RAMIPRAZ

*Hypertension:* Adult: Initially 1.25-2.5 mg once daily, increased if necessary up to 10 mg once daily, increased at intervals of 2-4 weeks. *Symptomatic heart failure (adjunct):* Adult: Initially 1.25 mg once daily, increased if tolerated to 10 mg daily in 2 divided doses, increase dose gradually at intervals of 1-2 weeks. *Prophylaxis after myocardial infarction in patients with clinical evidence of heart failure (started at least48 hours after infarction):* Adult: Initially 2.5 mg twice daily for 3 days, then increased to 5 mg twice daily, if initial dose not tolerated then 1.25 mg twice daily for 2 days, then increased to 2.5 mg twice daily, then increased to 5 mg twice daily, withdraw treatment if dose cannot be increased to 2.5 mg twice daily. *Prevention of cardiovascular events in patients with atherosclerotic cardiovascular disease or with diabetes mellitus and an additional risk factor for cardiovascular disease:* Adult: Initially 2.5 mg once daily for 1-2 weeks, then increased to 5 mg once daily for a further 2-3 weeks, then increased to 10 mg once daily. *Nephropathy:* Adult: Initially 1.25 mg once daily for 2 weeks, then increased to 2.5 mg once daily for a further 2 weeks, then increased if tolerated to 5 mg once daily. Children: Not recommended.

History of angioneurotic oedema, aortic stenosis, outflow obstruction.

Congestive heart failure; initiate therapy in hos-pital. Hepatic impairment; initiate therapy under close medical supervision, haemodialysis, renal impairment; reduce dose and assess renal function prior to and during treatment.

Antihypertensive agents, K+ sparing diuretics or K+ supplements, lithium.

Bronchitis, dyspnea, muscle cramps, stomatitis, syncope, angina, anxiety, arrhythmias, chest pain, depression, dry mouth, flushing, myocardial infarction, nervousness, palpitations, peripheral oedema, sweating, tachycardia, visual disturbances. Rare: Confusion, conjunctivitis, impaired hearing, onycholysis, tinnitus, tremor