Рамиприл Таблетки, пачка, 30 шт, 5 мг, для приема внутрь, цвет белый

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средствами»)."}},{"type":"paragraph","data":{"text":" Хроническая сердечная недостаточность в стадии декомпенсации (опыт клинического применения недостаточен)."}},{"type":"paragraph","data":{"text":"Возраст до 18 лет (опыт клинического применения недостаточен)."}},{"type":"paragraph","data":{"text":"Гемодиализ или гемофильтрация с использованием некоторых мембран с отрицательно заряженной поверхностью, таких как высокопроточные мембраны из полиакрилнитрила (опасность развития реакций повышенной чувствительности) (см. разделы «Взаимодействия с другими лекарственными средствами», «Особые указания»)."}},{"type":"paragraph","data":{"text":"Аферез липопротеинов низкой плотности с использованием сульфата декстрана (опасность развития реакций повышенной чувствительности) (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"Гипосенсибилизирующая терапия при реакциях повышенной чувствительности к ядам насекомых, таких как пчелы, осы (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"Кардиогенный шок."}},{"type":"paragraph","data":{"text":"Тяжелая печеночная недостаточность (нет опыта клинического применения)."}},{"type":"paragraph","data":{"text":"Как и в случае с другими ингибиторами АПФ, противопоказано совместное применение рамиприла и алискирена у пациентов с сахарным диабетом или почечной недостаточностью (КК менее 60 мл/мин)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Рамиприл противопоказан при беременности, так как он может оказывать неблагоприятное влияние на плод: нарушение развития почек плода, снижение АД плода и новорожденных, нарушение функции почек, гиперкалиемия, гипоплазия костей черепа, олигогид-рамнион, контрактура конечностей, деформация костей черепа, гипоплазия легких. Поэтому перед началом приема препарата у женщин детородного возраста следует исключить беременность. Если женщина планирует беременность, то лечение ингибиторами АПФ должно быть прекращено. В случае наступления беременности во время лечения препаратом рамиприл, следует, как можно скорее, прекратить его прием и перевести пациентку на прием других препаратов, при применении которых риск для ребенка будет наименьшим. Если лечение препаратом рамиприл необходимо в период кормления грудью, то грудное вскармливание должно быть прекращено."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Таблетки необходимо проглатывать целиком (не разжевывать) и запивать достаточным количеством (1/2 стакана) воды, независимо от приема пищи (то есть, таблетки могут приниматься как до, так и во время или после еды). Доза подбирается в зависимости от терапевтического эффекта и переносимости препарата больным. Для обеспечения ниже-следующего режима дозирования (доза 1,25 мг) необходимо применять препарат рами-прила в другой лекарственной форме: таблетки 2,5 мг с риской. Лечение препаратом рамиприл обычно является длительным, а его продолжительность в каждом конкретном случае определяется врачом. Если не назначается иначе, то при нормальной функции почек и печени рекомендуются представленные далее режимы дозирования."}},{"type":"paragraph","data":{"text":"При артериальной гипертензии Обычно начальная доза составляет 2,5 мг 1 раз в сутки утром. Если при приеме препарата в этой дозе в течение 3-х недель и более не удается нормализовать АД, то доза может быть увеличена до 5 мг рамиприла в сутки. При недостаточной эффективности дозы 5 мг через 2-3 недели она может быть еще удвоена до максимальной рекомендуемой суточной дозы - 10 мг в сутки (возможен прием 1 таблетки 5 мг 2 раза в сутки). В качестве альтернативы к увеличению дозы до 10 мг в сутки при недостаточной гипотензивной эффективности суточной дозы 5 мг, возможно добавление к лечению других гипотензивных средств, в частности, диуретиков или блокаторов «медленных» кальциевых каналов."}},{"type":"paragraph","data":{"text":"При хронической сердечной недостаточности Рекомендованная начальная доза: 1,25 мг 1 раз в сутки. В зависимости от реакции на про-водимую терапию пациента, доза может увеличиваться. Рекомендуется удваивать дозу с интервалом 1-2 недели. Максимальная рекомендованная суточная доза составляет 10 мг."