Berlipril

Berlipril is an ACE inhibitor drug.

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Indications Berlipril

It is used to treat the following disorders:

• high blood pressure;
• heart failure;
• a disorder in the functioning of the heart muscle associated with a previous myocardial infarction and occurring without symptoms.

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Release form

Available in tablet form.

Berlipril 10 contains 10 tablets per blister. Inside the package there are 3, 5 or 10 blister strips.

Berlipril 20 is available in 10 tablets per blister. The pack contains 3 blisters with tablets.

Berlipril 5 is available in a quantity of 10 tablets inside a blister. A separate pack contains 2, 3 or 5 or 10 such blister plates.

Berlipril plus 10/25 is available in 10 tablets per blister pack. The pack contains 2 or 3 blister strips.

Pharmacodynamics

Berlipril (substance enalapril) is a representative of the ACE inhibitor category. After entering the body, it undergoes a hydrolysis process, during which the active component is formed - enalaprilat. It slows down the action of the enzyme that converts angiotensin I into the substance angiotensin II (this component has strong vasoconstrictor properties, and also promotes the production of aldosterone, which helps retain water with Na ions in the body).

In addition, enalaprilat slows down the process of destruction of bradykinin, which has a vasodilatory effect and increases the production of PG elements, which also have vasodilatory properties. Due to the effect of the drug, the level of total peripheral vascular resistance decreases. As a result, the blood pressure indicator decreases (both systolic and diastolic), and the pre- and post-load on the heart muscles decreases. In addition, enalaprilat helps improve coronary circulation and blood flow inside the kidneys.

The drug has an antihypertensive effect and prevents the progression of heart failure.

Pharmacokinetics

Regardless of food intake, 60% of the active component is absorbed from the gastrointestinal tract. The drug undergoes hepatic metabolism. Enalapril and enalaprilat are excreted mainly by the kidneys, and the remainder is excreted by the intestines.

Dosing and administration

The initial daily dose of the drug in the case of treatment of elevated blood pressure is 5 mg. If the desired effect has not been achieved in 1-2 weeks, it is allowed to gradually increase the daily dosage to 40 mg. The average dose is 10 mg. It is necessary to take tablets 1-2 times a day.

In chronic heart failure, it is necessary to start the course with 2.5 mg per day. Then the dosage is selected taking into account blood pressure indicators, as well as the patient's tolerance and the effectiveness of the drug. The average daily dose is within 5-20 mg - it can be taken in 1 dose or divided into 2.

Elderly people are recommended to take the drug at an initial dose of 1.25 mg.

In case of kidney failure, the daily dose is adjusted taking into account the level of CC. At a rate of 80-30 ml/minute, a dosage of 5-10 mg is required, and in case of a level of 30-10 ml/minute, it is 2.5-5 mg. If the filtration rate is still lower than the specified values, the drug is allowed to be used only on the days of hemodialysis procedures - in the amount of 1.25-2.5 mg.

Use Berlipril during pregnancy

Berlipril is contraindicated for pregnant women.

Contraindications

Main contraindications:

• presence of porphyria;
• intolerance to drug components;
• lactation period;
• children and adolescents under 18 years of age.

Use with caution in cases of aortic stenosis, hyperkalemia, mitral valve stenosis, bilateral a.renalis stenosis, as well as CVD and liver/renal failure.

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Side effects Berlipril

Taking the pills may cause the following side effects:

• a decrease in blood pressure (in the case of severe hypotension, myocardial infarction with angina may also develop), the development of pulmonary embolism, arrhythmia or cardialgia, as well as fainting;
• a feeling of drowsiness, anxiety, confusion, as well as headaches, insomnia, depression, dizziness and the appearance of paresthesia;
• tinnitus, as well as hearing or vision disorders;
• development of anorexia, diarrhea, vomiting, and dry oral mucosa. Rarely, hepatitis, pancreatitis, or intestinal obstruction are observed;
• the occurrence of a dry cough or bronchial spasms, the development of pharyngitis or rhinorrhea;
• skin rashes, Quincke's edema and Stevens-Johnson syndrome, as well as itching, dermatitis, erythema multiforme, vasculitis with serositis, arthritis and stomatitis;
• development of azotemia or renal dysfunction;
• the appearance of eosinophilia, thrombocyto- or neutropenia, as well as anemia or agranulocytosis.

Side effects that require discontinuing the drug occur only in rare cases.

Overdose

As a result of an overdose, the victim develops a marked decrease in blood pressure, which may result in stupor, convulsions, stroke with myocardial infarction, and thromboembolism.

To eliminate the disorders, it is necessary to move the person to a horizontal position, then perform gastric lavage and give him sorbents. Then hemodialysis with infusion treatment is performed and the substance angiotensin II is administered.

Interactions with other drugs

NSAIDs weaken the antihypertensive properties of Berlipril.

When taken together with potassium-sparing diuretics (for example, with amiloride or triamterene, as well as spironolactone), hyperkalemia may develop.

Berlipril reduces the effectiveness of theophylline and also slows down the elimination of lithium drugs.

The drug enhances the antihypertensive effect of methyldopa, diuretics, prazosin, nitrates, beta-blockers, as well as calcium channel blockers and hydralazine.

In case of combination with immunosuppressants, allopurinol or cytostatics, potentiation of the hematotoxic properties of the drug is observed.

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Storage conditions

Berlipril is stored under standard conditions at a temperature of no more than 25°C.

Shelf life

Berlipril can be used for a period of 3 years from the date of manufacture of the tablets.