Acecard Tablet contains Ramipril. Acecard Tablet is used for:
Acecard Tabletis indicated in the following cases:
Acecard Tablet is an angiotensin converting enzyme (ACE) inhibitor, which after hydrolysis to Acecard Tabletat, blocks the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. So, inhibition of ACE by Acecard Tablet results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and decreased aldosterone secretion. Thus Acecard Tablet exerts its antihypertensive activity. It is also effective in the management of heart failure and reduction of the risk of stroke, myocardial infarction and death from cardiovascular events. It is long acting and well tolerated; so, can be used in long term therapy.
Angiotensin-converting enzyme (ACE) inhibitors
Dosage of Acecard Tablet must be adjusted according to the patient tolerance and response.
Hypertension: For the management of hypertension in adults not receiving a diuretic, the usual initial dose of Acecard Tablet is 1.25 - 2.5 mg once daily. Dosage generally is adjusted no more rapidly than at 2 week intervals. The usual maintenance dosage in adults is 2.5 - 20 mg daily given as a single dose or in 2 divided doses daily. If BP is not controlled with Acecard Tablet alone, a diuretic may be added.
Congestive heart failure after myocardial infarction: In this case, Acecard Tablet therapy may be initiated as early as 2 days after myocardial infarction. An initial dose of 2.5 mg twice daily is recommended, but if hypotension occurs, dose should be reduced to 1.25 mg twice daily. Therapy is then titrated to a target daily dose of 5 mg twice daily.
Prevention of major cardiovascular events: In this case, the recommended dose is 2.5 mg once daily for the first week of therapy and 5 mg once daily for the following 3 weeks; dosage then may be increased, as tolerated, to a maintenance dosage of 10 mg once daily.
Acecard Tablet is generally well tolerated. Dizziness, headache, fatigue and asthenia are commonly reported side effects. Other side effects occurring less frequently include symptomatic hypotension, cough, nausea, vomiting, diarrhoea, rash, urticaria, oliguria, anxiety, amnesia etc. Angioneurotic oedema, anaphylactic reactions and hyperkalaemia have also been reported rarely.
Acecard Tablet should be used with caution in patients with impaired renal function, hyperkalaemia, hypotension, and impaired hepatic function.
With Diuretics: Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Acecard Tablet.
With Potassium Supplements and Potassium-sparing Diuretics: Acecard Tablet can attenuate potassium loss caused by thiazide diuretics. Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia.
Other: Neither Acecard Tablet nor its metabolites have been found to interact with food, digoxin, antacid, furosemide, cimetidine, indomethacin, and simvastatin. The combination of Acecard Tablet and propranolol showed no adverse effects on dynamic parameters (blood pressure and heart rate). The co-administration of Acecard Tablet and warfarin did not adversely affect the anticoagulant effects of the latter drug.
If pregnancy is detected, Acecard Tablet should be discontinued as early as possible unless continued use is considered life saving. Acecard Tablet should not be used during lactation.
Limited data on human overdosage are available. The most likely clinical manifestations would be symptoms attributable to hypotension. Because the hypotensive effect of Acecard Tablet is achieved through vasodilation and effective hypovolemia, it is reasonable to treat Acecard Tablet overdosage by infusion of normal saline solution.
It is contraindicated in patients who are hypersensitive to any component of this product and in patients with a history of angioedema related to previous treatment with a ACE inhibitor.
Store at cool & dry place, protect from light and moisture.
Dosage in renal impairment: For the patients with hypertension and renal impairment, the recommended initial dose is 1.25 mg Acecard Tablet once daily. Subsequent dosage should be titrated according to individual tolerance and BP response, up to a maximum of 5 mg daily. For the patients with heart failure and renal impairment, the recommended dose is 1.25 mg once daily. The dose may be increased to 1.25 mg twice daily and up to a maximum dose of 2.5 mg twice daily depending upon clinical response and tolerability.
Use in children: No information is yet available on the use of Acecard Tablet in children.
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