Ramipril 5 mg. 30 tablets

WHAT ramipril 5 mg TEVA AND WHAT IT IS USED
Teva ramipril 5 mg tablets contain the active substance called ramipril. It belongs to a group of medicines called ACE inhibitors (angiotensin converting enzyme).

Teva ramipril 5 mg tablets act as:
Reduced production in your body substances that may increase blood pressure;
Helps to relax and widen your blood vessels;
Helps the heart to pump blood around your body.
Teva ramipril 5 mg tablets are used:
For the treatment of high blood pressure (hypertension);
To reduce the risk or delay the worsening of kidney problems (if you have or do not have diabetes);
For the treatment of heart when it can not pump enough blood to the body (heart failure);
For treatment after a heart attack (myocardial infarction) complicated with heart failure.
2. BEFORE YOU TAKE TEVA ramipril 5 mg tablet:
Do not take Ramipril Teva 5 mg tablets if:
You are hypersensitive (allergic) to ramipril or other ACE inhibitor medicine or any of the excipients;
Have ever had a serious allergic reaction called "angioedema" (symptoms include itching, hives, redness of the hands, feet and throat, swelling of the tongue, oral mucosa and / or throat, swelling around the eyes and lips, difficulty breathing and swallowing;
You are having dialysis or any other type of blood filtration. Depending on the apparatus used, this product may not be suitable for you;
If you have kidney problems where the blood supply to your kidney is reduced (renal artery stenosis);
In the last 6 months of pregnancy (see. Point Pregnancy);
If your blood pressure is abnormally low or unstable. Your doctor should make that assessment.
Do not take Ramipril Teva 5 mg tablets, if any of the above applies to you. If you are not sure, ask your doctor before taking this medicine.

Take special care with Ramipril Teva 5 mg tablets:
Ask your doctor or pharmacist before taking this medicine:
If you have had heart problems, liver or kidney;
If you have lost a lot of body salts or fluids (through vomiting, diarrhea, sweating more than usual, if you are on a diet low in salt if you are taking diuretics (water tablets) for a long time or having had dialysis;
If you are going to have treatment to reduce allergy to stings from bees or wasps (desensitization);
If you are going to have anesthesia. It can be given for an operation or dental work. You may need to stop treatment with Ramipril Teva 5 mg tablets a day earlier. Please ask your doctor for advice;
If you have high amounts of potassium in the blood (seen in blood tests);
If you have collagen vascular disease such as scleroderma or systemic lupus erythematosus;
You should tell your doctor if you are pregnant or think you are pregnant. Teva ramipril 5 mg tablets are not recommended for use during the first three months of pregnancy and may cause serious harm to your baby after the third month of pregnancy (see. Point Pregnancy).
Paediatric population
Teva ramipril 5 mg tablets are not recommended for use in children as safety and efficacy of ramipril have not been established in children.
If any of the above conditions apply to you (or are not sure), please consult your doctor before taking Ramipril Teva 5 mg tablets.

Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. Teva ramipril 5 mg tablets can affect the way some other medicines work and some medicines can affect the way Ramipril of Teva 5 mg tablets.
Please ask your doctor if you are taking any of these medicines. They can weaken the effect of Ramipril Teva 5 mg tablets:
Drugs used to relieve pain and inflammation (e.g., non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or indomethacin and aspirin);
Drugs used for the treatment of low blood pressure, shock, heart failure, asthma or allergies such as ephedrine, noradrenaline or adrenaline. Your doctor should check your blood pressure.
Please tell your doctor if you are taking any of these medicines. They may increase the possibility of getting side effects if you take them with Ramipril Teva 5 mg tablets:
Drugs used to relieve pain and inflammation (e.g. NSAIDs, such as ibuprofen or indomethacin and aspirin);
Medicines to treat cancer (chemotherapy);
Medicines used to prevent organ rejection after transplantation, for example cyclosporin;
Diuretics (water pills) such as furosemide;
Drugs that can increase the amount of potassium in the blood, such as spironolactone, triamterene, amiloride, potassium salts and heparin (a medicine used to thin the blood);
Steroid medicines for inflammation such as prednisolone;
Allopurinol (a drug used to reduce uric acid in the blood);
Procainamide (a medicine used to treat heart rhythm disorders).
Please consult your doctor if you are taking any of these medicines. Their action can be influenced by Teva Ramipril 5 mg tablets:
Medicines for diabetes, blood sugar, which is taken orally and insulin. Teva ramipril 5 mg tablets can lower your blood sugar. Regularly check the blood sugar while taking Ramipril Teva 5 mg tablets;
Lithium (for mental health problems). Teva ramipril 5 mg tablets may increase the amount of lithium in your blood. The amount of lithium should be monitored regularly by your doctor.
If any of the above applies to you (or are not sure), please consult your doctor before taking Ramipril Teva 5 mg tablets.

