Ramipril
Ramipril
Klass: C
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Ramipril 2care4, Ramipril Actavis, Ramipril Aristo, Ram......
Ramipril 2care4, Ramipril Actavis, Ramipril Aristo, Ramipril Arrow, Ramipril Aurobindo, Ramipril Ebb, Ramipril HEXAL, Ramipril Hexal, Ramipril Krka, Ramipril Orifarm, Ramipril Ranbaxy, Ramipril STADA, Ramipril Sandoz, Ramipril Teva, Ramipril Winthrop, Ramipril ratiopharm, Ramipril/Hydrochlorothiazide Krka, Ramipril/Hydroklortiazid 2care4, Ramipril/Hydroklortiazid Actavis, Ramipril/Hydroklortiazid Alternova, Ramipril/Hydroklortiazid Ebb, Ramipril/Hydroklortiazid HEXAL, Ramipril/Hydroklortiazid Orifarm, Riprosil, Triatec, Triatec comp, Triatec comp miteATC-koder
C09AA05, C09BA05
C09AA05, C09BA05Substanser
ramipril
ramiprilSammanfattning
Ramipril minskar risken för död och allvarlig hjärtsvikt. Nyttan av behandling är lika för båda könen.
Män som behandlas med ramipril vid kronisk nefropati verkar löpa en ökad risk för sjukdomsprogression på grund av lägre behandlingseffekt av ramipril, jämfört med kvinnor.
En vanlig icke-dosberoende biverkan av ACE-hämmare är hosta som förekommer oftare hos kvinnor. Angiotensinreceptorblockerare kan då vara ett alternativ.
Background
Pharmacokinetics and dosing
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In a pharmacokinetic study (18 men, 18 women), patients received a single 5 mg oral dose of ramipril. Cmax and half-lives of the active metabolite ramiprilat were identical in both sexes, but women showed a higher AUC/kg than men. Since both men and women received a fixed dose, the differences were explained by a higher dose/kg in women, as a consequence of their lower body weight [19].
Effects
Heart failure
A European multicentre cohort study of patients with heart failure with reduced ejection fraction (HFrEF) (3609 men, 1114 women) found similar all-cause mortality for patients treated with ACE inhibitors (enalapril, lisinopril, or ramipril) given at equivalent doses. No differences between men and women or between age groups were seen [1].
In a large cohort study comparing angiotensin converting enzyme (ACE) inhibitors with angiotensin receptor blockers (ARBs) in patients with congestive heart failure (9 475 men, 10 223 women), women on ARBs had better survival than women on ACE inhibitors (HR 0.69, 95%CI 0.59-0.80) while men on ARBs had simil......
Försäljning på recept
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Fler män än kvinnor hämtade ut tabletter innehållande ramipril (ATC-kod C09AA05) på recept i Sverige år 20181, totalt 75 894 män och 39 330 kvinnor. Det motsvarar 15 respektive 8 personer per tusen invånare. Andelen som hämtat ut läkemedel ökade med stigande ålder hos båda könen. I genomsnitt var tabletter innehållande ramipril 2,6 gånger vanligare hos män [24]. Fler män än kvinnor hämtade ut tabletter innehållande kombination av ramipril och hydroklortiazid (ATC-kod C09BA05) på recept i Sverige år 2018, totalt 1 943 män och 1 379 kvinnor. Det motsvarar 0,4 respektive 0,3 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 70-84 år hos båda könen. I genomsnitt var tabletter innehållande kombination av ramipril och hydroklortiazid 1,8 gånger vanligare hos män [24].
Referenser
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Fröhlich H, Henning F, Täger T, Schellberg D, Grundtvig M, Goode K et al. Comparative effectiveness of enalapril, lisinopril, and ramipril in the treatment of patients with chronic heart failure: a propensity score-matched cohort study. Eur Heart J Cardiovasc Pharmacother. 2018;4(2):82-92.
Hudson M, Rahme E, Behlouli H, Sheppard R, Pilote L. Sex differences in the effectiveness of angiotensin receptor blockers and angiotensin converting enzyme inhibitors in patients with congestive heart failure--a population study. Eur J Heart Fail. 2007;9(6):602-9.
Coulter DM, Edwards IR. Cough associated with captopril and enalapril. Br Med J (Clin Res Ed). 1987;294:1521-3.