}},{"type":"paragraph","data":{"text":"При диабетической или недиабетической нефропатии Рекомендованная начальная доза: 1,25 мг 1 раз в сутки. Доза может увеличиваться до 5 мг один раз в сутки."}},{"type":"paragraph","data":{"text":"Для снижения риска развития инфаркта миокарда, инсульта или сердечно-сосудистой смертности у пациентов с высоким сердечно-сосудистым риском Рекомендованная начальная доза: 2,5 мг 1 раз в сутки. В зависимости от переносимости препарата пациентом дозу можно постепенно увеличивать. Рекомендуется удвоить дозу через 1 неделю лечения, а в течение следующих 3 недель лечения - увеличить ее до обычной поддерживающей дозы 10 мг 1 раз в сутки. Применение препарата у пациентов с КК менее 0,6 мл/сек изучено недостаточно. "}},{"type":"paragraph","data":{"text":"При сердечной недостаточности, развившейся в течение первых нескольких дней (со 2-ых no 9-е сутки) после острого инфаркта миокарда Рекомендованная начальная доза составляет 5 мг в сутки, разделенная на две разовые дозы по 2,5 мг, одна из которых принимается утром, а вторая - вечером. Если пациент не переносит эту начальную дозу (наблюдается чрезмерное снижение АД), то ему рекомендуется в течение двух дней давать по 1,25 мг 2 раза в сутки. Затем, в зависимости от реакции пациента, доза может быть увеличена. Рекомендуется, чтобы доза при ее увеличении удваивалась с интервалом 1-3 дня. Позднее общая суточная доза, которая вначале делилась на две дозы, может даваться однократно. Максимальная рекомендуемая доза составляет 10 мг. В настоящее время опыт лечения пациентов с выраженной сердечной недостаточностью (III-IV функциональный класс по классификации NYHA), возникшей непосредственно после острого инфаркта миокарда, является недостаточным. Если у таких пациентов принимается решение о проведении лечения препаратом рамиприл, рекомендуется, чтобы лечение начиналось с наименьшей возможной дозы - 1,25 мг 1 раз в сутки и особую осторожность следует соблюдать при каждом увеличении дозы."}},{"type":"paragraph","data":{"text":"Применение препарата рамиприл у отдельных групп пациентов"}},{"type":"paragraph","data":{"text":"Пациенты с нарушениями функции почек При КК от 50 до 20 мл/мин на 1,73 м2 поверхности тела начальная суточная доза обычно составляет 1,25 мг. Максимально допустимая суточная доза - 5 мг."}},{"type":"paragraph","data":{"text":"Пациенты с неполностью скорректированной потерей жидкости и электролитов, пациенты с тяжелой артериальной гипертензией, а также пациенты, для которых чрезмерное снижение АД представляет определенный риск (например, при тяжелом атеросклеротическом поражении коронарных и мозговых артерий)"}},{"type":"paragraph","data":{"text":"Начальная доза - 1,25 мг в сутки. Пациенты с предшествующей терапией диуретиками Необходимо при возможности отменить диуретики за 2-3 дня (в зависимости от продол-жительности действия диуретиков) перед началом лечения препаратом рамиприл или, по крайней мере, сократить дозу принимаемых диуретиков. Лечение таких больных следует начинать с самой низкой дозы, равной 1,25 мг рамиприла, принимаемой один раз в день, по утрам. После приёма первой дозы и всякий раз после увеличения дозы рамиприла и (или) «петлевых» диуретиков больные должны находиться под медицинским наблюдением не менее 8 часов во избежание неконтролируемой гипотензивной реакции. Пациенты пожилого возраста (старше 65 лет) Начальная доза уменьшается до 1,25 мг в сутки. Пациенты с нарушениями функции печени Реакция АД на прием препарата рамиприл может, как увеличиваться (за счет замедления выведения рамиприлата), так и уменьшаться (за счет замедления превращения малоактивного рамиприла в активный рамиприлат). Поэтому в начале лечения требуется тщательное медицинское наблюдение. Максимальная допустимая суточная доза - 2,5 мг."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"По данным Всемирной организации здравоохранения (ВОЗ) указанные ниже нежелатель-ные эффекты классифицированы в соответствии с частотой их развития следующим обра-зом: очень часто (?10 %); часто (?1% - <10%); нечасто (?0,1% - <1%); редко (0,01% - 0,1%); очень редко (<0,01%, включая отдельные сообщения); частота неизвестна: по имеющимся данным установить частоту возникновения не представляется возможным."