat)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Insuficien\u021b\u0103 cardiac\u0103 (CONSENSUS, SOLVD)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/lispro\/\">Lisinopril (Lispro, Hypernil)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Substan\u021b\u0103 activ\u0103 (nu necesit\u0103 metabolizare hepatic\u0103)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Preferat \u00een insuficien\u021ba hepatic\u0103; IC (ATLAS); post-IM (GISSI-3)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/ro\/coversyl\/\">Perindopril (Coversyl)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prodrog\u0103 (ficat \u2192 perindoprilat)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Cea mai lung\u0103 perioad\u0103 de \u00eenjum\u0103t\u0103\u021bire; HTA (ASCOT-BPLA); CAD (EUROPA); preven\u021bia accidentului vascular cerebral (PROGRESS)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Captopril<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Substan\u021b\u0103 activ\u0103<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Perioad\u0103 de \u00eenjum\u0103t\u0103\u021bire scurt\u0103 (6 h); agent de referin\u021b\u0103 istoric; rareori de prim\u0103 inten\u021bie acum<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Inhibitor ACE vs ARB \u2014 Care s\u0103 alegi?<\/h2>\n<p>Blocantele receptorului de angiotensin\u0103 (ARB \u2014 <a href=\"https:\/\/medsbase.com\/ro\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/olmin\/\">olmesartan<\/a>, valsartan, irbesartan) ac\u021bioneaz\u0103 pe aceea\u0219i cale renin\u0103-angiotensin\u0103 dar blocheaz\u0103 angiotensina II la nivelul receptorului AT1 \u00een loc s\u0103 blocheze formarea acesteia. Efectul clinic asupra TA este \u00een general echivalent. Diferen\u021be:<\/p>\n<ul>\n<li><strong>F\u0103r\u0103 tuse uscat\u0103<\/strong> cu ARB \u2014 nu cresc nivelurile de bradikinin\u0103. ARB-urile sunt prima alegere dup\u0103 tusea provocat\u0103 de inhibitori ACE.<\/li>\n<li><strong>Angioedemul este rar dar posibil cu ARB<\/strong> \u2014 NU \u00eencepe un ARB \u00een decurs de 4 s\u0103pt\u0103m\u00e2ni dup\u0103 un episod de angioedem provocat de inhibitor ACE; utilizarea pe termen lung a ARB la pacien\u021bii cu antecedente de angioedem provocat de inhibitor ACE este \u00een general acceptabil\u0103 dar monitorizat\u0103.<\/li>\n<li><strong>Cost<\/strong> \u2014 inhibitorii generici de ACE sunt u\u0219or mai ieftini dec\u00e2t ARB-urile generice \u00een majoritatea pie\u021belor<\/li>\n<li><strong>Dovezi \u00een insuficien\u021b\u0103 cardiac\u0103<\/strong> \u2014 inhibitorii de ACE au dovezi istorice u\u0219or mai puternice privind mortalitatea; ARB-urile sunt validate ca echivalente \u00een studiile mai recente \u0219i sunt utilizate c\u00e2nd inhibitorii de ACE nu sunt tolera\u021bi<\/li>\n<li><strong>NU combina\u021bi inhibitor de ACE + ARB<\/strong> \u2014 studiul ONTARGET a ar\u0103tat efecte adverse (mai mult\u0103 hiperkaliemie, insuficien\u021b\u0103 renal\u0103 acut\u0103, hipotensiune) f\u0103r\u0103 beneficii suplimentare privind mortalitatea<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Depozitare<\/h2>\n<p>Depozita\u021bi Rami Race sub 25\u00b0C \u00een ambalajul original blister. Proteja\u021bi de umiditate. P\u0103stra\u021bi \u00een afara reachii copiilor.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">C\u00e2t timp dureaz\u0103 ca Rami Race s\u0103 scad\u0103 tensiunea arterial\u0103?<\/h3>\n<p>Sc\u0103derea ini\u021bial\u0103 a TA \u00een 1-2 ore de la prima doz\u0103; efectul antihipertensiv complet la 2-4 s\u0103pt\u0103m\u00e2ni pe m\u0103sur\u0103 ce sistemul renin\u0103-angiotensin\u0103 se adapteaz\u0103 complet. M\u0103sura\u021bi TA acas\u0103 la aceea\u0219i or\u0103 \u00een fiecare zi pentru a monitoriza r\u0103spunsul.<\/p>\n<h3 class=\"wp-block-heading\">De ce am dezvoltat tuse dup\u0103 ce am \u00eenceput tratamentul cu Rami Race?<\/h3>\n<p>Inhibitorii de ACE cresc nivelurile de bradikinin\u0103 \u00een tractul respirator, provoc\u00e2nd o <strong>tuse uscat\u0103, persistent\u0103 la p\u00e2n\u0103 la 20% dintre utilizatori<\/strong>. Aceasta apare de obicei \u00een c\u00e2teva zile p\u00e2n\u0103 la s\u0103pt\u0103m\u00e2ni, nu se \u00eembun\u0103t\u0103\u021be\u0219te cu antitusive \u0219i nu dispare dac\u0103 continua\u021bi tratamentul. Dac\u0103 tusea este deranjant\u0103, trece\u021bi la un ARB (<a href=\"https:\/\/medsbase.com\/ro\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/olmin\/\">olmesartan<\/a>) \u2014 tusea dispare \u00een 1-4 s\u0103pt\u0103m\u00e2ni dup\u0103 \u00eentreruperea inhibitorului de ACE.