Sumilar HCT, 5 mg + 5 mg + 12.5 mg, hard capsules
Ramipril + Amlodipine + Hydrochlorothiazide
You should keep this leaflet so that you can read it again if you need to. If you have any further questions, ask your doctor or pharmacist. This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours. If you experience any side effects, including those not listed in this leaflet, please tell your doctor or pharmacist. See section 4.
Sumilar HCT contains three active substances: ramipril, amlodipine, and hydrochlorothiazide. Ramipril belongs to a group of medicines called ACE inhibitors (angiotensin-converting enzyme inhibitors) and works by: reducing the production of substances in the body that can increase blood pressure, reducing tension and expanding blood vessels, and making it easier for the heart to pump blood to all parts of the body. Amlodipine belongs to a group of medicines called calcium antagonists and works by: reducing tension and expanding blood vessels, making it easier for blood to flow. Hydrochlorothiazide belongs to a group of so-called thiazide diuretics and works by: increasing the amount of urine excreted, which reduces blood pressure. Sumilar HCT is used to treat high blood pressure (hypertension) in adult patients who have achieved adequate blood pressure control with the individual active substances at the same doses as in the combination medicine, but in the form of separate tablets.
if you are allergic to ramipril, amlodipine, or hydrochlorothiazide (active substances), or to other calcium antagonists, ACE inhibitors, other thiazide diuretics, or to any of the other ingredients of this medicine (listed in section 6), if you have severe narrowing of the aortic valve (aortic stenosis) or are in cardiogenic shock (a condition in which the heart cannot supply enough blood to the body), if you have ever had a severe allergic reaction called "angioedema" - its symptoms include: itching, hives, red spots on the hands, feet, and throat, swelling of the throat and tongue, swelling around the eyes and lips, difficulty breathing and swallowing, if you have taken or are currently taking sacubitril/valsartan, a medicine used to treat a certain type of long-term (chronic) heart failure in adults, as the risk of angioedema (rapid swelling of tissues under the skin, such as in the throat) increases, if you are undergoing dialysis or other blood filtration - depending on the equipment used, taking Sumilar HCT may not be suitable for you, if you have severe kidney problems, if you have liver problems, if you have abnormal levels of electrolytes (calcium, potassium, sodium) and uric acid (with symptoms of gout or kidney stones) in your blood, if you have kidney problems where blood flow to the kidney is reduced (renal artery stenosis), in the last 6 months of pregnancy and during breastfeeding (see "Pregnancy, breastfeeding, and fertility" below), if your blood pressure is very low or unstable, if you have heart failure after a heart attack, if you have diabetes or kidney problems and are taking a blood pressure-lowering medicine containing aliskiren. You must not take Sumilar HCT if any of the above conditions apply to you. If in doubt, consult your doctor before taking Sumilar HCT.
Before taking Sumilar HCT, discuss it with your doctor or pharmacist. Tell your doctor if you have or have had any of the following conditions: you are elderly and need to increase the dose of the medicine, you have heart, liver, or kidney problems, you have very high blood pressure (hypertensive crisis), you have lost a lot of electrolytes or fluids (due to vomiting, diarrhea, excessive sweating, a low-sodium diet, taking diuretics for a long time, or undergoing dialysis), you are going to undergo desensitization to bee or wasp venom (desensitization), you are going to receive anesthesia, e.g., before surgery or dental procedure - it may be necessary to stop taking Sumilar HCT the day before the procedure; consult your doctor, you have high levels of potassium in your blood, detected in blood tests, you are taking medicines or have conditions that may cause low sodium levels in your blood - your doctor may order regular blood tests, especially to check sodium levels in your blood (especially in elderly patients), you are taking any of the following medicines, which may increase the risk of angioedema: mTOR inhibitors, used to prevent transplant rejection and treat cancer (e.g., temsirolimus, everolimus, sirolimus), saxagliptin, a medicine used to treat type 2 diabetes, neprilysin inhibitors (NEP), such as racecadotril, a medicine used to treat diarrhea, sacubitril/valsartan (see "When not to take