Taking Ramipril 5 mg Teva with food and drink
Taking alcohol with Ramipril Teva can cause dizziness and fainting. If you are taking Ramipril Teva 5 mg tablets, please consult your doctor how much you can drink as medicines to lower blood pressure and alcohol can have additive effects.
Teva ramipril 5 mg tablets may be taken with or without food.
The tablets should be taken with a sufficient amount of water, preferably in the morning.

Pregnancy and lactation
Pregnancy
You should tell your doctor if you are pregnant or think you may be pregnant. You should not take ramipril in the first 12 weeks of pregnancy and did not have to take it after the 13th week, as it can harm your baby. If you become pregnant while taking ramipril, please contact your doctor immediately. A planned pregnancy you should first discuss with your doctor appropriate alternative treatment.

Breastfeeding
You should not take ramipril if you are breastfeeding.
Please ask your doctor or pharmacist before taking any medicine.

Driving and using machines
At the beginning of treatment with Ramipril Teva 5 mg tablets or with a higher dose may temporarily feel fatigue and dizziness, which can affect your ability to drive and use machines. If this happens, do not drive or use any tools or machines.

Important information about some of the ingredients of Ramipril Teva 5 mg tablets
This medicine contains a sugar called lactose. If you have been told that you have an intolerance to some sugars, consult your doctor before you start taking this medicine.

3. HOW TO TAKE ramipril TEVA
Always take Ramipril Teva 5 mg tablets exactly as your doctor tells you. If you are not sure, ask your doctor or pharmacist.
The tablets should be swallowed whole with some liquid. Tablets should not be crushed or chewed. Try to take this medicine at the same time each day.

Treatment of high blood pressure:
The usual starting dose is 1,25 mg or 2,5 mg once daily;
Your doctor will adjust the dose if your blood pressure is not well 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 Teva 5 mg tablets.
To reduce the risk of heart attack or stroke:
The usual starting dose is 2,5 mg once daily;
Your doctor may then increase the dose;
The usual dose is 10 mg once daily.
Treatment to reduce or delay the worsening of kidney problems:
The usual starting dose is 1,25 mg or 2,5 mg once daily;
Your doctor will adjust your dose;
The usual dose is 5 or 10 mg once daily.
Treatment of heart failure:
The usual starting dose is 1,25 mg once daily;
Your doctor will adjust your dose;
The maximum dose is 10 mg daily. It is recommended to be divided into two doses.
Treatment after myocardial infarction:
The usual initial dose is 1.25 mg once daily to 2,5 mg twice daily;
Your doctor will adjust your dose;
The usual dose is 10 mg daily. It is recommended to be divided into two doses.
Elderly:
Your doctor will reduce the initial dose and adjust your treatment more slowly.
If you take a large dose of Ramipril Teva 5 mg tablets of the required
Call your doctor or go to the nearest hospital. Do not drive to the hospital, get somebody else to take you or call for an ambulance. Take the medicine pack with you to the doctor to understand what you have taken.

If you forget to take Ramipril Teva 5 mg tablets
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose. Do not take a double dose to make up the missed dose.

If you stop taking Ramipril Teva 5 mg tablets
Discontinuation of treatment with Ramipril Teva 5 mg tablets can lead to worsening of your condition. Do not stop taking your medicine unless your doctor has advised you to do so.