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua Rami Race \u00een timpul sarcinii?<\/h3>\n<p><strong>Nu \u2014 inhibitorii de ACE sunt absolut contraindica\u021bi \u00een sarcin\u0103.<\/strong> Ele provoac\u0103 agenezie renal\u0103 fetal\u0103, oligohidramnios, hipoplazie pulmonar\u0103 \u0219i hipoplazie cranian\u0103. \u00cenceta\u021bi imediat dac\u0103 apare o sarcin\u0103 \u0219i trece\u021bi la un antihipertensiv sigur \u00een sarcin\u0103 \u2014 <a href=\"https:\/\/medsbase.com\/ro\/labebet\/\">labetalol<\/a>, metildopa, nifedipin\u0103 sau hidralazin\u0103. Femeile \u00een v\u00e2rst\u0103 fertil\u0103 ar trebui s\u0103 foloseasc\u0103 metode contraceptive sigure.<\/p>\n<h3 class=\"wp-block-heading\">Creatinina mea a crescut dup\u0103 ce am \u00eenceput Rami Race \u2014 ar trebui s\u0103 opresc?<\/h3>\n<p>A <strong>cre\u0219terea creatininei de p\u00e2n\u0103 la 30%<\/strong> \u00een primele 1-2 s\u0103pt\u0103m\u00e2ni este <strong>a\u0219teptat\u0103<\/strong> \u0219i acceptabil\u0103 \u2014 reflect\u0103 o ajustare hemodinamic\u0103 intrarenal\u0103 pe m\u0103sur\u0103 ce constric\u021bia arteriolelor eferente dependente de angiotensin-II este eliminat\u0103, nu nefrotoxicitate. O cre\u0219tere &gt;30% sugereaz\u0103 posibil\u0103 stenoz\u0103 bilateral\u0103 a arterei renale, deple\u021bie de volum sau interac\u021biune cu AINS \u2014 \u00eentrerupe\u021bi medicamentul \u0219i investiga\u021bi.<\/p>\n<h3 class=\"wp-block-heading\">Pot consuma alcool \u00een timp ce iau Rami Race?<\/h3>\n<p>Consumul moderat de alcool este \u00een general acceptabil, dar alcoolul are un efect aditiv cu cel vasodilatator \u2014 s-ar putea s\u0103 sim\u021bi\u021bi ame\u021beli c\u00e2nd v\u0103 ridica\u021bi dup\u0103 consum. Consumul excesiv de alcool cre\u0219te independent tensiunea arterial\u0103; reducerea consumului de alcool \u00eembun\u0103t\u0103\u021be\u0219te adesea controlul tensiunii arteriale independent de Rami Race.<\/p>\n<h3 class=\"wp-block-heading\">Ar trebui s\u0103 evit alimentele bogate \u00een potasiu \u00een timp ce iau Rami Race?<\/h3>\n<p>Consumul moderat de alimente bogate \u00een potasiu (banane, portocale, spanac, avocado) este acceptabil pentru majoritatea pacien\u021bilor. Evita\u021bi suplimentele de potasiu (comprimate slow-K) \u0219i \u00eenlocuitorii de sare care con\u021bin clorur\u0103 de potasiu, cu excep\u021bia cazurilor \u00een care sunt prescrise \u00een mod specific \u2014 acestea pot provoca hiperkaliemie periculoas\u0103 atunci c\u00e2nd sunt combinate cu inhibitori ACE, \u00een special la pacien\u021bii cu boli renale cronice (CKD) sau care folosesc diuretice economisitoare de potasiu.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua ibuprofen \u00een timp ce iau Rami Race?<\/h3>\n<p>Utilizarea ocazional\u0103 pe termen scurt a AINS este de obicei acceptabil\u0103, dar <strong>utilizarea cronic\u0103 zilnic\u0103 de AINS<\/strong> (ibuprofen, diclofenac, naproxen) reduce efectul antihipertensiv al inhibitorilor ACE \u0219i cre\u0219te semnificativ riscul de insuficien\u021b\u0103 renal\u0103 acut\u0103 (AKI) \u2014 mai ales atunci c\u00e2nd este combinat\u0103 cu un diuretic (\u201ctriplu impact\u201d = inhibitor ACE + diuretic + AINS). Pentru dureri cronice, paracetamolul este mai sigur; pentru inflama\u021bii, discuta\u021bi alternative cu medicul dumneavoastr\u0103.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua Rami Race \u00eempreun\u0103 cu alte medicamente pentru tensiune?<\/h3>\n<p>Da \u2014 inhibitorii ACE se combin\u0103 bine cu <strong>blocante ale canalelor de calciu<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">amlodipine<\/a>, nifedipin\u0103), <strong>diuretice tiazidice<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/aquazide\/\">HCTZ<\/a>, indapamid\u0103), <strong>beta-blocante<\/strong> (<a href=\"https:\/\/medsbase.com\/ro\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/ro\/betablock-xl\/\">metoprolol<\/a>), \u0219i <strong>antagoni\u0219ti ai aldosteronului<\/strong> (spironolacton\u0103 \u2014 monitoriza\u021bi potasiul<sup>+<\/sup>). <strong>Nu combina\u021bi cu un ARB<\/strong> (studiul ONTARGET a demonstrat efecte adverse f\u0103r\u0103 beneficii).