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Enafril
Last reviewed: 04.07.2025
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Enafril is a complex drug used for the treatment of high blood pressure, as well as the development of CHF.
The drug contains the diuretic substance hydrochlorothiazide, and along with it a drug from the ACE inhibitor subcategory – enalapril.
Often the medication is tolerated by patients without any complications, but occasionally negative side effects may still appear when taking it.
Indications Enafril
It is used for the following disorders and diseases:
- increased blood pressure;
- CHF;
- prevention of myocardial infarction;
- renal failure.
Release form
The therapeutic agent is released in the form of tablets - in quantities of 6, 12, as well as 60 or 120 pieces per pack.
Pharmacodynamics
The drug has an intense diuretic and antihypertensive effect, which develops due to the activity of its active ingredients.
Enalapril maleate, which is a subgroup of ACE inhibitors, is a drug with a high degree of medicinal effectiveness. It is often used for elevated blood pressure, and in addition to this, for CHF.
This element helps slow down the formation of the protein angiotensin-2, which initiates an increase in blood pressure. At the same time, the substance prevents the destruction of PG type E2 and bradykinin, which have significant vasodilating activity.
The second active ingredient of the medication is hydrochlorothiazide, a diuretic substance with a moderate degree of severity.
The use of this component in monotherapy or in combination with other antihypertensive drugs has a positive effect in cases of CHF, portal hypertension, elevated blood pressure, nephrotic syndrome and chronic renal failure.
The combination of both elements leads to a decrease in blood pressure values, as well as to a reduction in the load on the myocardium.
Pharmacokinetics
Enalapril maleate.
After administration of the drug, the component is absorbed at a high rate, reaching Cmax values after 60 minutes. Based on information regarding urinary secretion, the absorption rate of enalapril is approximately 60%.
The absorbed element undergoes hydrolysis at high speed and in large volumes with the formation of enalaprilat (which has a powerful ACE inhibitor effect). Serum Cmax values of enalaprilat are noted after 3-4 hours from the moment of oral administration.
Enalapril is excreted mainly through the kidneys. In the urine, the main element is enalaprilat, whose share is approximately 40% of the dosage, as well as unchanged enalapril.
Excluding conversion with the processes of formation of enalaprilat, manifestations of significant metabolic processes of enalapril are not observed. The serum profile includes a prolonged terminal stage, which is most likely associated with the synthesis of ACE.
In people with healthy kidney function, stable enalaprilat levels are achieved by day 4 (when using enalapril maleate once a day). The effective half-term accumulation of enalaprilat, with multiple oral doses of enalapril, is 11 hours.
The presence of food in the gastrointestinal tract does not affect the extent of absorption of enalapril. The intensity of hydrolysis and absorption of enalapril is similar for different portions within the standard therapeutic dose range.
Hydrochlorothiazide.
When plasma parameters were maintained for 24 hours, the plasma half-life varied in the range of 5.6–14.8 hours.
Hydrochlorothiazide is not metabolized but is excreted by the kidneys at high speed. After oral administration, approximately 61% of the dose is excreted unchanged over the next 24 hours. The component is able to cross the placenta, but not the BBB.
Dosing and administration
The medication tablets can be taken without reference to food intake. People with increased blood pressure are often prescribed 1 tablet per day. But in the case of a weak antihypertensive effect with such a portion, after consultation with a doctor, it can be increased to 2 tablets.
The duration of the medication course is selected by the doctor individually.
In individuals who have used diuretics and experienced disturbances in EBV parameters shortly before the start of a treatment cycle with Enafril, symptomatic hypotension may be observed during the first days of therapy.
To prevent such a disorder, you should stop using diuretics at least 2-3 days before starting treatment with Enafril.
Contraindications
Main contraindications:
- anuria;
- strong personal sensitivity to the elements of the drug;
- stenosis affecting the arteries of both kidneys (bilateral), or the artery of only one of them;
- Chronic renal failure, in which the CC values are below 30 ml per minute.
The medication is prescribed with extreme caution in the presence of the following disorders and pathologies:
- diabetes mellitus;
- diseases of a cerebrovascular nature;
- systemic pathologies affecting connective tissue;
- presence of Quincke's edema in the anamnesis.
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Overdose
In case of intoxication with a drug, a significant decrease in blood pressure may occur, and in addition, nausea, dizziness and severe weakness are observed.
If such disorders develop, the use of the drug should be stopped immediately and symptomatic procedures should be carried out under medical supervision.
Interactions with other drugs
When combining the drug with barbiturates, phenothiazine derivatives, narcotics and other hypotensive substances, it is necessary to regularly monitor blood pressure values, because these drugs lead to their increase.
The combination of the drug with GCS may lead to potentiation of electrolyte imbalance.
The use of drugs together with potassium agents, as well as with potassium-sparing diuretics, may cause hyperkalemia.
It is prohibited to use the medication together with cyclosporine, because this increases the risk of kidney failure.
It is forbidden to combine drugs with lithium substances, because this increases the toxic parameters of this mineral; at the same time, its renal excretion is complicated.
In diabetics, use of the drug may increase the risk of hypoglycemia.
You should not drink alcohol during treatment with Enafril.
Storage conditions
Enafril should be stored in a dark and dry place, out of the reach of small children. Temperature values should not exceed +25°C.
Shelf life
Enaphril can be used for a period of 24 months from the date of manufacture of the therapeutic substance.
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Application for children
There is no information regarding the efficacy and safety of drug use in pediatrics.
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Analogues
Analogues of the drug are Capotiazid, Ramiten, Prilamid, Rami Compositum with Noliprel, and also Capozid, Enapril, Fozid with Iruzid, Scopril Plus and Enzix with Ko-renitek, as well as Enap, Tritace and Ena Sandoz Compositum.
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Reviews
Enafril usually receives positive feedback from patients - the drug is effective in cases of CHF or high blood pressure. In addition, the affordable cost of the drug is noted as an advantage.
Among the downsides, side effects are mentioned in the comments, but they only develop occasionally.
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Attention!
To simplify the perception of information, this instruction for use of the drug "Enafril" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.