Dilaprel

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Dilaprel: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. In case of impaired liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Dilaprel

ATX code: C09AA05

Active ingredient: Ramipril (Ramipril)

Manufacturer: CJSC VERTEX (Russia)

Description and photo update: 2018-10-05

Dilaprel is an angiotensin-converting enzyme (ACE) inhibitor, an antihypertensive drug.

Release form and composition

Dilaprel dosage form - capsules: hard gelatinous, size No. 3; 2.5 mg each - white body, yellow cap, 5 mg each - yellow body and cap, 10 mg each - white body and cap; inside capsules - compacted (when pressed, disintegrates) or powdery mass of almost white or white color (in a blister strip: 7 pcs., in a cardboard box 2 or 4 packs; 10 pcs., in a cardboard box 1, 2, 3, 5 or 6 packs; 14 pcs., In a cardboard box 1, 2 or 4 packs).

1 capsule contains:

active substance: ramipril - 2.5 mg, 5 mg or 10 mg;
excipients: lactose (10 mg capsules - lactose monohydrate), colloidal silicon dioxide (aerosil), calcium stearate;
composition of capsules: titanium dioxide, gelatin.

Additionally, in the composition of capsules of 2.5 mg and 5 mg - iron oxide yellow dye.

Pharmacological properties

Pharmacodynamics

Under the influence of liver enzymes, an active metabolite of ramipril, ramiprilat (a long-acting ACE inhibitor), is formed. Angiotensin II has a vasoconstrictor, bradykinin - a vasodilator. Since ACE catalyzes the conversion of angiotensin I into angiotensin II in blood plasma and tissues and the breakdown of bradykinin, taking ramipril reduces the formation of angiotensin II and promotes the accumulation of bradykinin, vasodilation and a decrease in blood pressure (BP). The cardioprotective and endothelioprotective effect of ramipril increases the activity of the kallikrein-kinin system in the blood and tissues by activating the prostaglandin system and increasing the synthesis of prostaglandins, which stimulate the formation of nitric oxide (NO) in endotheliocytes.

Ramipril reduces the secretion of aldosterone, increases the content of potassium ions in the blood plasma.

A decrease in the concentration of angiotensin II in the blood eliminates its inhibitory effect on the secretion of renin and increases its activity in the blood plasma.

With arterial hypertension, ramipril lowers blood pressure in the standing and lying position without a compensatory increase in heart rate (HR), significantly reduces total peripheral vascular resistance (OPSR), almost without causing changes in the glomerular filtration rate, as well as changes in renal blood flow. The manifestation of the antihypertensive effect occurs within 1–2 hours after taking the drug, is fully achieved after 3–6 hours and lasts for 24 hours. The course allows you to gradually increase the antihypertensive effect, stabilize blood pressure by 3-4 weeks of regular therapy and maintain it for a long time. Sudden withdrawal of the drug does not cause a rapid and significant increase in blood pressure.

While taking ramipril in patients with arterial hypertension, the development or progression of hypertrophy of the vascular wall and myocardium slows down.

In chronic heart failure, the systemic vascular resistance decreases, the capacity of the venous bed increases, the filling pressure of the left ventricle decreases, and the preload on the heart decreases. The action of the drug helps to increase cardiac output, ejection fraction and improve exercise tolerance.

In non-diabetic and diabetic nephropathy, ramipril reduces the rate of progression and the onset of end-stage renal failure. This reduces the need for hemodialysis and kidney transplant procedures. In the initial stages of the disease, ramipril reduces the severity of albuminuria.

In patients with a high risk of developing cardiovascular diseases caused by vascular lesions [diagnosed ischemic heart disease (IHD), history of stroke, history of obliterating peripheral artery disease] or diabetes mellitus with at least one additional risk factor [arterial hypertension, microalbuminuria, an increase in total cholesterol, smoking, a decrease in the concentration of high-density lipoprotein (HDL) cholesterol], the inclusion of ramipril in standard therapy contributes to a significant decrease in the incidence of myocardial infarction, stroke or death from cardiovascular causes. In addition, ramipril slows down the development or progression of chronic heart failure, the need for revascularization procedures, and lowers overall mortality rates.