Sumilar HCT" above); you have been diagnosed with collagenosis, such as scleroderma or systemic lupus erythematosus; you have experienced vision impairment or eye pain. These may be symptoms of fluid accumulation in the vascular layer surrounding the eye (excessive fluid accumulation between the choroid and sclera) or increased pressure inside the eye - they can occur within a few hours to a week after taking Sumilar HCT and, if left untreated, can lead to permanent vision loss. The risk of developing such disorders may be higher in patients who are at risk of developing a disease called glaucoma or have previously been allergic to penicillin or sulfonamides; if you experience hypersensitivity reactions to light - you should then stop taking Sumilar HCT; if you have diabetes - it may be necessary to adjust the dose of insulin or oral antidiabetic medicines; if you are taking any of the following antihypertensive medicines: angiotensin II receptor antagonist (also known as sartan, e.g., valsartan, telmisartan, irbesartan), especially if you have diabetic kidney disease, aliskiren; your doctor may recommend regular monitoring of kidney function, blood pressure, and electrolyte levels (e.g., potassium) in your blood. See also the information under "When not to take Sumilar HCT". If you have had skin cancer or have experienced unexpected skin changes during treatment - taking hydrochlorothiazide, especially long-term and in high doses, may increase the risk of developing certain types of skin and lip cancer (non-melanoma skin cancer); when taking Sumilar HCT, you should protect your skin from sunlight and UV radiation. If you have previously experienced breathing or lung problems after taking hydrochlorothiazide (including pneumonia or fluid accumulation in the lungs). If you experience severe shortness of breath or difficulty breathing after taking Sumilar HCT, seek medical attention immediately. Your doctor may recommend regular monitoring of uric acid levels in your blood. See also the information under "When not to take Sumilar HCT". If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. You should tell your doctor if you are pregnant or think you might be pregnant, or if you are planning to have a baby. Sumilar HCT should not be taken during the first 12 weeks of pregnancy and should not be taken after the 12th week of pregnancy, as it may harm your baby. If you become pregnant while taking Sumilar HCT, you should inform your doctor immediately. If you are planning to become pregnant, your doctor will advise you to take a different medicine.
Sumilar HCT should not be used in children and adolescents under 18 years of age due to the lack of data on safety and efficacy.
Tell your doctor or pharmacist about all the medicines you are taking now or have recently taken, as well as any medicines you plan to take, including those available without a prescription (including herbal medicines). Sumilar HCT may affect the action of other medicines, and other medicines may affect the action of Sumilar HCT. Your doctor may need to change the dose of the medicine and/or take other precautions: if you are taking an angiotensin II receptor antagonist or aliskiren (see also "When not to take Sumilar HCT" and "Warnings and precautions"). The following medicines may reduce the effect of Sumilar HCT: pain and anti-inflammatory medicines (e.g., non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, indomethacin, and acetylsalicylic acid); medicines used to treat low blood pressure, shock, heart failure, asthma, or allergies, such as ephedrine, noradrenaline, or adrenaline - your doctor will recommend regular blood pressure monitoring; rifampicin (an antibiotic used to treat tuberculosis); St. John's Wort (Hypericum perforatum) (a herbal medicine used to treat depression). The following medicines may increase the risk of side effects when taken with Sumilar HCT: a combination medicine containing sacubitril and valsartan - used to treat chronic heart failure in adults (see section 2, "When not to take Sumilar HCT"); pain and anti-inflammatory medicines (e.g., non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, indomethacin, and acetylsalicylic acid); anticancer medicines (used in chemotherapy); medicines that may lower potassium levels in the blood, such as medicines used to treat constipation, glucocorticosteroids, tetracosactide (used to test adrenal function), amphotericin B (used to treat fungal infections); diuretics (e.g., furosemide); desmopressin (used to treat congenital bleeding disorders); steroid anti-inflammatory medicines, such as prednisolone; potassium supplements (including salt