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Altace

Altace
Ramipril Altace is an antihypertensive drug belonging to the group of ACE inhibitors. It is intended to maintain the target blood pressure level in persons with arterial hypertension.

Brand: Ramipril

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: November 2023
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Package Price Per pill Save Order
Altace 10 mg
360 pills - 10 mg
+ 12 free Viagra 100 mg, 7% discount for future orders
$396.03 $1.10 $179.13 Add to cart
180 pills - 10 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$203.79 $1.13 $83.79 Add to cart
120 pills - 10 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$141.55 $1.18 $50.17 Add to cart
90 pills - 10 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$109.93 $1.22 $33.86 Add to cart
60 pills - 10 mg $78.99 $1.32 $16.87 Add to cart
30 pills - 10 mg $47.93 $1.60 No Add to cart
Altace 5 mg
360 pills - 5 mg
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$352.91 $0.98 $150.97 Add to cart
180 pills - 5 mg
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$183.99 $1.02 $67.95 Add to cart
120 pills - 5 mg
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$125.99 $1.05 $41.97 Add to cart
90 pills - 5 mg $99.01 $1.10 $26.96 Add to cart
60 pills - 5 mg $69.99 $1.17 $13.99 Add to cart
30 pills - 5 mg $41.99 $1.40 No Add to cart
Altace 2.5 mg
360 pills - 2.5 mg
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$280.83 $0.78 $151.05 Add to cart
180 pills - 2.5 mg
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$145.19 $0.81 $70.75 Add to cart
120 pills - 2.5 mg
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$101.35 $0.84 $42.61 Add to cart
90 pills - 2.5 mg $79.59 $0.88 $28.38 Add to cart
60 pills - 2.5 mg $57.45 $0.96 $14.53 Add to cart
30 pills - 2.5 mg $35.99 $1.20 No Add to cart
Altace 1.25 mg
360 pills - 1.25 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$258.95 $0.72 $124.93 Add to cart
180 pills - 1.25 mg
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$132.33 $0.74 $59.61 Add to cart
120 pills - 1.25 mg $93.91 $0.78 $34.05 Add to cart
90 pills - 1.25 mg $74.95 $0.83 $21.02 Add to cart
60 pills - 1.25 mg $52.99 $0.88 $10.99 Add to cart
30 pills - 1.25 mg $31.99 $1.07 No Add to cart

Product description

Pharmacological action

Buy ramipril Altace canada

ACE inhibitor. It is a prodrug from which the active metabolite ramiprilat is formed in the body. It is believed that the mechanism of antihypertensive action is associated with competitive inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor. As a result of a decrease in the concentration of angiotensin II, a secondary increase in plasma renin activity occurs due to the elimination of negative feedback during the release of renin and a direct decrease in aldosterone secretion. Due to the vasodilating effect, it reduces the OPSS (afterload), the pressure of wedging in the pulmonary capillaries (preload) and resistance in the pulmonary vessels; increases cardiac output and exercise tolerance.

In patients with signs of chronic heart failure after myocardial infarction, ramipril reduces the risk of sudden death, the progression of heart failure to severe / resistant heart failure, and reduces the number of hospitalizations for heart failure.

It is known that ramipril significantly reduces the incidence of myocardial infarction, stroke and cardiovascular death in patients with an increased cardiovascular risk due to vascular diseases (coronary artery disease, stroke or peripheral vascular disease) or diabetes mellitus, which have at least one additional risk factor (microalbuminuria , arterial hypertension, increased total cholesterol, low HDL, smoking). Reduces overall mortality and the need for revascularization procedures, slows down the onset and progression of chronic heart failure. In both patients with diabetes mellitus and without it, ramipril significantly reduces existing microalbuminuria and the risk of developing nephropathy. These effects are observed in patients with both elevated and normal blood pressure.

The hypotensive effect of ramipril develops in about 1-2 hours, reaches a maximum within 3-6 hours, lasts at least 24 hours.

Pharmacokinetics

When taken orally, absorption is 50-60%, food does not affect the degree of absorption, but slows down absorption. Cmax is achieved after 2-4 hours. In the liver, it is metabolized to form the active metabolite of ramiprilat (6 times more active in inhibiting ACE than ramipril), inactive diketopiperazine and glucuronidation. All formed metabolites, with the exception of ramiprilat, have no pharmacological activity. Plasma protein binding for ramipril - 73%, for ramiprilat - 56%. Bioavailability after oral administration of 2.5-5 mg of ramipril - 15-28%; for ramiprilat - 45%. After daily intake of ramipril at a dose of 5 mg / day, a steady concentration of ramiprilat in plasma is reached by 4 days.