In heart failure with clinical manifestations that developed in the first days of acute myocardial infarction, the use of ramipril from 3 to 10 days reduces the mortality rate by 27%, the risk of sudden death by 30%, and the risk of progression of chronic heart failure to severe or resistant to therapy by 23% forms, 26% development of heart failure and the need for subsequent hospitalization.

Ramipril significantly reduces the risk of developing nephropathy and microalbuminuria.

Pharmacokinetics

After oral administration, ramipril is rapidly absorbed from the gastrointestinal tract, C _max (maximum concentration) of ramipril is reached after 1 hour and ramiprilat after 2-4 hours. The connection with plasma proteins for ramipril - 73%, ramiprilat - 56%, _Vd (volume of distribution) ramipril - 90 l, ramiprilat - 500 l. Food intake does not affect the completeness of absorption, it only slows down its absorption.

Dilaprel metabolism occurs in the liver with the formation of ramiprilat (an active metabolite that inhibits ACE 6 times more actively than ramipril) and inactive metabolites - diketopiperazinic acid, diketopiperazine ester, ramipril and ramiprilat glucuronides. Only ramiprilat has pharmacological activity.

T _1/2 (half-life) of ramipril - 5.1 hours. A decrease in the concentration of ramiprilat in blood serum in the distribution phase and elimination occurs with T _1/2 - 3 hours, in the transition phase with T _1/2 - 15 hours, the final half-life phase with an insignificant concentration of ramiprilat in blood plasma lasts 4-5 days. In chronic renal failure, T _1/2 increases. The rate of elimination of ramipril and its metabolites decreases in proportion to the decrease in creatinine clearance (CC).

It is excreted by the kidneys - 60%, through the intestines - 40%.

In case of impaired liver function, the conversion to ramiprilat slows down.

The concentration of ramiprilat in heart failure is increased by 1.5-1.8 times.

Indications for use

combination therapy of chronic heart failure, including diuretics;
arterial hypertension - monotherapy or with the simultaneous use of other antihypertensive drugs (including blockers of slow calcium channels, diuretics);
preclinical and clinically pronounced stages of nondiabetic or diabetic nephropathy, including patients with severe proteinuria, especially against the background of arterial hypertension;
heart failure with clinical manifestations, which developed from 2 to 9 days after acute myocardial infarction.

In addition, the use of Dilaprel is indicated to reduce the likelihood of developing myocardial infarction, stroke or cardiovascular mortality with a high cardiovascular risk of the following pathologies:

history of stroke;
confirmed ischemic heart disease in patients with a history of myocardial infarction or without it, including patients who have undergone coronary artery bypass grafting, percutaneous transluminal coronary angioplasty;
occlusive lesion of peripheral arteries;
diabetes mellitus in patients with additional risk factors (one or more) - arterial hypertension, microalbuminuria, increased plasma concentrations of total cholesterol, smoking, decreased plasma HDL cholesterol levels.

Contraindications

a history of angioneurotic edema (idiopathic or occurring while taking ACE inhibitors);
bilateral hemodynamically significant renal artery stenosis (or unilateral in patients with a single kidney);
arterial hypotension (systolic blood pressure below 90 mm Hg) or pathology with unstable hemodynamic parameters;
simultaneous use of angiotensin II receptor antagonists in diabetic nephropathy;
hypertrophic obstructive cardiomyopathy or hemodynamically significant stenosis of the mitral or aortic valve;
primary hyperaldosteronism;
hemodialysis;
severe stage of renal failure (CC less than 20 ml / min with 1.73 m ² body surface area);
the simultaneous use of non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticosteroids (GCS), immunomodulators and / or other cytotoxic agents in the treatment of nephropathy;
chronic heart failure in the stage of decompensation;
hemofiltration or hemodialysis using high-flow membranes made of polyacrylonitrile and others with a negatively charged membrane surface;
use of dextran sulfate for apheresis of low density lipoprotein (LDL);
desensitizing therapy for hypersensitivity reactions to the poisons of hymenoptera insects (including bees, wasps);
simultaneous use of drugs with aliskiren in diabetes mellitus and renal failure with CC less than 60 ml / min;
period of pregnancy;
breast-feeding;
age up to 18 years;
syndrome of glucose-galactose malabsorption, lactase deficiency, lactose intolerance;
individual intolerance to the components of the drug and other ACE inhibitors.

