Enochoid

Enalozid is a complex antihypertensive agent with diuretic properties.

Indications Enalapril

It is used in cardiology and for therapy in individuals with elevated BP values: symptomatic or primary form of hypertension.

It may also be administered in combination treatment for chronic heart failure.

[1], [2]

Release form

The release of the medicinal element is made in tablet form, 10 pieces inside the cell packaging. Inside the box - 2 such packages.

[3], [4], [5], [6],

Pharmacodynamics

The drug contains 2 active elements that mutually potentiate the medicinal effects of each other and reduce the degree of negative manifestations.

Enalapril is a prodrug that undergoes metabolic processes inside the human body, during which a pharmacoactive substance is formed - enalaprilat. The active component can improve the blood circulation inside the kidneys, reduce the pre- and afterload in relation to the myocardial cardiac muscle and has a powerful antihypertensive activity. At the same time, the substance reduces the volume of potassium loss due to the use of hydrochlorothiazide. The therapeutic effect is produced by slowing the specific component of ACE, resulting in reduced production of angiotensin-2, which has a vasoconstrictive effect.

Due to the administration of enaloside, the systemic resistance of peripheral vessels is reduced and vascular vasodilation occurs, which does not lead to the development of reflex tachycardia. The effect of drugs helps prevent the breakdown of bradykinin and reduce the release of aldosterone.

Hydrochlorothiazide is the second element of the drug, a diuretic substance from the thiazide category. The active component has a diuretic and natriuretic effect, reduces the amount of circulating blood and has anti-hypertensive activity, reducing the performance of sodium ions inside the vascular membranes, as a result of which vascular sensitivity to vasoconstrictor agents is weakened.

[7], [8], [9], [10], [11], [12]

Pharmacokinetics

The active elements of the drug are well absorbed by penetrating the digestive system. During metabolic processes, therapeutically inactive metabolic products with the active ingredient enalaprilat are formed. After oral administration, plasma Cmax values of enalaprilat are observed after 3-4 hours. Medical effect develops after 2 hours, reaching a peak level after 4 hours. The resulting antihypertensive effect can last for 24 hours, so you can take Enaloside 1 times a day.

The half-life of hydrochlorothiazide is 10 hours, and enalaprilat is 11 hours. The period of excretion of active elements in people with renal diseases increases.

[13], [14], [15],

Dosing and administration

Enalozid is taken orally. Therapy begins with the use of minimal portions of enalapril with hydrochlorothiazide. For 14 days it is required to monitor the values of blood pressure and the strength of the severity of the drug effect; if necessary, correction of the therapeutic regimen is performed. You need to increase the portion at 2-week intervals, if necessary. Daily portion consumed for 1 reception.

Antihypertensive treatment begins with the use of 10 + 12.5 servings. A maximum of 20 mg of enalapril and 25 mg of hydrochlorothiazide per day is allowed.

If the patient has a violation of the kidneys, it is necessary to adjust the dosage of Enalozide, because its action is based on the CC indicators.

In order to prevent the risk of orthostatic collapse, it is necessary to avoid any sudden movements, as well as to lie for a while after using the drug (if there is such a possibility). It is necessary to stop using other diuretic substances before starting therapy. You should also be sure to monitor the values of electrolytes, glucose, the main indications of a general blood test, and the condition of the kidneys.

[22]

Use Enalapril during pregnancy

Enalozid cannot be appointed on the 2nd and 3rd trimesters of pregnancy. The drug can be used in the 1st trimester, but only if there are strict indications, for symptomatic lowering of high blood pressure values, if there are no other treatment options. Women in reproductive age are required to use reliable contraception. If pregnancy has been established, the use of drugs should be canceled.

Do not use the medicine during breastfeeding.

Contraindications

Main contraindications:

• severe personal intolerance associated with enalapril, hydrochlorothiazide, and other diuretic substances of the thiazide type;
• diabetes;
• glucose-galactose malabsorption;
• hypolactasia or galactosemia;
• gout or anuria;
• conditions after kidney transplantation;
• renal disease and liver function failure;
• Conn's syndrome;
• porphyria;
• use in people who undergo hemodialysis procedures in which specific high-flow membranes and LDL apheresis are used with the addition of dextran sulfate;
• renal artery stenosis;
• after performing desensitization procedures regarding bee and wasp venom.