Drug Ramipril altace

T1/2 for ramipril - 5.1 h; in the phase of distribution and elimination, a drop in the concentration of ramiprilat in the blood serum occurs with T1/2 - 3 hours, followed by a transition phase with T1/2 - 15 hours, and a long final phase with very low concentrations of ramiprilat in plasma and T1/2 - 4-5 days. T1/2 increases with chronic renal failure. Vd ramipril - 90 l, ramiprilat - 500 l. 60% is excreted by the kidneys, 40% through the intestines (mainly in the form of metabolites). In case of impaired renal function, the excretion of ramipril and its metabolites slows down in proportion to the decrease in CC; in case of impaired liver function, the conversion to ramiprilat slows down; in case of heart failure, the concentration of ramiprilat increases 1.5-1.8 times.

Dosage regimen

Altace logo

The method of administration and dosing regimen of a particular drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. The compliance of the used dosage form of a particular drug with indications for use and dosage regimen should be strictly observed.

Is taken internally. The initial dose is 1.25-2.5 mg 1-2 times / day. If necessary, a gradual dose increase is possible. The maintenance dose is set individually, depending on the indications for use and the effectiveness of treatment.


Contraindications for use

Severe renal and hepatic dysfunction, bilateral renal artery stenosis or stenosis of an artery of a single kidney; condition after kidney transplantation; primary hyperaldosteronism, hyperkalemia, aortic stenosis, pregnancy, lactation (breastfeeding), children and adolescents up to 18 years, hypersensitivity to ramipril and other ACE inhibitors.

Use during pregnancy and lactation

Ramipril is contraindicated in pregnancy and lactation (breastfeeding).

Application for violations of liver function

Contraindicated in severe violations of liver function.

Application for impaired renal function

Contraindicated in severe impaired renal function, condition after kidney transplantation. In patients with concomitant renal dysfunction, doses are selected individually in accordance with the CC values. Before starting treatment, all patients need to conduct a study of renal function.

Use in children

Contraindicated in children and adolescents under 18 years of age.

Special instructions

In patients with concomitant renal impairment, the dose is selected individually in accordance with the CC values. Before starting treatment, all patients need to conduct a study of renal function. In the course of treatment with ramipril, kidney function, blood electrolyte composition, the level of hepatic enzymes in the blood, as well as the picture of peripheral blood are regularly monitored (especially in patients with diffuse connective tissue diseases, in patients receiving immunosuppressants, allopurinol). Patients who have a deficiency of fluid and / or sodium, before starting treatment, it is necessary to correct water-electrolyte disturbances. During treatment with ramipril, hemodialysis using polyacrylonitrile membranes should not be performed (the risk of anaphylactic reactions is increased).

Drug interaction

With the simultaneous use of potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements containing potassium, hyperkalemia may develop (especially in patients with impaired renal function), because ACE inhibitors reduce the content of aldosterone, which leads to a retention of potassium in the body against the background of limiting the excretion of potassium or its additional intake into the body.

With simultaneous use with NSAIDs, it is possible to reduce the hypotensive effect of ramipril, impaired renal function.

When used simultaneously with "loop" or thiazide diuretics, the antihypertensive effect is enhanced. Severe arterial hypotension, especially after taking the first dose of a diuretic, apparently occurs due to hypovolemia, which leads to a transient increase in the hypotensive effect of ramipril. There is a risk of developing hypokalemia. The risk of impaired renal function increases.

With simultaneous use with drugs that have a hypotensive effect, an increase in the hypotensive effect is possible.

With simultaneous use with insulin, hypoglycemic agents, sulfonylurea derivatives, metformin, hypoglycemia may develop.

With simultaneous use with allopurinol, cystostatics, immunosuppressants, procainamide, the risk of leukopenia may increase.

With simultaneous use with lithium carbonate, an increase in the concentration of lithium in the blood serum is possible.


Side effect

From the side of the cardiovascular system: arterial hypotension; rarely - chest pain, tachycardia.

From the side of the central nervous system: dizziness, weakness, headache; rarely - sleep disorders, mood disorders.

From the digestive system: diarrhea, constipation, loss of appetite; rarely - stomatitis, abdominal pain, pancreatitis, cholestatic jaundice.

From the respiratory system: dry cough, bronchitis, sinusitis.

From the urinary system: rarely - proteinuria, an increase in the concentration of creatinine and urea in the blood (mainly in patients with impaired renal function).

From the hematopoietic system: rarely - neutropenia, agranulocytosis, thrombocytopenia, anemia.

On the part of laboratory parameters: hypokalemia, hyponatremia.

Allergic reactions: skin rash, angioedema and other hypersensitivity reactions.

Others: rarely - muscle spasms, impotence, alopecia.