Additional contraindications for the appointment of Dilaprel in the acute stage of myocardial infarction:

III – IV functional class of chronic heart failure according to NYHA classification (New York Heart Association);
unstable angina;
life-threatening ventricular arrhythmias;
pulmonary heart.

Caution should be exercised with the simultaneous use of drugs containing aliskiren, as well as angiotensin II receptor antagonists due to the increased risk of developing hyperkalemia, a sharp decrease in blood pressure, and deterioration of renal function with a double blockade of the RAAS (renin-angiotensin-aldosterone system) …

In addition, careful monitoring of the condition of patients with atherosclerotic lesions of the coronary and cerebral arteries (risk of an excessive decrease in blood pressure), severe arterial hypertension (especially in malignant arterial hypertension), chronic heart failure (especially in severe form or with concomitant therapy with other antihypertensive drugs) is required, violation of water and electrolyte balance (with insufficient consumption of sodium chloride and liquid, diarrhea, vomiting, profuse sweating), hemodynamically significant unilateral renal artery stenosis (in patients with two kidneys) - this condition is accompanied by a unilateral deterioration of renal function; impaired liver function, diabetes mellitus, impaired renal function (CC above 20 ml / min) - the risk of developing leukopenia and hyperkalemia; hyperkalemia,systemic diseases of the connective tissue (including systemic lupus erythematosus, scleroderma, concomitant therapy with myelotoxic drugs that affect the change in the peripheral blood picture); in the period after kidney transplantation, after the previous intake of diuretics, in old age.

Instructions for the use of Dilaprel: method and dosage

Dilaprel capsules are taken orally, swallowed whole and washed down with a sufficient amount (100 ml) of water, before, during or after meals.

The doctor prescribes the dose and duration of treatment individually, taking into account clinical indications, drug tolerance and therapeutic effect. The period of application is usually long.

Recommended dosage of Dilaprel:

arterial hypertension: initial dose - 2.5 mg once in the morning. If after 21 days of therapy, blood pressure is not normalized, the daily dose can be increased to 5 mg. In the absence of a sufficient therapeutic effect from an increased dose, the patient can be additionally prescribed another antihypertensive agent (including diuretics or slow calcium channel blockers) or after 14–21 days of use, increase it to a maximum dose of 10 mg per day;
chronic heart failure: starting dose 1.25 mg daily. If the drug is well tolerated, the dose can be gradually increased, with an interval of 7-14 days, to a dose that provides sufficient control of the disease, but not more than 10 mg per day. The dose above 2.5 mg can be divided into 2 doses;
heart failure with clinical manifestations, which developed from 2 to 9 days after acute myocardial infarction: the initial dose is 2.5 mg 2 times a day (morning and evening). In the case of an excessive decrease in blood pressure, the initial dose should be reduced to 1.25 mg 2 times a day. Then, taking into account the patient's condition, the dose can be doubled with an interval of 1-3 days. Then the patient can be transferred to a single daily dose. The daily dose should not exceed 10 mg;
severe chronic heart failure (NYHA functional class III – IV), arising immediately after acute myocardial infarction: initial dose - 1.25 mg once a day, then special care should be taken with each dose increase;
non-diabetic or diabetic nephropathy: the initial dose is 1.25 mg once a day. Then it can be increased to a maximum daily dose of 5 mg and taken once;
reducing the likelihood of developing myocardial infarction, stroke or cardiovascular mortality in patients with high cardiovascular risk: the initial dose is 2.5 mg once a day. If the drug is well tolerated, it is recommended to double the dose after 7 days of treatment, then increase it to 10 mg within 21 days of treatment - the usual maintenance dose.

The recommended correction of the Dilaprel dosage regimen for special patient groups:

impaired renal function (CC 50–20 ml / min per 1.73 m ² of body surface): the daily initial dose is 1.25 mg. The maximum dose is 5 mg per day;
violation of water and electrolyte balance, or severe arterial hypertension, or severe atherosclerotic lesions of the coronary and cerebral arteries: initial dose - 1.25 mg per day;
patients over the age of 65: initial dose - 1.25 mg per day;
liver dysfunction: the maximum daily dose is 2.5 mg. Taking the drug at the beginning of therapy should take place under close medical supervision, since blood pressure can both decrease and increase significantly.

