Liracen 1,25 mg/2,5 mg/5 mg/10 mg Capsules

LIRACEN are used to treat high blood pressure and to reduce the risk of heart attack, stroke and heart-related death in patients at risk for these problems. LIRACEN are also used to improve survival in patients with heart failure after a heart attack. LIRACEN belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

Do not take LIRACEN:

• If you have ever had an unusual or allergic reaction to ramipril or any ingredient of LIRACEN.
• If you have or have ever had angioedema (a condition that causes difficulty in swallowing or breathing and painful swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs) whilst taking previous angiotensin-converting enzyme (ACE) inhibitor medication or angiotensin receptor blockers (ARBs). You must never again take these medicines.
• If you have abnormal narrowing of the valve between the left part of your heart to the major blood vessel of the heart (the aorta).
• If you have abnormal thickening of the heart muscle.
• If you have moderate to severe kidney disease.
• If you have narrowing of the blood vessel of kidney with a single kidney.
• If you have narrowing of the blood vessels to both kidneys.
• If you suffer from porphyria which could result in symptoms such as severe abdominal pain, restlessness, excessive sweating, dehydration, painful skin redness, and red urine.
• If you are currently taking diuretics (water tablets) that increase potassium in the blood such as triamterene, amiloride or spironolactone.
• If you are taking lithium, a medicine used to treat mental illness. LIRACEN may increase the lithium levels in your blood.
• If you are pregnant or breast-feeding your baby.
• LIRACEN should not be given to children.

Take special care with LIRACEN:

• Vomiting, diarrhoea, heavy sweating or not drinking enough fluids can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking LIRACEN.
• If you develop swelling of the face around your lips, tongue, or throat or difficulty swallowing, you should stop taking LIRACEN and contact your doctor immediately.
• If you are having surgery, tell you doctor that you are taking LIRACEN.
• Do not use salt substitutes or potassium supplements while taking LIRACEN.
• To be sure LIRACEN is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Tell your doctor:

• if you have heart or blood vessel disease.
• if you have an autoimmune disease (such as lupus) or scleroderma or if you are taking immunosuppressive medication.
• if you have kidney disease.
• if you have liver disease.
• if you have bone marrow disease.
• if you have diabetes.
• if you are on a special diet, such as a low-salt diet.

Pregnancy and Breast-feeding: LIRACEN can cause birth defects in the baby if taken during pregnancy. Use an effective form of birth control. Stop using LIRACEN and tell your doctor right away if you become pregnant during treatment. Do not use LIRACEN if you are breast-feeding your baby. If you are pregnant or breast-feeding your baby while taking LIRACEN, please consult your doctor, pharmacist or other health care professional for advice.

• Take LIRACEN only as directed by your doctor.
• Do not take more or less of LIRACEN or take LIRACEN more often than prescribed by your doctor.
• LIRACEN should be taken during or after meals with half a glass of liquid.
• The usual dose of LIRACEN is 2,5 – 10 mg a day. Your doctor may start you on a lower dose of LIRACEN (1,25 mg per day) and gradually increase your dose.

Always take LIRACEN exactly as your doctor has instructed you. You should check with your doctor or pharmacist if you are unsure. If you have the impression that the effect of LIRACEN is too strong or too weak, talk to your doctor or pharmacist.

If you take more LIRACEN than you should: Symptoms of overdose may include lightheadedness and fainting. In the event of overdosage, consult your doctor or pharmacist. If neither is available, seek help at the nearest hospital or poison control centre.

If you forget to take LIRACEN: Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

LIRACEN can have side effects. Get emergency medical help if you have any of these signs of an allergic reaction:

• Hives (skin rash)
• Difficulty breathing
• Swelling of your face, lips, tongue, or throat

Call your doctor at once if you have any of these serious side effects:

• Feeling light-headed; fainting
• Yellowing of the skin or eyes
• Blood disorders which may manifest with fever, sore throat, chills, and other signs of infection
• Urinating less than usual, or not at all
• Fast or uneven heart beat, fast or irregular heart beat or chest pain
• Pale skin, easy bruising or bleeding

Other side effects include: Headache, excessive tiredness, confusion, dizziness, nausea, diarrhoea, vomiting, indigestion, sleep problems, sexual dysfunction, weakness, dry cough, rash, itching, hair loss, loss of appetite, dry mouth, visual disturbance, runny nose, abdominal pain, taste disturbance. Not all side effects reported for LIRACEN are included in this leaflet. Should your general health worsen while taking LIRACEN, please consult your doctor, pharmacist or other health care professional for advice.

Store at or below 25 °C. Do not remove the blisters from the carton until required. Keep all medicines out of the reach and sight of children. Return all unused medicine to your pharmacist. Do not dispose of unused medicine in drains or sewerage systems (e.g. toilets).