Enziks

Enzapi includes 2 active medicinal elements - enalapril with indapamide. Their combined effect leads to the development of sustained and rapid diuretic and hypotensive effects.

After the hydrolysis process, enalapril inside the body is converted into the active component enalaprilat, further providing a therapeutic effect.

Indapamide contained in the drug enhances the excretion of Cl, Na, Ca and Mg ions together with urine.

Indications Enziksa

It is used for the treatment of hypertension, having a primary or secondary form.

[1], [2], [3]

Release form

The release of the drug is implemented in the form of tablets - sets, including the substances indapamide and enalapril.

Enzix form - 3 combined packs, 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 combined plates (enalapril 20 mg - 10 tablets and indapamide 2.5 mg - 5 tablets).

Pharmacodynamics

Enalaprilat slows down the production of an ACE element, as well as the intrahepatic production of angiotensin; in addition, it reduces the volume of aldosterone produced by the adrenal glands. Due to this effect, vasoconstriction and an increase in blood pressure values occur, and diuresis is enhanced.

The drug helps to reduce blood pressure, weakens the load on the heart in case of myocardial insufficiency, restores the physiological blood flow within the small circle and respiration, and at the same time weakens the resistance of the kidney vessels and stabilizes the renal blood circulation.

Indapamide strengthens the stability of blood vessel membranes in relation to the effects of angiotensin and norepinephrine, and besides this, it activates PG-E2 production. Its medication effect is based on relaxing the smooth muscles of the arterial membranes and increasing diuresis, which in combination helps to lower the level of blood pressure.

Dosing and administration

At treatment it is necessary to apply on the 1st tablet of indapamide with enalapril at the same time; the procedure is carried out in the morning. Taking into account personal susceptibility, during therapy, a portion of enalapril can be increased to 2 tablets per day.

You must comply with the daily rate of the drug - no more than 40 mg of enalapril and 2.5 mg of indapamide.

In the case of light or moderate intensity of renal insufficiency, it is allowed to take no more than 5-10 mg of enalapril per day.

[4]

Use Enziksa during pregnancy

The drug is strictly prohibited for appointment during breastfeeding or pregnancy.

Contraindications

You can not use the drug in the presence of a history of allergies to the elements of the drug, ACE inhibitors, as well as derivatives of sulfonamide.

It is contraindicated to appoint with porphyria.

Indapamide is not prescribed to persons with hypokalemia, anuria, or liver / kidney function failure (severe), which can also be accompanied by encephalopathy. In addition, indapamide is not combined with substances prolonging the QT-gap.

Enalapril is used very carefully in the case of 2-sided stenosis of the renal arteries, hyperkalemia, primary form hyper aldosteronism, and also for IHD and a decrease in the BCC values. Caution is also required in the case of kidney transplantation, connective tissue lesions, stenosis (mitral, arterial or subaortic hypertrophic and idiopathic), cerebrovascular pathologies, liver / kidney failure, and diabetes mellitus. At the same time, care is taken when combining drugs with saluretics or immunosuppressants, hemodialysis, limited intake of salt, as well as in the elderly.

Indapamide is carefully prescribed to diabetics with decompensation, as well as in the case of hyperuricemia.

Side effects Enziksa

The use of an Enzix can provoke negative manifestations in the form of drowsiness, nervousness, headaches, paresthesias, insomnia and depression. In addition, abdominal discomfort, cough, impaired stool and digestion, xerostomia, anorexia, pharyngitis and rhinorrhea can be observed. Arrhythmia, critical reduction in blood pressure, palpitations, visual disturbances, increased blood levels of urea, hypercreatinemia and epidermal signs of allergy (rash, itching or urticaria) are also noted.

Occasionally, the use of drugs leads to anxiety, weakness, fatigue, runny nose, orthostatic hypotension, pancreatitis, renal dysfunction and weakening of libido and potency. During laboratory testing, changes in the values of potassium were detected, and in addition, a decrease in blood indicators of chlorine, sodium and sugar.

Side effects occurring when using enalapril: vertigo, dyspnea, auditory disorders, asthenia, bronchial spasm, dry-type cough, dysfunction associated with the vestibular apparatus, interstitial pneumonitis, hot flashes, and increased activity of liver enzymes.

