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Ramipril is a potent and long acting inhibitor of the angiotensin-converting enzyme (ACE). After hydrolysis to Ramiprilat, it blocks the conversion of angiotensin-I to the vasoconstrictor substance angiotensin-II. So, inhibition of ACE by Ramipril results in decreased plasma angiotensin-II, which leads to decreased vasopressor activity and decreased aldosterone secretion thus reduces high blood pressure. In addition it has a nephroprotective effects on glumerular permeability, which reduces protein filtration and thus contributes to its antiproteinuria effects.