For patients with previous diuretic therapy, the use of Dilaprel is indicated only a few days after the cancellation or reduction of the dose of diuretics at an initial daily dose of 1.25 mg. After taking the first dose and each time it is increased, the patient should be provided with medical supervision for 8 hours in order to prevent the development of an uncontrolled hypotensive reaction.

Side effects

on the part of the vessels: often - a significant decrease in blood pressure, syncope, orthostatic hypotension; infrequently - rush of blood to the skin of the face; rarely - vasculitis, the appearance or intensification of circulatory disorders with stenosing vascular lesions; frequency unknown - Raynaud's syndrome;
from the heart: infrequently - the appearance or intensification of cardiac arrhythmias, palpitations, myocardial ischemia (including the development of myocardial infarction or angina pectoris attack), peripheral edema, tachycardia;
from the nervous system: often - a feeling of "lightness" in the head or dizziness, headache; infrequently - ageusia (violation of taste), paresthesia, dysgeusia, vertigo; rarely - imbalance, tremor; frequency unknown - cerebral ischemia (including transient cerebrovascular accident, ischemic stroke), decreased speed of psychomotor reactions, parosmia, burning sensation;
on the part of the respiratory system, chest and mediastinal organs: often - bronchitis, dry cough (activated when lying down and at night), shortness of breath, sinusitis; infrequently - nasal congestion, bronchospasm, aggravation of the course of bronchial asthma;
from the organ of hearing: rarely - tinnitus, hearing impairment;
on the part of the organ of vision: infrequently - blurred images and other visual disturbances; rarely - conjunctivitis;
mental disorders: infrequently - anxiety, nervousness, depressed mood, sleep disturbances, drowsiness, restlessness; rarely - confusion of consciousness; frequency unknown - impaired attention;
from the hepatobiliary system: infrequently - an increase in the activity of liver enzymes, an increase in the level of conjugated bilirubin in the blood plasma; rarely - hepatocellular lesions, cholestatic jaundice; frequency unknown - cholestatic hepatitis (extremely rarely fatal), acute liver failure;
from the digestive system: often - nausea, indigestion, diarrhea, vomiting, inflammation in the stomach and intestines, dyspepsia, abdominal discomfort; infrequently - dryness of the oral mucosa, constipation, fatal pancreatitis (extremely rarely fatal), angioedema of the small intestine, increased activity of pancreatic enzymes in the blood plasma, pain in the upper abdomen (including those caused by gastritis); rarely - glossitis; frequency unknown - aphthous stomatitis;
on the part of the blood and lymphatic system: infrequently - eosinophilia; rarely - leukopenia, agranulocytosis, neutropenia, a decrease in the number of erythrocytes in the peripheral blood, thrombocytopenia, a decrease in the level of hemoglobin; frequency unknown - hemolytic anemia, pancytopenia, inhibition of bone marrow hematopoiesis;
on the part of the urinary system: infrequently - an increase in the volume of excreted urine, impaired renal function, exacerbation of already existing proteinuria, the development of acute renal failure, an increase in the concentration of creatinine and urea in the blood;
on the part of the genitals and mammary gland: infrequently - transient impotence against the background of erectile dysfunction, decreased libido; frequency unknown - gynecomastia;
dermatological reactions: often - skin rash, maculopapular rash; infrequently - itchy skin, angioedema (including fatal ones), hyperhidrosis; rarely - onycholysis, urticaria, exfoliative dermatitis; very rarely - photosensitivity reactions; frequency unknown - erythema multiforme, toxic epidermal necrolysis, pemphigus, Stevens-Johnson syndrome, exacerbation of psoriasis, alopecia, psoriasis-like dermatitis, lichenoid or pemphigoid exanthema or enanthema;
on the part of metabolism and nutrition: often - an increase in the level of potassium in the blood; infrequently - loss of appetite, anorexia; the frequency is unknown - a decrease in the level of sodium in the blood;
from the immune system: the frequency is unknown - anaphylactic or anaphylactoid reactions, an increase in the titer of antinuclear antibodies;
on the part of connective and musculoskeletal tissue: often - myalgia, muscle cramps; infrequently - arthralgia;
from the endocrine system: frequency is unknown - syndrome of inappropriate antidiuretic hormone secretion;
general disorders: often - feeling tired, chest pain; infrequently - an increase in body temperature; rarely, weakness.

