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Enzyx
Last reviewed: 04.07.2025
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Enzix includes 2 active medicinal elements – enalapril with indapamide. Their combined effect leads to the development of a stable and rapid diuretic and hypotensive effect.
After the hydrolysis process, enalapril is converted inside the body into the active ingredient enalaprilat, which then has a therapeutic effect.
Indapamide contained in the drug increases the excretion of Cl, Na, Ca and Mg ions in the urine.
Indications Enzyxa.
It is used for the treatment of hypertension, whether primary or secondary.
Release form
The drug is released in the form of tablets - kits that include the substances indapamide and enalapril.
Enzix form – 3 combination packages, 5 tablets of both substances (enalapril 10 mg and indapamide 2.5 mg).
Enzix Duo – 3 complex packs (enalapril 10 mg – 10 tablets and indapamide 2.5 mg – 5 tablets).
Enzix Duo Forte – 3 combination tablets (enalapril 20 mg – 10 tablets and indapamide 2.5 mg – 5 tablets).
Pharmacodynamics
Enalaprilat slows down the production of the ACE element, as well as the intrahepatic production of angiotensin; in addition, it reduces the volume of aldosterone produced inside the adrenal glands. Due to this effect, vasoconstriction and an increase in blood pressure values occur, and diuresis increases.
The medication helps to reduce blood pressure, reduces the load on the heart in case of myocardial insufficiency, restores physiological blood flow within the pulmonary circulation and breathing, and at the same time reduces the resistance of the renal vessels and stabilizes renal blood flow.
Indapamide strengthens the resistance of blood vessel membranes to the effects of angiotensin and norepinephrine, and also activates the production of PG-E2. Its medicinal effect is based on the relaxation of smooth muscles of arterial membranes and increased diuresis, which in combination helps to lower blood pressure.
Dosing and administration
During treatment, it is necessary to use 1 tablet of indapamide with enalapril simultaneously; the procedure is carried out in the morning. Taking into account personal susceptibility, during therapy the dose of enalapril can be increased to 2 tablets per day.
It is necessary to adhere to the daily dose of the drug - no more than 40 mg of enalapril and 2.5 mg of indapamide.
In case of mild or moderate renal insufficiency, it is allowed to take no more than 5-10 mg of enalapril per day.
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Use Enzyxa. during pregnancy
The medication is strictly prohibited for use during breastfeeding or pregnancy.
Contraindications
The medication should not be used if there is a history of allergy to the components of the medication, ACE inhibitors, or sulfanilamide derivatives.
Contraindicated for use in porphyria.
Indapamide is not prescribed to patients with hypokalemia, anuria or liver/renal insufficiency (severe), which may also be accompanied by encephalopathy. In addition, indapamide is not combined with substances that prolong the QT interval.
Enalapril is used with extreme caution in cases of bilateral renal artery stenosis, hyperkalemia, primary hyperaldosteronism, as well as coronary heart disease and decreased circulating blood volume. Caution is also required in cases of kidney transplantation, connective tissue lesions, stenosis (mitral, arterial or subaortic hypertrophic and idiopathic), cerebrovascular pathologies, liver/renal failure and diabetes mellitus. At the same time, caution is exercised when combining the drug with saluretics or immunosuppressants, hemodialysis, limited salt intake, and in the elderly.
Indapamide is prescribed with caution to diabetics with decompensation, as well as in the presence of hyperuricemia.
Side effects Enzyxa.
The use of Enzix may provoke negative manifestations in the form of drowsiness, nervousness, headaches, paresthesia, insomnia and depression. In addition, abdominal discomfort, cough, stool and digestion disorders, xerostomia, anorexia, pharyngitis and rhinorrhea may be observed. Arrhythmia, a critical decrease in blood pressure, palpitations, visual disturbances, an increase in blood urea values, hypercreatinemia and epidermal signs of allergy (rashes, itching or urticaria) are also noted.
Rarely, the use of the drug leads to anxiety, weakness, severe fatigue, runny nose, orthostatic hypotension, pancreatitis, renal dysfunction and weakening of libido and potency. During laboratory tests, changes in potassium values were detected, as well as a decrease in blood chlorine, sodium and sugar.
Side effects that occur with the use of enalapril include: vertigo, dyspnea, auditory disturbances, asthenia, bronchial spasm, dry cough, dysfunction associated with the vestibular apparatus, interstitial pneumonitis, hot flashes and increased activity of liver enzymes.