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы:"}},{"type":"paragraph","data":{"text":"часто: выраженное снижение АД, ортостатическая гипотензия, синкопальные состояния;"}},{"type":"paragraph","data":{"text":"нечасто: ортостатический коллапс, ишемия миокарда, включая развитие приступа стенокардии или инфаркта миокарда, нарушение мозгового кровообращения, тахикардия, аритмия, периферические отеки, пальпитация, «приливы» крови к коже лица;"}},{"type":"paragraph","data":{"text":"редко: возникновение или усиление нарушений кровообращения на фоне стенозирующих сосудистых поражений, васкулит;"}},{"type":"paragraph","data":{"text":"частота неизвестна: синдром Рейно."}},{"type":"paragraph","data":{"text":"Со стороны органов кроветворения:"}},{"type":"paragraph","data":{"text":"нечасто: эозинофилия;"}},{"type":"paragraph","data":{"text":"редко: лейкопения (в т. ч. нейтропения и агранулоцитоз), анемия, тромбоцитопения, лимфаденопатия;"}},{"type":"paragraph","data":{"text":"частота неизвестна: угнетение костномозгового кроветворения, панцитопения, гемолитическая анемия."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы:"}},{"type":"paragraph","data":{"text":"часто: головная боль, головокружение, слабость (астения);"}},{"type":"paragraph","data":{"text":"нечасто: лабильность настроения, тревожность, беспокойство, нервозность, парестезия, головокружение, нарушения сна (включая сонливость), двигательное беспокойство, агевзия (утрата вкусовой чувствительности), дисгевзия (нарушение вкусовой чувствительности);"}},{"type":"paragraph","data":{"text":"редко: тремор, нарушение равновесия, спутанность сознания;"}},{"type":"paragraph","data":{"text":"частота неизвестна: ишемия головного мозга, включая инсульт и преходящее нарушение мозгового кровообращения, паросмия (нарушение восприятия запахов), нарушение психомоторных реакций, ощущение жжения."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств:"}},{"type":"paragraph","data":{"text":"нечасто: зрительные расстройства, включая расплывчатость изображения;"}},{"type":"paragraph","data":{"text":"редко: конъюнктивит, нарушение слуха, тиннитус (ощущение звона, шума в ушах)."}},{"type":"paragraph","data":{"text":"Со стороны дыхательной системы:"}},{"type":"paragraph","data":{"text":"часто: «сухой» кашель (усиливающийся по ночам и в положении лежа), бронхит, синусит, одышка;"}},{"type":"paragraph","data":{"text":"нечасто: бронхоспазм, включая утяжеление течения бронхиальной астмы, заложенность носа."}},{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта:"}},{"type":"paragraph","data":{"text":"часто: воспалительные реакции в желудке и кишечнике, расстройства пищеварения, ощущение дискомфорта в области живота, диспепсия, диарея, тошнота, рвота;"}},{"type":"paragraph","data":{"text":"нечасто: панкреатит (летальный исход наблюдался крайне редко), повышение активности ферментов поджелудочной железы, интестинальный ангионевротический отек, боль в области живота, гастрит, запор, сухость слизистой оболочки рта;"}},{"type":"paragraph","data":{"text":"редко: глоссит;"}},{"type":"paragraph","data":{"text":"частота неизвестна: афтозный стоматит (воспалительная реакция слизистой оболочки полости рта)."}},{"type":"paragraph","data":{"text":"Со стороны печени и желчевыводящих путей:"}},{"type":"paragraph","data":{"text":"нечасто: повышение активности «печеночных» трансаминаз и концентрации конъюгированного билирубина в плазме крови;"}},{"type":"paragraph","data":{"text":"редко: холестатическая желтуха, гепатоцеллюлярные поражения;"}},{"type":"paragraph","data":{"text":"частота неизвестна: острая печеночная недостаточность, холестатический или цитолитический гепатит (летальный исход наблюдался крайне редко)."}},{"type":"paragraph","data":{"text":"Со стороны почек и мочевыводящих путей:"}},{"type":"paragraph","data":{"text":"редко: нарушение функции почек, включая развитие острой почечной недостаточности, увеличение выделения количества мочи, усиление ранее существовавшей протеинурии, повышение концентрации мочевины и креатинина в крови."}},{"type":"paragraph","data":{"text":"Со стороны репродуктивной системы и молочных желез:"}},{"type":"paragraph","data":{"text":"нечасто: преходящая импотенция за счет эректильной дисфункции, снижение либидо;"}},{"type":"paragraph","data":{"text":"частота неизвестна: гинекомастия."