Enalapril: instructions for use, reviews, analogs, contraindications, price

Enalapril is considered one of the most effective medicines of its group. With it, you can lower blood pressure and monitor it throughout the treatment period. Enalapril is referred to as ACE inhibitory drugs.

In addition to pronounced hypotensive effect, it has the ability to improve blood flow and prevents certain diseases. About the features of this medication, indications, instructions for the use of Enalapril, its price, analogues and reviews of it doctors and patients, we now know.

Features of the drug

  • The drug is not recommended to combine with alcoholic beverages, so as not to increase the hypotensive effect.
  • Enalapril affects the ability of concentration, therefore it is recommended to refrain from working with complex mechanisms.
  • At the initial stage of treatment, it is also necessary to abandon the complex work, including those associated with danger or requiring attention, since dizziness is possible.
  • During treatment, it is necessary to be more careful in hot weather, as well as in physical activity, since there is a risk of a stronger lowering of blood pressure due to a low volume of circulating blood.

About treatment Enalapril always need to warn doctors before surgery, including dental.

The following video will describe in more detail the features of the drug Enalapril:

Composition

The tablet contains the active substance enalapril maleate at a dosage of 5, 10, 20 mg. Components that are auxiliary:

  • sugar,
  • magnesium stearate or calcium stearate,
  • lactose,
  • gelatin medical,
  • potato starch.

Dosage forms of

Enalapril is available in tablet form. The price category is very affordable. So, in the smallest dosage( 5 mg), two blisters of 10 tablets will cost 10-20 rubles. The cost of the drug does not exceed usually 100 rubles.

Pharmacological action and pharmacodynamics

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  • The drug belongs to the group of antihypertensive medications. Its action is aimed at inhibiting the activity of angiotensin enzymes, which directly leads to a decrease in the production of aldosterone. A consequence of this is a reduction in diastolic and systolic blood pressure.
  • Enalapril also helps to dilate blood vessels, improves blood flow in the kidney and brain area.
  • After long-term use, there is a decrease in left ventricular hypertrophy, which allows to slow down or completely prevent the development of heart failure.
  • The blood supply to the myocardium also improves.
  • Enalapril has some diuretic effect and lowers the aggregation of platelets.

Already after an hour noticeable hypotensive effect, the maximum it will be after 6 hours. The effect is completely preserved throughout the day. In some groups of patients, longer-term therapy( usually several weeks) is required to develop a lasting result.

Pharmacokinetics

The absorption of the drug after consumption is 60%.About half of the drug binds to proteins. In the process of metabolism, a metabolite is formed, which is absorbed in the body. Enalapril is modified into enalaprilat - more bioavailable( 40%) and an active ACE inhibitor.

Medication is able to penetrate into breast milk and the placenta. The half-life is about 11 hours. Up to 60% is excreted by the kidneys, and another 33% by the intestine. With peritoneal dialysis and hemodialysis completely removed.

Indications

Enalapril is necessary for different types of arterial hypertension. Often it replaces low-effective antihypertensive drugs. For use, it is prescribed in the same way if there are:

  1. bronchospastic states,
  2. heart failure,
  3. IBS,
  4. diabetic nephropathy,
  5. chronic renal failure,
  6. scleroderma,
  7. angina,
  8. Raynaud's disease, as well as complex therapy for other diseases.

Enalapril is not prescribed for children, as there is no data on the efficacy and safety of such treatment.

Instructions for use

Inside. The application is not associated with the time of ingestion. The initial dosage should be 5 mg, in the future after adjusting it correct.

Usually it is enough to take 10 mg of Enalapril for treatment of essential hypertension. The maximum dosage of the drug is 40 mg. After taking the drug and up to the stabilization of blood pressure( usually 2-3 hours), the patient is under observation. After therapy with Enalapril in the maximum dosage should go to maintenance treatment with 10-20 mg per day.

Before starting therapy stop taking diuretics 2-3 days before the first use of tablets. If it is impossible to cancel them, the initial dosage should be significantly reduced( up to 2.5 mg).

  • In the presence of reninvascular hypertension, the maximum dosage is 20 mg. Treatment begins with a small dose.
  • For chronic heart failure, the initial dosage is 2.5 mg, increasing it every few days.
  • Patients with reduced systolic blood pressure should begin with tablets of 1.25 mg. Within 4 weeks, the dose is adjusted.

The duration of treatment determines the effectiveness of therapy. If there is a pronounced effect of lowering blood pressure, lower the dose of Enalapril. The drug is suitable for the complex use of antihypertensive drugs, as well as for monotherapy.