substitutes), potassium-sparing diuretics, and other medicines that increase potassium levels in the blood (such as spironolactone, triamterene, amiloride, trimetoprim, or trimetoprim in combination with sulfamethoxazole [co-trimoxazole], used to treat bacterial infections; cyclosporine, an immunosuppressive medicine used to prevent transplant rejection, and heparin, a medicine used to thin the blood to prevent blood clots); medicines used to treat heart conditions, including arrhythmias (quinidine, amiodarone); calcium preparations; allopurinol (used to reduce uric acid levels in the blood); procainamide (used to treat arrhythmias); cholestyramine (used to reduce cholesterol levels in the blood); carbamazepine, oxcarbazepine (antiepileptic medicines); ketoconazole, itraconazole (used to treat fungal infections); erythromycin, clarithromycin (antibiotics used to treat certain bacterial infections); ritonavir, indinavir, nelfinavir (protease inhibitors used in HIV-infected patients); verapamil, diltiazem (used to treat certain heart conditions and high blood pressure); dantrolene (given as an infusion in severe temperature regulation disorders); temsirolimus (used to treat cancer); sirolimus, everolimus (used to prevent transplant rejection); saxagliptin (used to treat type 2 diabetes); racecadotril (an anti-diarrheal medicine); tacrolimus (an immunosuppressive medicine that enables the body to accept a transplanted organ); other blood pressure-lowering medicines, such as phosphodiesterase inhibitors (used to treat erectile dysfunction), nitrates, alpha-adrenergic blockers (used in urology to reduce muscle tension in the prostate and urethra), methyldopa, certain medicines used to treat Parkinson's disease, tricyclic antidepressants, and neuroleptics, amifostine (used in chemotherapy), and baclofen (a muscle relaxant). Medicines whose action may be affected by Sumilar HCT: medicines used to treat diabetes (oral hypoglycemic medicines and insulin) - Sumilar HCT may lower blood sugar levels, so blood sugar levels should be closely monitored during its use; lithium (used to treat mental disorders) - Sumilar HCT may increase lithium levels in the blood, so your doctor will recommend close monitoring of lithium levels in the blood; simvastatin (a medicine used to lower cholesterol levels) - since amlodipine increases exposure to simvastatin, your doctor will recommend reducing the dose of simvastatin in patients taking Sumilar HCT; medicines containing iodine (contrast agents used in imaging tests, e.g., X-ray), oral anticoagulants, such as warfarin. If any of the above conditions apply to you (or you are in doubt), consult your doctor before taking Sumilar HCT. Before taking this medicine, consult your doctor or pharmacist if: you are going to have a parathyroid function test, as ramipril and hydrochlorothiazide may affect the results, you are an athlete and are going to have a doping test, as ramipril and hydrochlorothiazide may cause a positive test result.
Sumilar HCT can be taken before or after a meal. Do not eat grapefruits or drink grapefruit juice while taking Sumilar HCT, as they may cause an increase in the level of the active substance amlodipine in the blood and, consequently, an unpredictable increase in the blood pressure-lowering effect of Sumilar HCT. Drinking alcohol while taking Sumilar HCT may cause dizziness or fainting. If you are in doubt about the amount of alcohol that can be consumed while taking Sumilar HCT, consult your doctor, as blood pressure-lowering medicines and alcohol can enhance each other's sedative effects.
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. PregnancyYou should tell your doctor if you are pregnant or think you might be pregnant, or if you are planning to have a baby. Sumilar HCT should not be taken during the first 12 weeks of pregnancy and should not be taken after the 12th week of pregnancy, as it may harm your baby. If you become pregnant while taking Sumilar HCT, you should inform your doctor immediately. If you are planning to become pregnant, your doctor will advise you to take a different medicine. BreastfeedingYou should not take Sumilar HCT while breastfeeding. Before taking any medicine, consult your doctor or pharmacist. FertilityThere is not enough data on the potential impact on fertility.
Sumilar HCT may affect your ability to drive or operate machinery. If you experience nausea, dizziness, fatigue, or headache while taking the medicine, do not drive or operate machinery; consult your doctor immediately.
This medicine contains less than 1 mmol (23 mg) of sodium per hard capsule, which means it is essentially "sodium-free".