Less commonly, enalapril causes tension, asthma, irritability, muscle spasms, intestinal obstruction, liver dysfunction, and problems with bile excretion. In addition, it rarely causes hepatitis, jaundice, increased blood bilirubin levels, angina, chest pain, and myocardial infarction, as well as pulmonary embolism, fainting, decreased hemoglobin, hematocrit, neutrophils, and platelets in the blood, eosinophilia, agranulocytosis, proteinuria, increased ESR, alopecia, and photodermatosis. Also occasionally observed during treatment are dysphonia, dermatitis, glossitis, Quincke's edema in the larynx and tongue, erythema (also exudative, malignant in nature), pemphigus, myositis with necrolysis, vasculitis, stomatitis, serositis with arthritis and joint pain.
Indapamide causes adverse effects such as sinusitis, weight loss, confusion, changes in ECG values, conjunctivitis, hyperhidrosis, glucosuria, increased blood Ca levels, polyuria with nocturia, back pain, and an increased risk of developing urinary tract infections.
Overdose
In case of poisoning with enalapril, signs of collapse, critical decrease in blood pressure, cerebral blood flow disorders, thromboembolism and infarction, as well as stupor and convulsions appear.
Indapamide intoxication causes gastrointestinal dysfunction, abnormal EBV levels, confusion, decreased blood pressure, and respiratory distress. In people with liver cirrhosis, such an overdose can cause hepatic coma.
Interactions with other drugs
Antipyretics and NSAIDs can weaken the antihypertensive activity of enalapril and potentiate its negative effect on renal function. Such deterioration is reversible.
The medicinal effect of enalapril is potentiated by the use of methyldopa, nitrates, diuretic drugs, prazosin with Ca channel blockers, hydralazine and β-blockers.
An increased risk of hyperkalemia is observed when enalapril is combined with potassium-containing substances and potassium-sparing diuretics.
Medicines containing theophylline significantly weaken their effect when combined with enalapril.
Medicines that suppress bone marrow function, allopurinol, cytostatics and immunosuppressants, when administered together with enalapril, increase the toxic activity of the latter in relation to hematopoiesis.
Antidiabetic drugs potentiate the side effects of Enzix and also increase the risk of hypoglycemia.
Rarely, the administration of enalapril together with substances containing gold leads to the development of such negative symptoms as nausea, hypertension, vomiting and facial flushing.
Ethyl alcohol enhances the medicinal effect of enalapril.
The combination of indapamide with GCS, mineralocorticoids, glycemic control, tetracosactide, as well as laxatives, saluretics and amphotericin B increases the risk of hypokalemia and weakens the antihypertensive activity of the former.
When administered with indapamide, the effect of non-depolarizing muscle relaxants is enhanced.
The combination of indapamide and glycoside increases the risk of glycoside poisoning.
Calcium-containing elements can lead to hypercalcemia, and metformin can lead to the development of lactic acidosis.
The risk of arrhythmia increases with the combination of indapamide with pentamidine, erythromycin, astemizole and terfenadine, as well as with sultopride, antiarrhythmic drugs and vincamine.
Baclofen enhances the antihypertensive activity of indapamide.
The nephrotoxic effect of indapamide is potentiated when combined with iodine-containing drugs (contrast agents).
The antihypertensive effect of indapamide is potentiated when used concomitantly with antipsychotics and tricyclics.
An increased risk of hypercreatininemia has been observed when indapamide is administered concomitantly with cyclosporine.
Combination with indapamide weakens the medicinal effect of indirect anticoagulants.
Indapamide and enalapril inhibit the excretion of lithium, which is why when using Enzix together with substances containing lithium, it is necessary to monitor the blood levels of the latter.
Storage conditions
Enzix should be stored at temperatures in the range of 15-25°C.
Shelf life
Enzix can be used within 36 months from the date of sale of the medicine.
Application for children
Enzix should not be used in pediatrics.
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Analogues
Analogues of the drug are Ketanserin, Lipril, Lodoz with Gepar Compositum, Tivortin and Bidop with Glyoxal Compositum, as well as Kapilar, Sulfur, Enap, Teveten with Anaprilin, Aprovel and Vazar with Adalat and Atacand, as well as Ionic, Amlotop with Amprilan and Cordipin.
Attention!
To simplify the perception of information, this instruction for use of the drug "Enzyx" 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.