<\/p>\n<h3 class=\"wp-block-heading\">Ce fac dac\u0103 uit o doz\u0103?<\/h3>\n<p>Lua\u021bi comprimatul imediat ce v\u0103 aminti\u021bi, cu excep\u021bia cazului \u00een care este aproape timpul pentru urm\u0103toarea doz\u0103 \u2014 \u00een acest caz, omite\u021bi doza ratat\u0103 \u0219i continua\u021bi conform programului normal. Nu lua\u021bi o doz\u0103 dubl\u0103. O singur\u0103 doz\u0103 ratat\u0103 nu va afecta semnificativ controlul tensiunii arteriale, deoarece inhibitorii ACE au efecte farmacologice de lung\u0103 durat\u0103 prin legarea la \u021besuturi.<\/p>\n<h3 class=\"wp-block-heading\">Unde pot cump\u0103ra Rami Race online?<\/h3>\n<p>Pute\u021bi cump\u0103ra Rami Race (ramipril 10 mg, 30-180 comprimate) de la MedsBase cu ambalaj discret \u0219i livrare la nivel mondial.<\/p>\n<h2 class=\"wp-block-heading\">Antihipertensive \u00eenrudite pe MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/amlode\/\">Amlode \u2014 Amlodipine CCB<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/aquazide\/\">Aquazide \u2014 Hidroclorotiazid\u0103<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/cosart\/\">Cosart \u2014 Losartan (alternativ\u0103 ARB)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/enapril\/\">Enapril \u2014 Enalapril 2,5\/5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/hypernil\/\">Hypernil \u2014 Lisinopril 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/lipril-h\/\">Lipril-H \u2014 Combina\u021bie Lisinopril + HCTZ<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/high-blood-pressure-medication\/\"><strong>R\u0103sfoi\u021bi toate medicamentele pentru hipertensiune arterial\u0103<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 Dezaprobare medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop informativ \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui medic calificat. Hipertensiunea, insuficien\u021ba cardiac\u0103 \u0219i aritmiile necesit\u0103 diagnostic, monitorizare \u0219i individualizarea dozei de c\u0103tre un medic \u2014 utiliza\u021bi \u00eentotdeauna beta-blocante sub \u00eendrumare medical\u0103.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Alternative conexe<\/h3>\n<p>Alte produse din <strong>Afec\u021biuni cronice<\/strong> pe care clien\u021bii le vizualizeaz\u0103 de asemenea:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/diovan-160\/\">Diovan 160<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/cellcept\/\">Cellcept<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/ivabrad\/\">Ivabrad<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/monit\/\">Monit<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/ciplar-la\/\">Ciplar La<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Rami Race este comprimate de ramipril 10 mg de la Torrent \u2014 inhibitor ACE la doza \u021bint\u0103 pentru hipertensiune, insuficien\u021b\u0103 cardiac\u0103, post-infarct miocardic \u0219i reducerea riscului cardiovascular (studiu HOPE a stabilit 10 mg\/zi ca doz\u0103 protector vascular\u0103 la pacien\u021bii cu risc ridicat).<\/p>","protected":false},"featured_media":59125,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3342,3260,3356],"product_tag":[4631,3373],"class_list":{"0":"post-59124","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-general-health","9":"product_cat-heart-blood-pressure","10":"product_cat-high-blood-pressure-medication","11":"product_tag-rami-race","12":"product_tag-ramipril","14":"first","15":"instock","16":"shipping-taxable","17":"purchasable","18":"product-type-variable","19":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/59124","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=59124"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/59125"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=59124"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=59124"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=59124"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=59124"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}