The drug "Hartil" belongs to the category of ACE inhibitors. The tool is available in tablet form, has a pronounced effect on the human body, is used strictly as directed by the doctor. The drug is based on the substance ramipril. The manufacturer indicates that the increased effectiveness of taking the medication eliminates unauthorized treatment by him without medical supervision.
How it works?
Hartil tablets belong to the class of inhibitory ACE drugs. Under the influence of active components, the transformation of the first angiotensin into the second is inhibited. The process is independent of plasma renin. The use of the composition leads to a pronounced effect on pressure. Indicators are reduced both when the patient is standing, and when lying down. The process is not accompanied by an increase in the frequency of contractions of the heart muscle. Under the influence of the drug, the volumes of aldosterone produced in the body decrease.
Hartil tablets help reduce afterload, preload, reduce the resistance of the vessels of the respiratory system. The ability of the cardiovascular system to resist the load is growing, becoming higher than the IOC. Prolonged use of the drug helps to reverse hypertrophic processes in the myocardium, due to high blood pressure. The correct use of the composition reduces the risk of recurrence of episodes of arrhythmia, which is especially pronounced against the background of myocardial reperfusion. Under the influence of ramipril, blood flow in the areas of the heart muscle affected by ischemia becomes better. The drug prevents the transformation of vascular endothelium against the background of excessive intake of cholesterol with food.
Pharmacology and efficacy
The action of Hartil is assessed as cardioprotective. This is due to the adjustment of the production processes of Pg, NO. The kallikrein-kinin system becomes more active, the breakdown of bradykinin is prevented, due to which the concentration of this compound in the body increases. As a result, the chemical reactions of Pg production are activated. Under the influence of these processes, blood flow in the liver and heart becomes more active, platelet aggregation decreases.
The ramipril present in the Hartil preparation increases the sensitivity of organic tissues to insulin. At the same time, the content of fibrinogen is growing, the production of plasminogen is being activated. All these are prerequisites for active thrombolysis.
Performance Nuances
In the instructions for use of "Hartil", the manufacturer indicates the time frame for the effectiveness of the drug. Tests have shown that a pronounced hypotensive effect can be felt already an hour and a half after taking the medication orally. The strongest result is observed after 5-9 hours. The duration of the effectiveness of one dose is one day. The drug does not have a withdrawal syndrome.
Reasonable use in accordance with the instructions for use "Hartila" allows you to reduce the likelihood of death from a heart attack. This applies not only to the early, but also to the distant period. The likelihood of recurrence of a heart attack decreases, the risk of heart failure decreases. "Hartil" helps to increase the survival rate in the chronic form of heart failure, improves the quality of life of people suffering from this pathology.
About therapy: pay attention
In the instructions for use of "Hartil", the manufacturer draws attention to the benefits of taking pills for heart defects, obtained for various reasons, including those inherited from birth. Ramipril helps to relieve hypertension, affects the small circle of blood flow. Efficiency is observed with a six-month course of continuous use or a longer time period.
As follows from the instructions for use, "Hartil" can be used for hypertension in a portal form. The drug helps to stabilize, reduce pressure. The level of microalbuminuria is reduced if the pathological condition is just beginning to develop. The rate of progress of impaired functioning of the heart decreases with the failure of this organ in case of nephropathy against diabetes. "Hartil" is especially useful if this condition is accompanied by severe malfunctioning of the kidneys, organ damage.
Strongly impossible!
Hartil contraindications include hypersensitivity to ramipril and auxiliary compounds used by the manufacturer in the manufacturing process of the drug. You can not use these tablets if in the past, ACE inhibitors were accompanied by hypersensitivity reactions. It is forbidden to use the composition if angioneurotic edema has previously been transferred. It is especially important to observe this restriction if the condition was caused by an ACE inhibitor or was observed while taking such drugs.
You can not use the composition with severe renal failure, when creatinine clearance is estimated at 20 ml / min or less. The drug is not suitable for the treatment of pregnant women and nursing mothers. Hartil and alcohol are categorically not combined. During the treatment period, you will have to completely exclude any alcohol from your daily routine.
Is it worth it to apply?
As can be seen from the reviews about Hartil, the persons who underwent therapy with this compound were mostly satisfied with the course of treatment. The tool helps to stabilize the pressure readings, normalize the work of the heart system, blood vessels. At the same time, only reviews about Hartil left by people who used the composition under the supervision of a doctor were positive. Patients who choose it for themselves on their own, without medical advice, are very likely to encounter side effects, often significant enough so that continued administration of the tablets is impossible.