Always take this medicine exactly as your doctor or pharmacist has told you. If you are not sure, consult your doctor or pharmacist. The recommended dose is one Sumilar HCT capsule of the strength prescribed by your doctor, taken once a day. Depending on the result of the treatment, your doctor may adjust the dose. The maximum dose is one 10 mg + 10 mg + 25 mg capsule, taken once a day. Take the medicine orally, once a day, at the same time, before or after a meal. Swallow the hard capsules whole with a drink of water. Do not crush or chew the capsules. Do not take the medicine with grapefruit juice. Kidney diseaseYour doctor may adjust the dose of the medicine if you have kidney disease. ElderlyYour doctor may recommend a lower initial dose and gradually increase it. Sumilar HCT should not be used in elderly patients who are frail.
Sumilar HCT should not be given to children and adolescents under 18 years of age due to the lack of data on efficacy and safety.
Taking too many capsules may cause a decrease in blood pressure, including a significant decrease. You may experience dizziness, fainting, or weakness. A significant decrease in blood pressure can cause shock. The skin becomes cool and moist, and you may lose consciousness. Up to 24-48 hours after taking the medicine, you may experience shortness of breath due to excess fluid accumulation in the lungs (pulmonary edema). If you have taken too much Sumilar HCT, contact your doctor or go to the emergency department of the nearest hospital immediately. Do not drive yourself, but ask someone else to drive you or call an ambulance. Take the packaging of the medicine with you so that the doctor knows what medicine has been taken.
If you miss a dose, do not take the missed capsule. Take the next dose at the usual time. Do not take a double dose to make up for the missed dose.
Your doctor will tell you how long to take the medicine. Stopping treatment without consulting your doctor may cause the disease to recur. If you have any further questions about taking this medicine, ask your doctor or pharmacist.
Like all medicines, Sumilar HCT can cause side effects, although not everybody gets them.
Swelling of the face, lips, or throat, making it difficult to swallow or breathe, as well as itching and rash. These may be symptoms of a severe allergic reaction to Sumilar HCT. Severe skin reactions, including rash, hives, mouth ulcers, exacerbation of existing skin conditions, redness, severe itching, blistering, and peeling of the skin (Stevens-Johnson syndrome, toxic epidermal necrolysis, or erythema multiforme). Acute respiratory failure (symptoms include severe shortness of breath, fever, weakness, and confusion).
rapid heartbeat, irregular or strong heartbeats (palpitations), chest pain, tightness in the chest, or more severe disorders, including heart attack and stroke; shortness of breath or cough, which may be symptoms of lung diseases, including pneumonia; easy bruising, prolonged bleeding, or any signs of bleeding (e.g., bleeding from the gums), purpura, or increased susceptibility to infections, sore throat, and fever, feeling tired, fainting, dizziness, or pallor, which may be symptoms of blood or bone marrow disorders; severe abdominal pain, which may radiate to the back - this may be a symptom of pancreatitis; fever, chills, fatigue, loss of appetite, stomach pain, nausea, jaundice (yellowing of the skin and eyes) - these may be symptoms of liver diseases, such as hepatitis or liver damage; decreased or increased urination, or urination at night, which may be symptoms of severe kidney disorders (interstitial nephritis or acute kidney failure); exacerbation of existing proteinuria (increased protein levels in the urine); general malaise; weight gain or loss; dizziness (peripheral vertigo); hair loss (alopecia); itching, purpura, or petechiae; abnormal sensations on the skin, such as numbness, tingling, prickling, burning, or stinging (paresthesia), reduced skin sensitivity (hypoesthesia); taste disturbances; increased sweating; myocardial infarction, coronary artery disease (myocardial ischemia), chest tightness, and pain (angina pectoris), rapid heartbeat (tachycardia), or arrhythmias; bradycardia (slow heart rate), certain arrhythmias (atrial fibrillation, ventricular tachycardia); back pain, joint pain, general pain; fever; decreased libido in men and women, gynecomastia (breast enlargement in men); increased white blood cell count (eosinophilia), detected in blood tests; liver function test abnormalities (increased liver enzyme activity and/or increased bilirubin levels), pancreas (increased pancreatic enzyme activity), or kidney (increased creatinine levels) function test abnormalities, detected in blood tests; glucose detected in urine; cough; vasculitis, often with skin rash, purpura, itching, fever, chills, and fatigue; Uncommon(may affect up to 1 in 100 people) angioedema (in rare cases, life-threatening airway obstruction due to angioedema may occur); peripheral edema (edema of the hands and feet, which may be a sign of fluid retention); mood