Enafril

Enafril is a complex medication used for therapy in patients with elevated blood pressure and, moreover, in the development of CHF.

The drug contains in its composition the diuretic substance hydrochlorothiazide, and with it the agent from the subcategory of ACE inhibitors - enalapril.

Often, the medication is tolerated by patients without developing any complications, but occasionally with its use, negative side effects may still appear.

Indications Enafrila

It is used for such disorders and diseases:

• increased blood pressure;
• CHF;
• prevention of  myocardial infarction ;
• renal failure.

[1], [2], [3],

Release form

The release of a therapeutic agent is implemented in the form of tablets - in the amount of 6, 12, as well as 60 or 120 pieces inside the pack.

Pharmacodynamics

The drug has an intensive diuretic and antihypertensive effect, which develops in connection with the activity of its active elements.

Enalapril maleate, which is included in the subgroup of ACE inhibitors, is a drug with a high degree of drug efficacy. It is often used with elevated blood pressure, and beyond that in CHF.

This element helps to slow down the formation of angiotensin-2 protein, which initiates an increase in blood pressure values. At the same time, the substance prevents the destruction of EG type E2 and bradykinin, which have significant vasodilating activity.

The second active element of the drug 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 the case of CHF, portal hypertension, elevated BP, nephrotic syndrome, and CRF.

The combination of both elements leads to a decrease in blood pressure values, as well as to easing the load on the myocardium.

[4], [5]

Pharmacokinetics

Maleate enapril.

After the drug is injected, the component is absorbed at high speed, reaching Cmax values after 60 minutes. Based on information regarding secretion in the urine, enalapril absorption is approximately 60%.

The absorbed element at high speed and in large volumes undergoes hydrolysis with the formation of enalaprilat (with a powerful effect of ACE inhibitors). Serum Cmax values of enalaprilat are marked after 3-4 hours from the moment of oral administration.

Enalapril is excreted mostly through the kidneys. Inside the urine, the main element is enalaprilat, whose portion is equal to approximately 40% of the dosage, as well as the unchanged component enalapril.

Excluding conversion with the processes of enalaprilat formation, 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 the 4th day (when using enalapril maleate 1-fold per day). The effective half-term cumulation of enalaprilat, with multiple use of oral enalapril dosages, is 11 hours.

The presence of food inside the gastrointestinal tract does not affect the degree of absorption of enalapril. The intensity of hydrolysis and absorption of enalapril is similar for different portions within the standard therapeutic dose range.

Hydrochlorothiazide.

While maintaining plasma parameters for 24 hours, the term plasma half-life varied in the range of 5.6-14.8 hours.

Hydrochlorothiazide does not undergo metabolic processes, but is excreted at a high rate by the kidneys. After ingestion, approximately 61% of the dosage is displayed in unchanged form over the next 24 hours. The component is able to overcome the placenta, but not the BBB.

[6], [7]

Dosing and administration

You can take medication tablets without reference to eating. Persons with increased blood pressure are often assigned in the amount of 1 piece per day. But in the case of weak expression of the antihypertensive effect at such a portion, after consulting with a doctor, it can be increased to 2 tablets.

The duration of the drug course is chosen by the doctor personally.

In people who, shortly before the start of the treatment cycle using Enafril, used diuretic substances and experienced EBV indices, hypotension may be observed during the first days of therapy, which is symptomatic.

To prevent such a disorder, the use of diuretics should be discontinued at least 2-3 days before the start of treatment with Enafril.

Use Enafrila during pregnancy

With lactation, as well as pregnancy, Enafril cannot be taken.

[8], [9], [10]

Contraindications

The main contraindications:

• anuria;
• strong personal sensitivity towards medication elements;
• stenosis affecting the arteries of both kidneys (bilateral), or the only one of them;
• CKD, in which the CC values are below 30 ml per minute.

The drug is prescribed with extreme caution in case of the following disorders and pathologies:

• diabetes;
• cerebrovascular diseases;
• systemic pathologies affecting connective tissue;
• presence of angioedema in history.

[11]

Side effects Enafrila

Among the side signs (occur only occasionally):

• systemic weakness, headaches, orthostatic collapse, and convulsive muscle spasms;
• urticaria, dry-type cough, asthma, hyperemia or bronchial cramps;
• arthralgia, stomatitis or nervousness.

[12], [13], [14],

Overdose

In case of intoxication with a drug, a significant decrease in blood pressure can occur, and nausea, dizziness and severe weakness can be observed.

In the event of the development of such disorders, the use of the drug should be immediately discontinued, and symptomatic procedures should be carried out under medical supervision.

[15], [16]

Interactions with other drugs

When combining drugs with barbiturates, phenothiazine derivatives, narcotic drugs and other antihypertensives, you should regularly monitor blood pressure values, because these drugs lead to their increase.

The combination of the drug with GCS can lead to a potentiation of electrolyte imbalance.

The use of drugs with potassium drugs, as well as diuretic potassium-sparing character may cause hyperkalemia.

It is forbidden to use the drug together with cyclosporine, because there is an increase in the likelihood of kidney failure.

It is forbidden to combine drugs with lithium substances, because it increases the toxic parameters of this mineral; at the same time, its renal excretion is complicated.

In diabetics, using the medication may increase the likelihood of hypoglycemia.

You can not drink alcohol during therapy with enafril.

[17], [18], [19]

Storage conditions

Enafril needs to be kept in a closed and dark place, away from small children. The temperature values are not higher than + 25 ° С.

Shelf life

Enafril can be used for a 24-month term from the time the therapeutic substance is manufactured.

[20]

Application for children

There is no information regarding the efficacy and drug safety of using drugs in pediatrics.

[21]

Analogs

Analogs of drugs are means Kapotiazid, Ramiten, Prilamid, Rami Compositum with Noliprel, and in addition Caposid, Enapril, Fozid with Iruzid, Skopril Plus and Enziks with Krenitiek, and Enap, Tritatse and Ena Sandoz Compositum.

[22]

Reviews

Enafril usually receives positive feedback from patients - the drug is effective in the case of CHF or elevated blood pressure. In addition, one of the advantages note the affordable cost of the drug.

Of the minuses in the comments mentioned side effects, but they develop only one.

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