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Anaphylactoid reactions during desensitization: Two patients undergoing desensitizing treatment with hymenoptera venom while receiving ACE inhibitors sustained life-threatening anaphylactoid reactions. In the same patients, these reactions were avoided when ACE inhibitors were temporarily withheld, but they reap-peared upon inadvertent rechallenge. Anaphylactoid reactions during membrane exposure: Text Continues Below
Anaphylactoid reactions have been reported in patients dialyzed with high-flux membranes and treated concomitantly with an ACE inhibitor. Anaphylactoid reactions have also been reported in patients undergoing low-density lipoprotein apheresis with dextran sul-fate absorption. Hypotension ALTACE can cause symptomatic hypotension, after either the initial dose or a later dose when the dosage has been increased. Like other ACE inhibitors, ramipril has been only rarely associated with hypotension in uncomplicated hypertensive patients. Symptomatic hypotension is most likely to occur in patients who have been volume-and/ or salt-depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diar-rhea, or vomiting. Volume and/ or salt depletion should be corrected before initiating therapy with ALTACE. In patients with congestive heart failure, with or without associated renal insufficiency, ACE inhibitor thera-py may cause excessive hypotension, which may be associated with oliguria or azotemia and, rarely, with acute renal failure and death. In such patients, ALTACE therapy should be started under close medical supervision; they should be followed closely for the first 2 weeks of treatment and whenever the dose of ramipril or diuret-ic is increased. If hypotension occurs, the patient should be placed in a supine position and, if necessary, treated with intra-venous infusion of physiological saline. ALTACE treatment usually can be continued following restoration of blood pressure and volume. Page: << Prev | 1 | 2 | 3 | 4 | 5 | Next >>
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