changes, depression, anxiety, nervousness, restlessness, sleep disturbances (insomnia); tinnitus (ringing in the ears); sneezing, rhinitis (inflammation of the nasal mucosa), nasal congestion; shortness of breath (bronchospasm), including asthma exacerbation; dry mouth, abdominal pain, including gastritis, gastrointestinal disorders, and discomfort in the abdomen (including nausea); pancreatitis (in rare cases, fatal); kidney disorders, including interstitial nephritis and kidney failure, urinary disorders, increased urination at night, proteinuria; general malaise; weight gain or loss; dizziness (peripheral vertigo); hair loss (alopecia); itching, purpura, or petechiae; abnormal sensations on the skin, such as numbness, tingling, prickling, burning, or stinging (paresthesia), reduced skin sensitivity (hypoesthesia); taste disturbances; increased sweating; myocardial infarction, coronary artery disease (myocardial ischemia), chest tightness, and pain (angina pectoris), rapid heartbeat (tachycardia), or arrhythmias; bradycardia (slow heart rate), certain arrhythmias (atrial fibrillation, ventricular tachycardia); back pain, joint pain, general pain; fever; decreased libido in men and women, gynecomastia (breast enlargement in men); increased white blood cell count (eosinophilia), detected in blood tests; liver function test abnormalities (increased liver enzyme activity and/or increased bilirubin levels), pancreas (increased pancreatic enzyme activity), or kidney (increased creatinine levels) function test abnormalities, detected in blood tests; glucose detected in urine; cough; vasculitis, often with skin rash, purpura, itching, fever, chills, and fatigue; Rare(may affect up to 1 in 1,000 people) confusion, balance disorders; redness and swelling of the tongue (glossitis); skin peeling (exfoliative dermatitis); nail disorders (e.g., nail loosening or separation from the nail bed); redness, itching, swelling, or tearing of the eyes (conjunctivitis); hearing disorders; severe itching, jaundice (obstructive jaundice), dark urine, light-colored stools due to liver or bile duct disorders; narrowing of blood vessels; circulatory disorders (reduced blood flow); decreased red blood cell count, white blood cell count, or platelet count, detected in blood tests; decreased red blood cell count, white blood cell count, or platelet count, detected in blood tests; increased blood sugar levels, detected in blood tests, exacerbation of diabetes in patients with diabetes; hypersensitivity to sunlight or artificial light (photosensitivity); increased calcium levels in the blood (hypercalcemia); allergic reactions; Very rare(may affect up to 1 in 10,000 people) widespread rash with blistering and peeling of the skin, especially on the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome); hepatitis (in most cases, with bile duct obstruction); skin rash with possible blistering, resembling target-like lesions (erythema multiforme); lupus-like reaction, lupus exacerbation, vasculitis, and toxic epidermal necrolysis; gum hypertrophy; increased muscle tone; peripheral neuropathy; bone marrow failure; severe reduction in red blood cell count, detected in blood tests; allergic reactions; metabolic acidosis; respiratory failure (including pneumonia and pulmonary edema); Frequency not known(cannot be estimated from the available data) pancytopenia, detected in blood tests; anaphylactic or anaphylactoid reactions; skin blistering (pemphigus); increased antinuclear antibody titers; attention disorders; oral mucosal ulcers (aphthous stomatitis); aplastic anemia; changes in finger and toe color after cooling and sensation of tingling or pain after warming (Raynaud's phenomenon); cerebral hypoperfusion, including ischemic stroke and transient ischemic attack; psychomotor disorders; burning sensation; smell disorders; acute liver failure, cholestatic and cytolytic hepatitis (in rare cases, fatal); skin inflammation (psoriasiform dermatitis), acute skin rash (pemphigus or psoriasiform dermatitis), exacerbation of psoriasis, skin rash on the mucous membranes; dark urine (due to liver or bile duct disorders), nausea or vomiting, muscle cramps, confusion, and seizures, which may be caused by inadequate secretion of antidiuretic hormone (vasopressin) - if you experience such symptoms, consult your doctor as soon as possible; tremors, rigidity, mask-like facial expression, slow movements, and shuffling gait; sudden vision loss or eye pain due to increased pressure (possible symptoms of fluid accumulation in the vascular layer surrounding the eye or acute angle-closure glaucoma); skin and lip cancer (non-melanoma skin cancer). Reporting side effects If you experience any side effects, including those not listed in this leaflet, please tell your doctor or pharmacist. Side effects can be reported directly to the Department of Drug Safety Monitoring, Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl. Side effects can also be reported to the marketing authorization holder. By reporting side effects, you can help provide more information on the safety of this medicine.