Strocchi E, Valtancoli G, Ambrosioni E. The incidence of cough during treatment with angiotensin converting enzyme inhibitors. J Hypertens Suppl. 1989;7:S308-9.
Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB, Kohn RM et al. Adverse effects of enalapril in the Studies of Left Ventricular Dysfunction (SOLVD) SOLVD Investigators. Am Heart J. 1996;131:350-5.
Sharma S, Gupta U, Bapna JS, Sahai A. Tolerability of enalapril in mild to moderate hypertension. J Assoc Physicians India. 1995;43:475-6.
Yeşil S, Yeşil M, Bayata S, Postaci N. ACE inhibitors and cough. Angiology. 1994;45:805-8.
Yeo WW, Ramsay LE. Persistent dry cough with enalapril: incidence depends on method used. J Hum Hypertens. 1990;4:517-20.
Just PM. The positive association of cough with angiotensin-converting enzyme inhibitors. Pharmacotherapy. 1989;9:82-7.
Gibson GR. Enalapril-induced cough. Arch Intern Med. 1989;149:2701-3.
Os I, Bratland B, Dahlöf B, Gisholt K, Syvertsen JO, Tretli S. Female sex as an important determinant of lisinopril-induced cough. Lancet. 1992;339:372.
Dykewicz MS. Cough and angioedema from angiotensin-converting enzyme inhibitors: new insights into mechanisms and management. Curr Opin Allergy Clin Immunol. 2004;4:267-70.
Morimoto T, Gandhi TK, Fiskio JM, Seger AC, So JW, Cook EF et al. An evaluation of risk factors for adverse drug events associated with angiotensin-converting enzyme inhibitors. J Eval Clin Pract. 2004;10:499-509.
Zapater P, Novalbos J, Gallego-Sandín S, Hernández FT, Abad-Santos F. Gender differences in angiotensin-converting enzyme (ACE) activity and inhibition by enalaprilat in healthy volunteers. J Cardiovasc Pharmacol. 2004;43(5):737-44.
Komukai K, Mochizuki S, Yoshimura M. Gender and the renin-angiotensin-aldosterone system. Fundam Clin Pharmacol. 2010;24(6):687-98.
Renitec (enalapril). Summary of Product Characteristics. Swedish Medical Products Agency [updated 2019-05-14, cited 2019-05-16].
Zestril (lisinopril). Summary of Product Characteristics. Medical Products Agency Sweden; 2016.
Triatec (ramipril). Summary of Product Characteristics. Swedish Medical Products Agency [updated 2019-05-14, cited 2019-05-16].
Vree TB, Dammers E, Ulc I, Horkovics-Kovats S, Ryska M, Merkx et al. Lack of male-female differences in disposition and esterase hydrolysis of ramipril to ramiprilat in healthy volunteers after a single oral dose. ScientificWorldJournal. 2003;3:1332-43.
Altace (ramipril) DailyMed 2018. DailyMed [www]. US National Library of Medicine. [updated 2018-02-15, cited 2019-05-16].
[No authors listed]. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Lancet. 1993;342(8875):821-8.
Ruggenenti P, Perna A, Zoccali C, Gherardi G, Benini R, Testa A et al. Chronic proteinuric nephropathies II Outcomes and response to treatment in a prospective cohort of 352 patients: differences between women and men in relation to the ACE gene polymorphism Gruppo Italiano di Studi Epidemologici in Nefrologia (Gisen). J Am Soc Nephrol. 2000;11:88-96.
Wyskida K, Jura-Szołtys E, Smertka M, Owczarek A, Chudek J. Factors that favor the occurrence of cough in patients treated with ramipril--a pharmacoepidemiological study. Med Sci Monit. 2012;18:PI21-8.
Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2018 [cited 2019-03-08.]
- Fröhlich H, Henning F, Täger T, Schellberg D, Grundtvig M, Goode K et al. Comparative effectiveness of enalapril, lisinopril, and ramipril in the treatment of patients with chronic heart failure: a propensity score-matched cohort study. Eur Heart J Cardiovasc Pharmacother. 2018;4(2):82-92.