Among the conditional contraindications:

• chronic alcoholism;
• atherosclerotic vascular lesions;
• aortic stenosis;
• disorders of cerebral blood flow;
• idiopathic form of stenosis in the muscle area, which is subaortic in nature;
• conditions in which dehydration develops (hemodialysis processes, diuretic drugs, diarrhea syndrome or vomiting).

The medication must be discontinued before the procedures of the parathyroid glands.

[16], [17], [18], [19], [20]

Side effects Enalapril

The drug is often transferred without complications. Only occasionally the occurrence of adverse symptoms:

• disorders of the digestive system: pain in the abdominal zone, hyperbilirubinemia, nausea, epigastric discomfort, disorders of the chair, increased values of hepatic enzymes, hepatitis with cholestasis, and in addition, vomiting, pancreatitis and digestive disorders;
• problems affecting the function of the cardiovascular system and hematopoietic processes: orthostatic collapse, decrease in blood pressure, rhythm disorders, angina attacks, anemia, decrease in platelet count, neutropenia and hyperemia in the face and upper body;
• PNS or CNS lesions: asthenia, vertigo, convulsive syndrome, visual perception disorder, dizziness, and severe headaches;
• allergic disorders: itching, urticaria, photophobia, rashes, angioedema, and psoriasis-like symptoms;
• other negative symptoms: dyspnea, hypercreatininemia, proteinuria, and also Raynaud's disease, impotence, changes in blood indices of electrolytes and glucose, structural changes in the nails, dry cough (often develops with the use of ACE inhibitors) and acute kidney failure.

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Overdose

In case of drug poisoning, a pronounced decrease in blood pressure indicators occurs. When orthostatic collapse occurs hypokalemia, headaches, disorders of renal function and dizziness.

Enaloside does not have an antidote. Activities related to gastric lavage and the use of enterosorbents (activated carbon, polysorb, and bakistatin) can be performed.

If the patient is diagnosed with a decrease in blood pressure, it should be laid horizontally, raising his legs. If the violation has a pronounced degree, 0.9% NaCl is required. Angiotensin-2 can also be used if the patient is in serious condition. The active elements of the drug are excreted during hemodialysis.

[23], [24], [25], [26], [27], [28],

Interactions with other drugs

The drug weakens the activity of amines pressor character.

The antihypertensive effect of enaloside is potentiated when combined with diuretic drugs, ethanol, barbiturates, other antihypertensive drugs, phenothiazines, and also tricyclics and MAOI.

The reverse effect develops when used together with Kolestiramine or NSAIDs, as well as when used with foods containing large amounts of salt.

An increase in the likelihood of anemia, leuko- or pancytopenia, as well as other diseases affecting the hematopoietic system, is expected with a combination of drugs with allopurinol, immunosuppressants, cytotoxic drugs and systemic corticosteroids (hypokalemia may additionally develop).

The drug can prolong the half-life of non-depolarizing muscle relaxants, as well as increase the toxic effects of the drugs Li and SG (the effect occurs due to the slowing down of the excretion of metabolic products).

The drug can alter blood glucose levels in diabetics. Enalozide has been found to affect the effectiveness of oral hypoglycemic agents with insulin. It is required to additionally adjust the dosage regimen of antidiabetic drugs.

The activity of allopurinol, terazosin, as well as estrogen-containing type oral contraception is impaired when using hydrochlorothiazide.

An increase in the likelihood of developing hyperkalemia is observed when using the drug in combination with potassium-sparing diuretics and potassium drugs.

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Storage conditions

Enalozide is required to be stored in a place protected from moisture. Temperature marks - within 25 ° C.

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Shelf life

Enaloside can be used within a 12-month period from the time the drug was manufactured.

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Use in children

You can not use the drug in pediatrics (up to 14 years of age).

Analogs

Analogues of the drug are medicines Enam N, Berlipril Plus, as well as Co-Renitec with Enap N.

[39], [40], [41], [42], [43], [44], [45], [46]

Reviews

Enalozide effectively lowers blood pressure to optimal levels, thereby ensuring a stable state in people with hypertension. You can also use the drug in cardiology. Patients in their reviews note that the drug is transferred without noticeable complications - pronounced negative signs do not occur (especially with prolonged treatment).