Keep out of the sight and reach of children. Do not use this medicine after the expiry date stated on the blister and carton after EXP. The expiry date refers to the last day of that month. Store below 30°C. Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.
The active substances are ramipril, amlodipine, and hydrochlorothiazide. Sumilar HCT, 5 mg + 5 mg + 12.5 mgEach hard capsule contains 5 mg of ramipril, 5 mg of amlodipine (as amlodipine besylate), and 12.5 mg of hydrochlorothiazide. Sumilar HCT, 5 mg + 5 mg + 25 mgEach hard capsule contains 5 mg of ramipril, 5 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide. Sumilar HCT, 10 mg + 5 mg + 25 mgEach hard capsule contains 10 mg of ramipril, 5 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide. Sumilar HCT, 10 mg + 10 mg + 25 mgEach hard capsule contains 10 mg of ramipril, 10 mg of amlodipine (as amlodipine besylate), and 25 mg of hydrochlorothiazide. The other ingredients are: capsule contents: microcrystalline cellulose, anhydrous calcium hydrogen phosphate, maize starch, sodium carboxymethylcellulose (type A), sodium stearyl fumarate; capsule shell: (5 mg + 5 mg + 12.5 mg)red iron oxide (E 172), black iron oxide (E 172), titanium dioxide (E 171), gelatin; (5 mg + 5 mg + 25 mg) and (10 mg + 5 mg + 25 mg)red iron oxide (E 172), yellow iron oxide (E 172), titanium dioxide (E 171), gelatin; (10 mg + 10 mg + 25 mg)red iron oxide (E 172), yellow iron oxide (E 172), black iron oxide (E 172), titanium dioxide (E 171), gelatin.
Sumilar HCT, 5 mg + 5 mg + 12.5 mgThe capsule has a pink opaque cap and a light gray opaque body. Sumilar HCT, 5 mg + 5 mg + 25 mgThe capsule has a pink opaque cap and an ivory-colored opaque body. Sumilar HCT, 10 mg + 5 mg + 25 mgThe capsule has a dark pink opaque cap and a yellow opaque body. Sumilar HCT, 10 mg + 10 mg + 25 mgThe capsule has a brown opaque cap and a caramel-colored opaque body. The hard capsules are packaged in blisters of PA/Aluminum/PVC/Aluminum foil and placed in a cardboard box. Pack sizes: 10, 20, 30, 50, 60, 90, 100 hard capsules. Not all pack sizes may be marketed.
Marketing authorization holder Sandoz GmbH Biochemiestrasse 10 6250 Kundl, Austria Manufacturer Lek Pharmaceuticals d.d. Verovškova 57, 1526 Ljubljana, Slovenia
Sandoz Polska Sp. z o.o. ul. Domaniewska 50 C 02-672 Warsaw tel. 22 209 70 00 Sandoz logo Date of last revision of the leaflet:07/2022
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