In the accompanying documentation, the manufacturer indicates the possibility of dispensing Hartila strictly according to the prescription, the inadmissibility of taking the substance without the supervision of a qualified doctor. From the reviews it follows that the rules of strict leave are not observed in all pharmacies. Nevertheless, it is recommended not to risk your health and to use ACE inhibitors only after consulting a doctor.
How to use?
It is important not only to take the testimony of Hartil into account, but also to take the pill correctly, in the right doses. The manufacturer draws attention to the need to swallow the capsules completely, without chewing specimens. Reception is not tied to the meal. It is necessary to drink each tablet with at least half a glass of pure water without additives.
In case of arterial hypertension, the dosage of "Hartil" is as follows: the initial volume is 2.5 mg orally once a day. If this format of treatment does not show the desired result, after 2-3 weeks you can increase the dose. Up to 10 mg of the substance can be prescribed for a maximum of 24 hours. As a supportive optimal dosage of 2.5-5 mg.
In case of insufficient functioning of the heart in chronic form, initially “Hartil” is used in the amount of 1.25 mg per day. If this format does not provide the desired stabilization, the volumes are doubled. Between dose increases, it is necessary to withstand intervals of 7-14 days. If it is indicated to use 2.5 mg or more per day, you can use this amount at a time or divide it into two doses. You can not use more than 10 mg of the drug per day.
Dosage nuances: insufficient functioning of the cardiac system
The doctor, prescribing the composition, explains why "Hartil" is prescribed in a particular case, how the tablets will help stabilize the patient's condition and how to use it correctly so that tolerance is maximized. It is important to pay attention to this explanation for any diagnosis requiring the use of Hartil, but patients with heart failure, including the chronic form of this condition, should be especially careful.
If a person has had a heart attack during heart failure, Hartil is used with 5 mg daily, dividing this volume into two doses, between which they stand for strictly 12 hours. If tolerance is weak, the dose is halved, taking 1.25 mg of the drug twice a day. This format is supported for two days, after which you can again increase the used volumes. If it was decided to increase the dose, the first three days of the new intake should be divided into two stages, keeping a 12-hour break between them. After the first three days, the daily volume can be used at a time. Maximum per day is used no more than 10 mg of the drug. In severe chronic form of HF, “Hartil” is first prescribed in the amount of 1.25 mg per day, gradually increasing the composition in the future, carefully monitoring the patient’s response to therapy.
Other diagnoses and nuances of use
According to the instructions, the drug helps with nephropathy due to diabetes and other causes. With this diagnosis, the drug is taken at 1.25 mg per day, gradually increasing the dosage, if there is evidence for this. The optimal maintenance dose is considered to be 2.5 mg. If you need to increase the dose, doubling is usually practiced with an interval of 2-3 weeks between changes in quantity. A maximum of 5 mg is allowed to use the drug.
As a preventative measure to prevent stroke, heart attack, coronary death, Hartil is prescribed in the amount of 2.5 mg once every day. If necessary, once a week, you can raise the dosage, each time increasing the volume by half. You can not use the composition in an amount greater than 10 mg per day.
Dosage Features
If chronic renal failure is detected, while creatinine clearance varies between 20-50 mg / min, Hartil is first used in an amount of 1.25 mg per day. The maximum daily volume is 5 mg. In case of kidney failure for a day, it is allowed to use no more than 2.5 mg of the drug.
If the patient has previously used diuretics, first “Hartil” is prescribed in the amount of 1.25 mg. Refusal from diuretics should occur 3 days before the start of the use of ACE inhibitors.
If it is not possible to eliminate failures in the balance of electrolytes and fluids in the body against the background of severe hypertension, the drug begins to be used with 1.25 mg per day. A similar initial dose is recommended in a condition in which a decrease in pressure is associated with increased risks.
Negative consequences
The tablet manufacturer lists all possible side effects of Hartil in the accompanying documentation. It is known that the drug can cause too low pressure, ischemia, heart attack, fainting, a malfunction in the frequency and speed of the heartbeat rhythm, stroke, swelling. To a greater extent, the likelihood of such an organism's response is characteristic of improper unauthorized use of the medication and exceeding the recommended doses.