More rarely, enalapril leads to tension, asthma, irritability, muscle spasms, intestinal blockage, hepatic dysfunction and problems with the excretion of bile. In addition, it rarely causes hepatitis, jaundice, increased blood levels of bilirubin, angina pectoris, chest pain and myocardial infarction, as well as pulmonary embolism, fainting, decreased hemoglobin, hematocrit, neutrophils and platelets inside the blood, eosinophilia, agranulocytosis, and Iostoma, Iostoma, Iostoma, Iostoma, Iosophilism, eutrophilia, hematocrit, neutrophils and platelets inside the blood, eosinophilia, agranulocytosis, and Iosophilism and photodermatosis. Dysphonia, dermatitis, glossitis, angioedema in the larynx with tongue, erythema (also exudative, having a malignant character), pemphigus, myositis with necrolysis, vasculitis, stomatitis, serositis with arthritis and joint pain are also rarely observed during treatment.

Indapamide leads to the development of negative effects in the form of sinusitis, weight loss, confusion, changes in ECG values, conjunctivitis, hyperhidrosis, glycosuria, increased blood levels of Ca, polyuria with nocturia, pain in the back area, as well as an increased risk of developing infections of the urethra.

Overdose

In the case of enalapril poisoning, there are signs of collapse, a critical decrease in blood pressure, cerebral blood flow disorders, thromboembolism and heart attack, as well as stupor and convulsions.

When indapamide intoxication occurs, digestive dysfunctions, impaired EBV indicators, confusion, a decrease in blood pressure and respiratory distress occur. In individuals with hepatic cirrhosis, such an overdose can cause hepatic coma.

Interactions with other drugs

Antipyretics and NSAIDs can weaken the antihypertensive activity of enalapril, as well as potentiate its negative effect on renal function. This deterioration is reversible.

The drug effect of enalapril is potentiated by the use of methyldopa, nitrates, diuretic drugs, prazosin with Ca channel blockers, hydralazine and β-blockers.

There is an increase in the likelihood of hyperkalemia with a combination of enalapril with potassium-containing substances and diuretic potash-saving type.

Medicines based on theophylline, significantly weaken their effects when combined with enalapril.

Drugs that suppress bone marrow function, allopurinol, cytotoxic drugs and immunosuppressants, when administered together with enalapril, increase the toxic activity of the latter in relation to blood formation.

Antidiabetic drugs potentiate the side effects of Enzix and also increase the risk of hypoglycemia.

Occasionally, administration of enalapril along with substances that contain gold leads to the development of such negative symptoms as nausea, hypertension, vomiting and redness of the skin of the face.

Ethyl alcohol enhances the medicinal effect of enalapril.

Combining indapamide with GCS, mineralocorticoids, SG, tetrakozaktidom, and in addition with laxatives, saluretics and amphotericin B increases the risk of hypokalemia, and also weakens the first antihypertensive activity.

When administered with indapamide, the effect of non-depolarizing muscle relaxants is increased.

The combination of indapamide and SG increases the likelihood of glycoside poisoning.

Calcium-containing elements can lead to hypercalcemia, and metformin - to the development of lactic acidosis.

The likelihood of arrhythmia is increased in the case of a combination of indapamide with pentamidine, erythromycin, astemizole and terfenadine, and in addition 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 in the case of simultaneous use with antipsychotics and tricyclics.

There is an increase in the likelihood of hypercreatininemia with the introduction of indapamide together with cyclosporine.

The combination with indapamide weakens the medicinal effect of indirect type anticoagulants.

Indapamide with enalapril inhibits the excretion of lithium, which is why when using Enzix together with substances that contain lithium, it is necessary to monitor the blood indicators of the latter.

[5], [6]

Storage conditions

Enziksi need to save when the temperature in the range of marks 15-25 ° C.

Shelf life

Enzix can be used within the 36-month term from the date of sale of the drug.

Application for children

Enziks cannot be used in pediatrics.

[7]

Analogs

Analogues drugs are Ketanserin drugs Lipri, Lodoz with Hepar compositum, Tivortin and Bidop with Glyoxal compositum, but other than that Kapilar, Sulfur, Enap, Teveten with Inderal, Aprovel and Vasari with Adalat and Atacand and Ionic, Amlotop with Amprilanom and cordipin.