Enalapril

Enalapril is included in the category of drugs ACE inhibitors.

[1], [2], [3], [4], [5]

Indications Enalapril

It is used to treat such disorders:

• Raynaud's syndrome;
• hypertensive disease ;
• insufficiency of cardiac function;
• scleroderma;
• increased blood pressure - symptomatic;
• diabetic glomerulosclerosis,
• hyperaldosteronism, which has a secondary character.

In addition, the medication is used in the combined treatment of myocardial infarction, angina pectoris and chronic renal failure. Can be assigned to reduce high pressures.

[6], [7]

Release form

The release of the medication is realized in tablets packed in 10 pieces inside the blister plate. In the box there are 2 plates.

[8], [9], [10], [11], [12],

Pharmacodynamics

The drug reduces pressure, has a vasodilating effect on blood vessels, and besides it has natriuretic and cardioprotective properties.

The therapeutic effect is due to the slowing of ACE activity under the influence of Enalapril. As a result, the biosynthesis of angiotepsin 2 decreases, which causes vasodilation and the production of bradykinin with PGE2, which are powerful vasodilators.

In people with a lack of cardiac function with prolonged use of the drug (more than half a year) there is an increase in cardiac tolerance of various physical exertions, and in addition, a decrease in heart size and a decrease in the number of deaths. Influence of the drug allows to relieve a small circle of blood flow, reduce the level of pressure inside the pulmonary capillaries, lower OPSS and increase the values of cardiac output (with no increase in heart rate).

[13], [14], [15], [16], [17]

Pharmacokinetics

The level of absorption of drugs reaches 60% regardless of eating and the presence of food inside the gastrointestinal tract. Peak values of the enalaprilat component are recorded after 1 hour from the moment of reception.

Inside the liver, the element undergoes biotransformation with the formation of enalaprilate. This component easily penetrates the placenta and histiocytic barriers.

Excretion of drugs occurs in the kidneys. Antihypertensive effect is observed after 60 minutes from the moment of taking the pill; This effect lasts for 24 hours.

In order to achieve optimal blood pressure, it is necessary to constantly take medicine during several weeks.

[18], [19], [20],

Dosing and administration

Enalapril is used orally. First it is taken in a dose equal to 5 mg per day (single use). In diseases affecting the kidneys, as well as the use of diuretics, the dose should be reduced to 2.5 mg. To get the effect, according to the individual characteristics of the patient, it is allowed to increase the dosage to 10-40 mg per day (it is allowed to divide by 2 uses).

Methods of using Enalapril Hexal.

The medicine is used without binding to the reception of food.

To reduce the high values of blood pressure, you need to consume 5 mg of the substance in the morning. With maintenance treatment, dosages equal to 10 mg are used. Do not use more than 40 mg / day.

During CHF prescribe the use of 2.5 mg of the drug in the morning. To maintain the condition take 5-10 mg of the substance. It is forbidden to use more than 20 mg of medicine per day.

If problems with left ventricular function are used twice a day for 2.5 mg of the substance. The size of the maintenance dose is 10 mg with a 2-time intake per day.

In disorders of renal activity, the drug is used at a dosage of 2.5 mg per day. With maintenance therapy, 5-10 mg of the drug is used. For a day allowed to use no more than 20 mg.

Methods of application of Enalapril Acri.

You can consume the medicine at any time of the day. Initially, appoint a dose of 2.5-5 mg once in 24 hours. With a supportive scheme, 10-20 mg with 1-time administration for 24 hours is used. For a day, a maximum of 40 mg can be taken, for 1-2 applications.

The regimen of enalapril N.

In the period of 24 hours, 1-2 tablets of medicines should be consumed, without binding to food intake.

[26]

Use Enalapril during pregnancy

Do not use Enalapril during pregnancy.

Contraindications

Among the contraindications:

• hyperaldosteronism;
• presence of strong sensitivity to ACE inhibitors;
• stenosis affecting the arteries in the kidneys;
• azotemia;
• problems with renal activity;
• hereditary form of angioedema;
• gingivitis;
• aortic stenosis

[21], [22], [23], [24]

Side effects Enalapril

A medication can cause some side effects:

• dizziness, severe fatigue, nervousness, headaches and insomnia;
• dyspeptic symptoms, nausea, dry type cough, or glossitis;
• ear noise, palpitations, orthostatic collapse, convulsions, pain in the heart;
• disorders of renal or hepatic function, proteinuria, increased transaminase values of the liver or bilirubin, as well as hyperkalemia;
• alopecia, angioedema, erectile dysfunction or neutropenia.

[25]

Overdose

In case of overdose, there is a strong decrease in blood pressure, development of ONMC, myocardial infarction and complications of thromboembolic character (due to a significant drop in blood pressure).

To eliminate the disturbances, an isotonic liquid NaCl is injected intravenously. The medicine does not have an antidote.

[27], [28], [29], [30], [31], [32],

Interactions with other drugs

The degree of absorption of drugs is not determined by the ingestion of food with it.

Combined use with nitrates, calcium antagonists, hydralazines and, in addition, drugs that block the activity of β-adrenergic receptors, methyldopa and prazosin, leads to an increase in the antihypertensive properties of Enalapril.

Elongation of the half-life of drugs occurs when combined with cimetidine.

NSAIDs potentiate nephrotoxic effects and impair the effectiveness of the drug.

Diuretics of potassium-sparing nature and potassium medicines with simultaneous use with medication cause hyperkalemia.

The drug reduces the half-life of theophylline, and also reduces the level of lithium clearance.

Does not interact with SG.

[33], [34], [35]

Storage conditions

Enalapril should be kept out of the reach of children and in a dry place. The temperature level is not higher than 25 ° C.

[36], [37], [38], [39], [40]

Shelf life

Enalapril is allowed to be used within 36 months from the date of manufacture of the drug.

[41], [42]

Application for children

You can not prescribe medicine in pediatrics.

[43], [44], [45], [46], [47],

Analogues

Analogues of the drug are medicines Ednit, Berlipril, Enap with Invoril, and besides this, Enahexal, Renitek and Enam.

[48], [49], [50], [51], [52], [53], [54]

Reviews

Enalapril receives positive reviews from doctors - it is considered effective in blocking ACE activity. In the pluses of the drug can be entered and the fact that it is used widely and is available to most patients, since it has a low cost. The medication effectively lowers high blood pressure values, but it has drawbacks, including contraindications and negative symptoms (eg, coughing).