}},{"type":"paragraph","data":{"text":"Со стороны кожных покровов и слизистых оболочек:"}},{"type":"paragraph","data":{"text":" часто: кожная сыпь, в частности макулезно-папулезная;"}},{"type":"paragraph","data":{"text":"нечасто: ангионевротический отек, в том числе с летальным исходом (отек гортани может вызвать обструкцию дыхательных путей, приводящую к летальному исходу), кожный зуд, гипергидроз (повышенное потоотделение);"}},{"type":"paragraph","data":{"text":"редко: эксфолиативный дерматит, крапивница, онихолизис (отслоение ногтя от мягких тканей пальца);"}},{"type":"paragraph","data":{"text":"очень редко: реакции фотосенсибилизации;"}},{"type":"paragraph","data":{"text":"частота неизвестна: токсический эпидермальный некролиз, синдром Стивенса-Джонсона, мультиформная эритема, пемфигус (пузырная сыпь), утяжеление течения псориаза, псориазоподобный дерматит, пемфигоидная или лихеноидная экзантема или энантема, алопеция."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата:"}},{"type":"paragraph","data":{"text":"часто: мышечные судороги, миалгия;"}},{"type":"paragraph","data":{"text":"нечасто: артралгия."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ:"}},{"type":"paragraph","data":{"text":"часто: повышение содержания калия в крови;"}},{"type":"paragraph","data":{"text":"нечасто: анорексия, снижение аппетита;"}},{"type":"paragraph","data":{"text":"частота неизвестна: снижение содержания натрия в крови."}},{"type":"paragraph","data":{"text":"Со стороны иммунной системы:"}},{"type":"paragraph","data":{"text":"частота неизвестна: анафилактические или анафилактоидные реакции, повышение титра антинуклеарных антител."}},{"type":"paragraph","data":{"text":"Со стороны эндокринной системы:"}},{"type":"paragraph","data":{"text":"частота неизвестна: синдром неадекватной секреции антидиуретического гормона (СНСАДГ)."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: чрезмерная периферическая вазодилатация с развитием выраженного снижения АД, шока; брадикардия, нарушение водно-электролитного баланса, шок, острая почечная недостаточность, ступор. Лечение: в легких случаях передозировки: промывание желудка, введение адсорбентов, натрия сульфата (желательно в течение первых 30 мин после приема). Следует контроли-ровать функцию жизненно важных органов. В более тяжелых случаях - мероприятия, на-правленные на стабилизацию АД: внутривенное введение 0,9 % раствора хлорида натрия, плазмозаменителей, установка временного искусственного водителя ритма при устойчи-вой к медикаментозной терапии брадикардии, гемодиализ. При выраженном снижении АД к терапии по восполнению объема циркулирующей крови и восстановлению водно-электролитного баланса может быть добавлено введение альфа-адренергических агони-стов (норэпинефрин, допамин). В случае брадикардии рекомендуется назначение атропина или установка временного искусственного водителя ритма. Необходимо тщательно контролировать АД, функцию почек и содержание электролитов в сыворотке крови. Опыта применения форсированного диуреза, изменения рН мочи, гемофильтрации или диализа для ускоренного выведения рамиприла из организма нет. Гемодиализ показан в случаях развития почечной недостаточности."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Противопоказанные комбинации"}},{"type":"paragraph","data":{"text":"Применение некоторых высокопрочных мембран с отрицательно заряженной поверхностью (например, полиакрилнитрильных мембран) при проведении гемодиализа или гемофильтрации, применение декстрана сульфата при аферезе липопротеинов низкой плотности может повлечь риск развития тяжелых анафилактических реакций. Как и в случае с другими ингибиторами АПФ, противопоказано совместное применение рамиприла и алискирена у пациентов с сахарным диабетом или почечной недостаточностью (КК менее 60 мл/мин)."}},{"type":"paragraph","data":{"text":"Не рекомендуемые комбинации"}},{"type":"paragraph","data":{"text":"Одновременное назначение с солями калия, калийсберегающими диуретиками (например, амилоридом, триамтереном, спиронолактоном) может привести к повышению содержания калия в сыворотке крови (требуется тщательный контроль содержания калия в сыворотке крови). Комбинированное применение рамиприла и телмисартана не рекомендуется т.