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 immediately if you notice any of these side effects. You may need urgent medical treatment:
Swelling of the face, lips or throat that makes it difficult to swallow or breathe, as well as itching and rash. This may be a sign of a severe allergic reaction to ramipril;
Severe skin reactions including rash, ulcers in your mouth, worsening of pre-existing skin disease, reddening, blistering or peeling of the skin (eg. Stevens-Johnson, toxic epidermal necrolysis and erythema multiforme).
Consult a doctor if you experience:
Increased 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 cough. These may be signs of lung problems;
More easy bruising, prolonged bleeding (eg. Bleeding gums), purple spots blotching on the skin; susceptibility to infection, sore throat and fever, feeling tired, dizzy or having pale skin. This may be signs of problems with blood or bone marrow;
Severe stomach pain, which can spread to the back. This may be a sign of pancreatitis (inflammation of the pancreas);
Fever, chills, tiredness, loss of appetite, stomach pain, nausea, yellowing of the skin or whites of the eyes (jaundice). This may be signs of liver problems such as hepatitis (inflammation of the liver) or liver damage.
Other side effects include:
Please tell your doctor if any of these conditions become severe or last longer than a few days.

Common (occurs in less than 1 in 10 users):
Headache or tiredness;
Feeling dizzy. More likely to happen at the beginning of ramipril intake or increasing the dose;
Fainting, hypotension (abnormally low blood pressure), especially when you stand up from a lying or sitting position;
Dry, irritating cough, inflammation of the sinuses (sinusitis) or bronchitis, shortness of breath;
Stomach or gut pain, diarrhea, indigestion, nausea or vomiting;
Skin rash with or without swelling;
Chest pain;
Cramp or muscle pain;
Blood test showing elevated potassium level.
Uncommon (occurs in less than 1 in 100 users):
Disequilibrium (vertigo);
Itching and unusual skin sensations such as numbness, tingling, pricking, burning or creeping on your skin (paraesthesia);
Loss or change in taste;
Sleep problems;
Feeling depressed, anxious, more nervous or shaky than usual;
Stuffy nose, difficulty breathing or worsening of asthma;
Swelling in your gut called "intestinal angioedema" in which symptoms are abdominal pain, vomiting and diarrhea;
Heartburn, constipation or dry mouth;
Separation of the greater than usual amount of urine;
More sweating more than usual;
Loss or reduction of appetite (anorexia);
Fast or irregular heart rate. Swelling of the hands and feet. This may indicate to retain more liquids to the body;
Redness;
Blurred vision;
Joint pain;
Fever;
Sexual inability in men, reduced sexual desire in men or women;
An increased number of certain white blood cells (eosinophilia), detected in blood tests;
Blood tests showing changes in the function of the liver, pancreas or kidneys.
Rare (occurs in less than 1 in 1000 users):
Feelings of uncertainty or confusion;
Red and swollen tongue;
Severe flaking or peeling of the skin, itchy, bumpy rash;
Nail problems (eg. Loss or separation of the nail from the nail bed);
Skin rash or bruising;
Spots on the skin and cold extremities;
Red, itchy, swollen or watery eyes;
Impaired hearing or ringing in the ears;
A feeling of weakness;
Blood tests showing a decrease in the number of red blood cells, white blood cells or platelets, or the amount of hemoglobin.
Very rare (occurs in less than 1 in 10,000 users):
More sensitive to sunlight than usual.
Other reported side effects:
Please tell your doctor if any of these conditions become severe or last longer than a few days.
Severe constipation;
Swollen lips;
Blood tests, showing a very small number of cells;
Blood tests showing less sodium than usual amount;
Discoloration of the fingers and toes when cold and then tingling or painful when warming (Raynaud's phenomenon);
Breast enlargement in men;
Slowed or impaired reactions;
Burning sensation;
Change in sense of smell;
Hair loss.
If any of the side effects gets serious, or you notice other effects not listed in this leaflet, please tell your doctor or pharmacist.

5. HOW TO STORE ramipril TEVA
Keep out of reach of children.
Do not use Ramipril Teva 5 mg tablets after the expiry date stated on the carton and blister after "EXP" The expiry date refers to the last day of that month.
Do not store above 25 ° C. Store in the original package in order to protect from moisture.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.