- Hudson M, Rahme E, Behlouli H, Sheppard R, Pilote L. Sex differences in the effectiveness of angiotensin receptor blockers and angiotensin converting enzyme inhibitors in patients with congestive heart failure--a population study. Eur J Heart Fail. 2007;9(6):602-9.
- Coulter DM, Edwards IR. Cough associated with captopril and enalapril. Br Med J (Clin Res Ed). 1987;294:1521-3.
- Strocchi E, Valtancoli G, Ambrosioni E. The incidence of cough during treatment with angiotensin converting enzyme inhibitors. J Hypertens Suppl. 1989;7:S308-9.
- Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB, Kohn RM et al. Adverse effects of enalapril in the Studies of Left Ventricular Dysfunction (SOLVD) SOLVD Investigators. Am Heart J. 1996;131:350-5.
- Sharma S, Gupta U, Bapna JS, Sahai A. Tolerability of enalapril in mild to moderate hypertension. J Assoc Physicians India. 1995;43:475-6.
- Yeşil S, Yeşil M, Bayata S, Postaci N. ACE inhibitors and cough. Angiology. 1994;45:805-8.
- Yeo WW, Ramsay LE. Persistent dry cough with enalapril: incidence depends on method used. J Hum Hypertens. 1990;4:517-20.
- Just PM. The positive association of cough with angiotensin-converting enzyme inhibitors. Pharmacotherapy. 1989;9:82-7.
- Gibson GR. Enalapril-induced cough. Arch Intern Med. 1989;149:2701-3.
- Os I, Bratland B, Dahlöf B, Gisholt K, Syvertsen JO, Tretli S. Female sex as an important determinant of lisinopril-induced cough. Lancet. 1992;339:372.
- Dykewicz MS. Cough and angioedema from angiotensin-converting enzyme inhibitors: new insights into mechanisms and management. Curr Opin Allergy Clin Immunol. 2004;4:267-70.
- Morimoto T, Gandhi TK, Fiskio JM, Seger AC, So JW, Cook EF et al. An evaluation of risk factors for adverse drug events associated with angiotensin-converting enzyme inhibitors. J Eval Clin Pract. 2004;10:499-509.
- Zapater P, Novalbos J, Gallego-Sandín S, Hernández FT, Abad-Santos F. Gender differences in angiotensin-converting enzyme (ACE) activity and inhibition by enalaprilat in healthy volunteers. J Cardiovasc Pharmacol. 2004;43(5):737-44.
- Komukai K, Mochizuki S, Yoshimura M. Gender and the renin-angiotensin-aldosterone system. Fundam Clin Pharmacol. 2010;24(6):687-98.
- Renitec (enalapril). Summary of Product Characteristics. Swedish Medical Products Agency [updated 2019-05-14, cited 2019-05-16].
- Zestril (lisinopril). Summary of Product Characteristics. Medical Products Agency Sweden; 2016.
- Triatec (ramipril). Summary of Product Characteristics. Swedish Medical Products Agency [updated 2019-05-14, cited 2019-05-16].
- Vree TB, Dammers E, Ulc I, Horkovics-Kovats S, Ryska M, Merkx et al. Lack of male-female differences in disposition and esterase hydrolysis of ramipril to ramiprilat in healthy volunteers after a single oral dose. ScientificWorldJournal. 2003;3:1332-43.
- Altace (ramipril) DailyMed 2018. DailyMed [www]. US National Library of Medicine. [updated 2018-02-15, cited 2019-05-16].
- [No authors listed]. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Lancet. 1993;342(8875):821-8.
- Ruggenenti P, Perna A, Zoccali C, Gherardi G, Benini R, Testa A et al. Chronic proteinuric nephropathies II Outcomes and response to treatment in a prospective cohort of 352 patients: differences between women and men in relation to the ACE gene polymorphism Gruppo Italiano di Studi Epidemologici in Nefrologia (Gisen). J Am Soc Nephrol. 2000;11:88-96.
- Wyskida K, Jura-Szołtys E, Smertka M, Owczarek A, Chudek J. Factors that favor the occurrence of cough in patients treated with ramipril--a pharmacoepidemiological study. Med Sci Monit. 2012;18:PI21-8.
- Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2018 [cited 2019-03-08.]
Uppdaterat
Litteratursökningsdatum 5/16/2019
Litteratursökningsdatum 5/16/2019Se även
Enalapril
Lisinopril