к. не обеспечивает лучшего эффекта по сравнению с раздельным применением. Кроме того, зафиксирована более высокая частота возникновения гиперкалиемии, почечной недостаточности, артериальной гипотензии и головокружения при комбинированном лечении."}},{"type":"paragraph","data":{"text":"Комбинации, которые следует применять с осторожностью"}},{"type":"paragraph","data":{"text":"Гипотензивные средства (алфузозин, доксазозин, празозин, тамсулозин, теразозин), баклофен, диуретики,антидепрессанты, нейролептики, снотворные, наркотические анальгетики, средства для общей анестезии усиливают гипотензивное действие рамиприла. Вазопрессорные симпатомиметики и другие препараты, вызывающие гипотензивное действие (например, изопретеренол, добутамин, допамин, эпинефрин) уменьшают гипотензивное действие рамиприла, при этом требуется тщательный контроль АД. Одновременное применение с аллопуринолом, прокаинамидом, цитостатиками, иммунодепрессантами, системными глюкокортикостероидами и другими средствами, которые могут влиять на гематологические показатели, увеличивает риск развития лейкопении. Соли лития приводят к повышению концентрации лития в сыворотке крови и усилению кардио- и нейротоксического действия лития. Рамиприл усиливает эффект гипогликемических средств (производных сульфонилмочевины, инсулина) вплоть до развития гипогликемии."}},{"type":"paragraph","data":{"text":"Комбинации, которые следует принимать во внимание"}},{"type":"paragraph","data":{"text":"Нестероидные противовоспалительные препараты (НПВП) (например, ацетилсалициловая кислота (более 3 г/сутки), ингибиторы циклооксигеназы-2 (ЦОГ2)) могут ослаблять гипотензивное действие рамиприла, а также вызывать нарушение функции почек, иногда приводящее к развитию почечной недостаточности. Натрия хлорид может ослаблять эффект рамиприла. Одновременное применение с другими ингибиторами АПФ повышает риск развития почечной недостаточности (в том числе, острой почечной недостаточности), гиперкалиемии. Не рекомендуется одновременное назначение рамиприла с кортикостероидами. Не следует употреблять этанол во время лечения рамиприлом (усиливается угнетающее действие этанола на ЦНС). Эстрогены ослабляют гипотензивный эффект (задержка жидкости). Ингибиторы АПФ, включая рамиприл, увеличивают вероятность развития тяжелых анафилактических или анафилактоидных реакций на яды насекомых."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Перед началом лечения препаратом рамиприл необходимо устранить гипонатриемию и гиповолемию. У пациентов, ранее принимавших диуретики, необходимо их отменить или снизить их дозу за 2 - 3 дня до начала приема препарата рамиприл. В этом случае следует тщательно контролировать состояние пациентов с хронической сердечной недостаточностью в связи с возможностью развития у них декомпенсации на фоне увели-чения объема циркулирующей крови. После приема первой дозы, а также при увеличении дозировки диуретика и/или препарата рамиприл пациенты должны находиться в течение 8 ч под медицинским наблюдением ввиду возможности развития ортостатической гипотензии. Транзиторная артериальная гипотензия не является противопоказанием для продолжения лечения препаратом рамиприл, так как при восстановлении объема циркулирующей крови и нормализации уровня АД прием следующих доз препарата обычно не вызывает симптоматической артериальной гипотензии. В случае повторного возникновения выраженной артериальной гипотензии следует уменьшить дозу или отменить препарат. Пациенты со злокачественной артериальной гипертензией или сопутствующей сердечной недостаточностью, особенно в острой стадии инфаркта миокарда, должны начинать лечение только в условиях стационара. У пациентов с хронической сердечной недостаточностью прием препарата рамиприл мо-жет привести к развитию выраженного снижения АД, которое в ряде случаев сопровождается олигурией или азотемией и редко развитием острой почечной недостаточности. Следует соблюдать осторожность при лечении пожилых пациентов, так как они могут быть особенно чувствительны к ингибиторам АПФ. Следует соблюдать осторожность также при физической нагрузке