Hartil can cause the development or activation of chronic renal failure, large amounts of urine excreted, and malfunctions in the genital area. There are cases when patients had problems of maintaining equilibrium, they were sick and dizzy, their condition was nervous and irritated, worried, their consciousness was confused. There is a risk of depressive, depressed mental status, sleep disturbances, weakness. Possible vomiting and nausea, upset stool, craving for drink, impaired liver function.
"Hartil" can cause a runny nose, cough, spasm of the bronchi, disorders of perception of taste, smells, sounds, visual pictures. There is a risk of an allergic response of the body, disorders of the hematopoietic system. In the presence of psoriasis, the condition may worsen. Cases of hair loss, fever are known. Laboratory tests may show an increase in the content of creatinine, ammonium, bilirubin, potassium; in urine, protein structures are detected, hepatic enzymes are activated. In diabetics, Hartil in rare cases led to hypoglycemia.
Hartil and pregnancy
During the period of bearing a child, the drug in question is not allowed to be used. It has been established that the active components of the substance provoke improper formation of the embryo's kidneys. The fetus lowers blood pressure, this condition persists after birth. Because of Hartil, renal function disorder, lack of potassium in the body, limb contracture are possible. Cases of cranial deformity, hypoplasia are known. Hartil can cause pulmonary hypoplasia and oligohydramnios.
Prices and alternatives
Currently, for one package of “Khartil” in pharmacies they ask from 225 rubles or more. If it is impossible to afford such a drug, you must consult a doctor for a choice of replacement. As a rule, they recommend Russian analogues of Khartil: their cost is more affordable. You should not choose the drugs for yourself instead of the one prescribed by the doctor - this is associated with increased risks of course inefficiency, the appearance of severe adverse reactions.
Russian analogues of Hartila:
The first drug costs about the same as the drug in question, the second price is significantly lower - about 90 rubles.
A possible replacement for the described medication is also:
- The Pyramids.
- Amprilan.
- Tritace.
Safety First: Admission Features
The manufacturer in the accompanying documentation indicates the need to especially carefully assess the condition of the patient after the first use of Hartil, as well as after increasing the dosage of the drug or starting to take large doses of diuretics in combination with the drug in question. At least eight hours, it is necessary to monitor the patient's condition in the clinical setting in order to notice the hypotensive reaction in time, requiring urgent qualified help.
With CHF, the use of tablets can cause severe hypotension. There have been cases when this condition was accompanied by azotemia, oliguria, and even kidney failure in acute form, although the latter is extremely rare.
With an early heart attack, the minimum systole for the therapeutic course is 100 units. With a malignant form of hypertension or decompensated chronic heart failure, it is necessary to start taking Hartil only under stationary conditions, under the supervision of a doctor.
The specifics of therapy
Before you start using Hartil, you should take tests to assess the condition of the circulatory, hematopoietic systems. It is important to estimate the number of leukocytes, to calculate the leukocyte formula. In the future, such checks will be required once every 1-6 months. It is especially important to regularly take indicators from individuals for whom the probability of developing neutropenia is above the average. If neutropenia is confirmed, it is urgent to abandon ACE inhibitors.
When taking the described drug, it is important to regularly check the level of pressure, the functioning of the renal system, the serum electrolytes, potassium ions, and the activity of liver enzymes.
Epidemiological studies suggest that the combination of ACE inhibitors and insulin, as well as means for controlling hypoglycemia in the form for oral administration can cause hypoglycemia. The risks of this pathological condition are higher in the first few weeks of co-administration of drugs. Significantly more danger to the patient, whose kidneys work with abnormalities. Diabetics are shown to regularly monitor glycemia. This is especially important in the first month of using Hartil.
Features of the condition and administration of the drug
If "Hartil" is prescribed to people who are forced to eat with a minimum amount of salt, and also against the background of a complete rejection of salt, taking the medication should be especially careful, since the risks of hypotension are more significant than for other groups of patients. With a decrease in BCC, which is often observed against the background of diuretic use, with limited salt intake, vomiting, loose stool and the need for dialysis, the risks of hypotension are increased.
It is important to remember that transistor hypotension is not a reason to refuse Hartil tablets. The drug continues to be used when the pressure stabilizes. If the condition occurs again, the dosage is reduced or the medication is completely canceled.
If the mother used Hartil during pregnancy, after birth it is necessary to monitor the condition of the child in a hospital. High probability of increased potassium in the body, low blood pressure, oliguria. With the latter type of pathological condition, pressure support and kidney perfusion are practiced by the introduction of vasoconstrictor agents and fluids.