Overdose

Symptoms of Dilaprel overdose: change in water-electrolyte balance, acute renal failure, bradycardia, stupor, significant peripheral vasodilation with the appearance of a significant decrease in blood pressure, shock.

In mild cases, treatment is limited to immediate gastric lavage, intake of adsorbents and sodium sulfate. The patient should ensure control of the function of vital organs.

In severe cases, therapy is aimed at stabilizing blood pressure. The patient is prescribed intravenous (i / v) administration of 0.9% sodium chloride solution, plasma substitutes, with bradycardia resistant to drug therapy, a temporary artificial pacemaker is required. With a pronounced decrease in blood pressure, the administration of alpha-adrenergic agonists (dopamine, norepinephrine) is additionally prescribed, with bradycardia - atropine or the use of a temporary artificial pacemaker. They also carry out careful monitoring of blood pressure, the content of electrolytes in the blood plasma, and renal function.

With the development of renal failure, hemodialysis is indicated.

special instructions

The duration of treatment is usually long and requires regular medical supervision, including in patients with impaired renal and liver function.

Before taking Dilaprel, it is necessary to eliminate hypovolemia and hyponatremia.

Treatment of patients with malignant arterial hypertension and heart failure, especially in the acute stage of myocardial infarction, should be started only in a hospital setting.

In chronic heart failure, taking Dilaprel increases the risk of a pronounced decrease in blood pressure, the development of oliguria, azotemia, and acute renal failure.

Care should be taken during exercise, high ambient temperatures, since sweating and dehydration increase, which increases the risk of arterial hypotension.

Alcohol should not be consumed during treatment.

Transient arterial hypotension is not a reason for discontinuation of Dilaprel; after stabilization of blood pressure, treatment can be continued. With repeated severe arterial hypotension, the doctor decides to reduce the dose or discontinue therapy.

During treatment with ACE inhibitors, angioedema of the extremities, face, lips, tongue, larynx or pharynx may develop. The patient should be warned about the need to immediately stop taking the drug and see a doctor if swelling appears in the lips, eyelids or tongue, swallowing or breathing problems. The patient is subject to hospitalization and close observation until all signs are completely relieved.

In addition, the appearance of intestinal angioedema is possible, in rare cases it is accompanied by facial edema. Therefore, when carrying out a differential diagnosis of abdominal pain, nausea, vomiting, the possibility of intestinal angioedema should be taken into account and the patient should be assigned a computed tomography or ultrasound scan for a more accurate diagnosis.

For any surgical intervention (including dentistry), the doctor should be warned about taking Dilaprel.

Before starting use and during treatment with ACE inhibitors, it is necessary to determine the leukocyte formula and count the total number of leukocytes.

Monitoring of laboratory parameters must be carried out before starting the use of Dilaprel and then monthly during the period of taking the capsules for the first 3-6 months.

Regular monitoring of renal function, serum potassium content should be carried out, careful monitoring of its concentration is required in case of impaired renal function, chronic heart failure, a significant violation of the water-electrolyte balance.

To identify symptoms of the development of leukopenia, treatment with Dilaprel should be accompanied by monitoring the indicators of a general blood test. In addition, it is necessary to monitor the general condition of the patient and, in the event of an increase in lymph nodes, the appearance of fever or tonsillitis, urgent monitoring of the peripheral blood picture.

More careful observation at the beginning of treatment is required for patients with impaired renal function, connective tissue diseases, with concomitant therapy with other drugs that affect the peripheral blood picture.

When red-brown rashes and tiny petechiae appear on the skin and mucous membranes, it is necessary to examine the number of platelets in the peripheral blood.

With a significant increase in the activity of hepatic transaminases, the appearance of jaundice, taking ramipril should be discontinued.

Influence on the ability to drive vehicles and complex mechanisms

Since against the background of the use of Dilaprel, the speed of psychomotor reactions and concentration of attention may decrease, dizziness may appear, patients are advised to avoid potentially hazardous activities, including the management of various mechanisms and vehicles.

Application during pregnancy and lactation

According to the instructions, Dilaprel is contraindicated in pregnancy.

The absence of pregnancy should be confirmed before starting treatment. If conception occurs during the period of therapy, the drug must be canceled and another remedy prescribed.