и/или жаркой погоде из-за риска повышенного потоотделения и дегидратации с развитием артериальной гипо-тензии вследствие уменьшения объема циркулирующей крови и снижения концентрации натрия в крови. До и во время лечения препаратом рамиприл необходимо регулярно контролировать функцию почек (креатинин, мочевина), содержание калия в плазме крови, формулу крови, гемоглобин, функциональные пробы печени. При развитии холестатической желтухи или выраженном повышении активности «печеночных» трансаминаз следует прекратить прием ингибиторов АПФ. Группу риска в отношении гиперкалиемии составляют пациенты с почечной недостаточностью, сахарным диабетом, а также принимающие калийсберегающие диуретики, препараты калия или калийсодержащие заменители пищевой соли и препараты, способствующие повышению содержания калия в сыворотке крови (например, гепарин). У пациентов с повышенным риском развития нейтропении (при нарушении функции по-чек, системных заболеваниях соединительной ткани) при назначении препарата рамиприл необходим контроль общего анализа крови 1 раз в месяц в течение первых 3-6 месяцев терапии, а также при первых признаках инфекции. При выявлении нейтропении (число нейтрофилов меньше 2000/мкл) терапию ингибиторами АПФ следует прекратить. В редких случаях при лечении ингибиторами АПФ, в том числе рамиприлом, отмечаются ангионевротический отек лица, конечностей, губ, языка, гортани и/или глотки. При появлении отека, который может развиться внезапно, в любой период лечения, следует немедленно прекратить прием препарата, принять экстренные меры медицинской помощи и обеспечить тщательное наблюдение за пациентом вплоть до полного и устойчивого исчезновения симптоматики. Следует избегать применения некоторых высокопрочных мембран с отрицательно заря-женной поверхностью (например, полиакрилнитрильных мембран), для срочного гемодиализа или гемофильтрации в сочетании с ингибиторами АПФ (из-за возможности раз-вития у пациентов анафилактоидных реакций). В редких случаях при аферезе липопро-теинов низкой плотности (ЛПНП) с декстрана сульфатом и одновременном приеме инги-биторов АПФ возможно развитие анафилактоидных реакций. Поэтому данный метод не следует применять у пациентов, получающих ингибиторы АПФ. Антигипертензивные средства, ингибирующие ренин-ангиотензин-альдостероновую систему, обычно оказываются не эффективными при лечении пациентов с первичным гиперальдостеронизмом, поэтому назначение рамиприла в таких случаях не рекомендуется. Как и в случае с другими ингибиторами АПФ, противопоказано совместное применение рамиприла и алискирена у пациентов с сахарным диабетом или почечной недостаточно-стью (КК менее 60 мл/мин)"}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Данных об отрицательном влиянии препарата рамиприл в рекомендуемых дозах на спо-собность к управлению транспортными средствами или работу с механизмами нет. Одна-ко из-за вероятности проявления побочных эффектов, таких как снижение АД и сонливость, рекомендуется воздержаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций, включая управление транспортным средством, особенно после приема начальной дозы, переходе на другой препарат, одновременном приеме диуретиков и алкоголя."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 2,5 мг, 5 мг и 10 мг. По 7 или 10 таблеток в контурную ячейковую упаковку. По 1, 2, 3, 4 или 5 контурные ячейковые упаковки вместе с инструкцией по применению в пачку картонную."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света месте, при температуре не выше 25 °С. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не использовать после истечения срока годности"}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускается по рецепту врача"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ЗАО \"Биоком\", Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ЗАО \"Биоком\", Россия"}}]}],"source":null},"description_toggle":false,"short_description":"Таблетки белого или белого с сероватым оттенком цвета, круглые, плоскоцилиндрические, с фаской.","substance":[{"id":326,"title":"Рамиприл","title_latin":"Ramiprilum","slug":"ramipril_326"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Рамиприл - фото 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