Enam

Enam is an antihypertensive drug, is included in the group of ACE inhibitors.

[1]

Indications Enam

It is used in the treatment of CHF, as well as in various forms of hypertension - for example, of a renovascular nature.

[2], [3]

Release form

The release of therapeutic agent is made in tablet form - 10 pieces inside the strip. The pack contains 2 such strips.

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Pharmacodynamics

The drug reduces the activity of the action of ACE, and also stimulates a decrease in the processes of production of the element angiotensin-2.

The drug is considered a prodrug, because after the hydrolysis of drugs inside the human body, the active component enalaprilat is formed, which has a slowing effect on the action of the enzyme ACE.

At the same time, the drug has a diuretic effect and, in addition to lowering blood pressure values, contributes to a significant reduction in post- and preloads in relation to the myocardium in people with HF.

Enam promotes the stimulation of small blood flow and respiratory activity of the body, and with it stabilizes blood circulation inside the renal vessels.

[6], [7]

Pharmacokinetics

The drug is absorbed at high speed; bioavailability values reach 74%. Indicators Cmax of the active element of the drug are recorded after 4 hours. The impact of the drug lasts no more than 24 hours.

Later, the drug is subjected to intrahepatic metabolic processes, and then excreted through the kidneys.

[8], [9]

Dosing and administration

There are several different schemes of use of Enam that are suitable for different categories of treatment. It is necessary to use the drug orally.

It is required to use such dosage portions of the drug:

• people who do not use diuretic drugs - 5 mg of a substance per day with a gradual increase in dosage up to 10-40 mg (1-2 intakes per day);
• decreased blood pressure in people using diuretic substances - the initial portion of the dose is equal to 2.5 mg (if you can not cancel diuretics);
• with CHF, it is necessary to take 2.5 mg of the drug per day, in a maximum of 4 days, gradually increasing the serving size to 10 mg of the drug per day;
• Diabetics who also suffer from nephropathy and have elevated blood pressure need to consume 2.5–5 mg of drugs per day (with the condition that the level of blood pressure remains within normal limits; with an increase in these values, you should use no more than 40 mg day);
• Persons with kidney failure - no more than 2.5 mg of the drug per day (if the CC values are less than 30 ml / minute).

[14], [15], [16]

Use Enam during pregnancy

Do not use the drug during breastfeeding or pregnancy.

Contraindications

Main contraindications:

• strong sensitivity to ACE inhibitors;
• a history of the likelihood of Quincke edema;
• stenosis of the aortic or mitral valve.

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Side effects Enam

Usually, when using the drug in the recommended portions, it is tolerated without any complications. But sometimes, in isolated situations, the following adverse symptoms occur:

• severe fatigue, headaches, cough, dizziness and dyspnea;
• impotence;
• nausea, dry oral mucosa, diarrhea, glossitis and pain in the abdominal area;
• heart rhythm disorder, fainting and lowering blood pressure values;
• decreased hemoglobin, proteinuria, or hyperkalemia;
• ear noise, depression, insomnia, and increased excitability;
• agranulocytosis.

[11], [12], [13]

Overdose

Enam poisoning leads to signs of an increase in blood pressure.

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Interactions with other drugs

Combined use with NSAIDs lowers the antihypertensive properties of the drug.

The combination of drugs with potassium-sparing diuretics (for example, spironolactone, amiloride, or triamterene) can lead to hyperkalemia.

The introduction of the drug along with medicines that contain lithium salts, leads to inhibition of excretion of the latter from the body, because of which it is necessary to regularly monitor the blood values of lithium in the patient.

Because alcohol enhances the antihypertensive activity of drugs, they cannot be taken during therapy. Substances that block Ca channels, diuretic drugs, prazosin with hydralazine, and also nitrates and β-blockers, also have a similar effect.

The therapeutic effect of Ename is weakened when combined with antipyretic and analgesic drugs.

Enalapril, which is an integral part of the drug, weakens the properties of theophylline.

[19], [20], [21],

Storage conditions

Enam must be kept in a closed place for small children. Temperatures should be a maximum of 25 ° C.

[22],

Shelf life

Enam can be used within a 36-month period from the time the pharmaceutical product is manufactured.

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Application for children

It is forbidden to appoint Enam in pediatrics.

[24], [25]

Analogs

Analogues of the medication are the drugs Korandil, Renipril, Ednit and Berlipril with Bagopril and Invoril, and in addition, Vazolipril, Enafarm, Myopril, Envipril and Renitec with Enalacor and Vero-Enalapril. The list also includes Enasil, Enalapril and Enarenal with Envas.

[26]

Reviews

Enam receives both positive and negative feedback. This is due to the fact that not every patient can get this medicine. A large number of patients from the drawbacks of the drug, the presence of a fairly extensive number of negative symptoms, the development of which he can provoke.