The use of Dilaprel during pregnancy can cause impaired development and function of the kidneys of the fetus, a decrease in blood pressure of the fetus and newborn, the development of hyperkalemia, oligohydramnios, hypoplasia of the skull bones, violation of limb contracture, skull deformity, hypoplasia of the lungs, especially in the first trimester of pregnancy.

Newborns exposed to intrauterine exposure to ramipril require careful monitoring for hyperkalemia, arterial hypotension, oliguria. In addition, there is a risk of neurological disorders in newborns.

Since the drug is excreted in breast milk, the use of Dilaprel during breastfeeding is contraindicated.

Pediatric use

At the age of 18 years, the appointment of the drug is contraindicated due to insufficient clinical experience in children and adolescents.

With impaired renal function

The appointment of Dilaprel is contraindicated in severe renal failure (CC less than 20 ml / min at a body surface of 1.73 m ²), in patients with nephropathy taking NSAIDs, GCS, immunomodulators and / or other cytotoxic agents.

If liver function is impaired

Prescribing Dilaprel for violations of liver function should be done with caution due to the lack of experience with ramipril and the possible increase or decrease of its effects, and in patients with liver cirrhosis with the presence of ascites and edema - an increase in the activation of the RAAS.

Use in the elderly

The action of Dilaprel raises the risk of an increase in the hypotensive effect in elderly patients, therefore it is not recommended to prescribe the drug to this category of patients.

Drug interactions

With the simultaneous use of Dilaprel:

potassium salts, potassium-sparing diuretics (including amiloride, triamterene, spironolactone), trimethoprim, cyclosporine, tacrolimus and other drugs that increase the level of potassium in the blood plasma, can increase the concentration of potassium in the blood plasma;
Telmisartan in combination with ramipril does not provide the effect that is achieved when used separately, contributes to a more frequent occurrence of dizziness, hyperkalemia, arterial hypotension, renal failure;
antihypertensive drugs (including diuretics), tricyclic antidepressants, nitrates, baclofen, prazosin, alfuzosin, doxazosin, tamsulosin, terazosin, agents for local and general anesthesia and other drugs that lower blood pressure, potentiate the antihypertensive effect;
sodium aurothiomalate for intravenous administration in rare cases can cause nausea, vomiting, facial flushing, arterial hypotension;
hypnotics, narcotic, pain relievers can enhance the antihypertensive effect;
epinephrine, isoproterenol, dobutamine, dopamine (vasopressor sympathomimetics) reduce the antihypertensive effect of ramipril;
allopurinol, procainamide, cytostatics, immunosuppressants, corticosteroids (glucocorticosteroids and mineralocorticosteroids) and other drugs affecting hematological parameters increase the risk of developing hematological reactions;
heparin can increase serum potassium;
lithium salts increase the plasma concentration of lithium, cause an increase in the neuro- and cardiotoxic effect of lithium;
insulin, oral hypoglycemic agents (sulfonylurea derivatives) may enhance their effect, the risk of hypoglycemia increases;
vildagliptin, temsirolimus increase the incidence of angioedema;
indomethacin, acetylsalicylic acid (more than 3 g per day), inhibitors of cyclooxygenase COX-2 can reduce the effect of ramipril, the risk of impaired renal function and an increase in the concentration of potassium in the blood plasma increases;
sodium chloride helps to weaken the antihypertensive effect of the drug and the effectiveness of the treatment of symptoms of chronic heart failure;
ethanol increases the symptoms of vasodilation and adverse effects on the body;
estrogens reduce the hypotensive effect of the drug;
other ACE inhibitors increase the risk of developing renal failure (including acute renal failure), hyperkalemia;
Desensitizing therapy with hymenoptera poisons causes rapid development of severe anaphylactic or anaphylactoid reactions in patients with hypersensitivity to hymenoptera poisons.

Analogs

Dilaprel analogs are: capsules - Vasolong, Ramitren, Ramikardia, Corpril.

Terms and conditions of storage

Keep out of the reach of children.

Store at temperatures up to 25 ° C in a dark place.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Dilaprela

The few reviews about Dilaprel indicate its good effectiveness.

Dilaprel price in pharmacies

Dilaprel price depends on the dosage of the drug. The cost of packaging capsules (28 pcs.) In a dose of 10 mg is 400–420 rubles, 5 mg - 225–245 rubles, 2.5 mg - 140–180 rubles.

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!