Contraindications

  • Age under 18 years;
  • sensitivity to the components of the facility;
  • presence of an angioedema in history, if the cause of its appearance was associated with therapy with ACE inhibitors;
  • pregnancy;
  • lactation;
  • porphyria.

Side effects of

  • Digestive system : pancreatitis, hepatitis, jaundice, impaired liver function, dry mouth, abdominal pain, stool problems, nausea, increased activity of hepatic transaminases.
  • Urinary system : protein in the urine, impaired kidney function.
  • Nervous system : fatigue and fatigue, dizziness, headache. At large dosages, paresthesia, nervousness, sleep problems, tinnitus, depression are possible.
  • Heart and vessels : hot flashes - in rare cases;hypotension orthostatic, pain in the heart and rapid pulse, fainting, hot flashes.
  • Respiratory system : cough, bronchospasm, pharyngitis, shortness of breath, interstitial pneumonitis, rhinorrhea.
  • Bleeding : in the presence of autoimmune diseases, agranulocytosis is noted;neutropenia is a rare but possible phenomenon.
  • Influence on the reproductive capacity of : sometimes with high doses impotence occurs.
  • Allergic reactions : Quincke's edema, pruritus, skin rash, erythema polymorphic, serositis, myositis, vasculitis, Stephen-Johnson syndrome, stomatitis, angioedema and extremities.
  • Effect on laboratory parameters of : increased ESR, lowering of hemoglobin and hematocrit;neutropenia, hyperbilirubinemia, increased urea, eosinophilia.
  • Muscle cramps and hyperkalemia are relatively rare. There may be problems with the vestibular apparatus, the appearance of alopecia.

Special instructions

Cautions

Always with extreme caution Enalapril is used with:

  1. of hepatic failure,
  2. renal artery stenosis,
  3. salt-free diet,
  4. complex therapy with immunosuppressants,
  5. weakened state after surgery,
  6. hyperkalemia,
  7. diabetes mellitus.

It is also important to know:

  • Observation is important to establish and for patients older than 65 years. Particular attention is paid to people with cardiovascular diseases, in whom a sharp drop in blood pressure can provoke a heart attack, stroke or other serious consequences.
  • If enalapril has been previously treated with saluretic therapy, there is a risk of orthostatic hypotension. To eliminate the likelihood of its development, it will be necessary to restore the level of salts and liquid before using the tablets.
  • Prolonged therapy requires regular monitoring of the composition of peripheral blood. If a surgical procedure is performed during the treatment period, a sufficient amount of liquid is injected to prevent arterial hypotension.
  • In enforced admission Enalapril during pregnancy, it is necessary to establish control over the state of newborns. This will help in a timely manner to determine the deterioration of cerebral and renal blood flow, which occurs under the influence of ACE inhibitors, oliguria, neurological disorders and hyperkalemia.
  • A single dose should be adjusted and lowered if the patient suffers from a decreased kidney function. Abolition of Enalapril before the study of parathyroid function.

Overdose

Treatment of overdose is associated with symptomatic therapy, as well as the introduction of sodium chloride( isotonic solution) intravenously. The patient before this is transferred to a horizontal position, and the head should be located below. For mild cases, it is sufficient to wash the stomach. Overdosage is accompanied by the following symptoms:

  • cerebrovascular accident in acute form,
  • hypotension,
  • thromboembolic complications,
  • myocardial infarction,
  • collapse,
  • state of psychological retardation,
  • convulsions.

Interaction with other

tools
  • The risk of leukopenia increases with simultaneous therapy with cytostatics and immunosuppressants.
  • Hyperkalemia is most likely to develop with the use of potassium and BAD supplements together with Enalapril. ACE inhibitors lead to the retention of potassium in the body, which can aggravate the condition.
  • The antihypertensive effect is increased if the patient takes opioid analgesics. The same effect is possible when taking "loop" diuretics.
  • There is a risk of impaired renal function and hyperkalemia.
  • The development of anemia occurs with the use of azathioprine, since it, together with Enalapril, has a depressing effect on the activity of erythropoietin.

Reviews of patients and doctors about Enalapril

In the reviews, almost everyone who used the remedy notes its high efficiency. Additional effects on the body, which has Enalapril after long-term use, refers only to its benefits.

A sharp discontinuation of treatment or skipping of a pill will not cause an increase in blood pressure, which is very important in drugs that lower blood pressure. The use of a medicine without the supervision of a doctor can be dangerous.

In the video below the doctor tells about the responses to the drug Enalapril:

Analogs

  • Enziks,
  • Enap,
  • Enalozid,
  • Enziks,
  • Enam,
  • Renitek,
  • Enalozid,
  • Berlipril.

Some medicines are produced not only in tablet form, but also in the form of injectable solutions.

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