Enalapril

Enalapril is an antihypertensive drug from the group of ACE inhibitors.

Has hypotensive, cardioprotective, vasodilating and natriuretic effects on the body. The drug reduces the overall peripheral resistance of blood vessels, systolic and diastolic blood pressure. Long-term use of Enalapril significantly reduces hypertrophy of the left ventricle of the myocardium, preventing the development of chronic heart failure.

The drug exhibits a slight diuretic effect. The use of the drug contributes to the improvement of renal and coronary blood flow. The hypotensive effect of the drug manifests itself 1 hour after its administration and lasts for 24 hours.

Clinical and pharmacological group

ACE inhibitor.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Enalapril cost in pharmacies? The average price is at the level of15 rubles.

Composition and form of release

Enalapril from pressure is released in a single dosage form - in the form of small white tablets, they contain the main active substance

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enalaprilin three basic dosages - 5, 10 and 20 mg. In addition to the active substance, the tablets contain auxiliary components (lactose, stearin, magnesium stearate, crospovidone, etc.). Generals of Enalapril may have a dosage of 2.5 mg (for example, drugs such as Enap or Ednit).

Tablets of 10 pieces are packaged in blisters and packaged in cardboard packs. Each pack contains 2 or 3 blisters.

Pharmacological effect

Enalapril has an antihypertensive effect (gradually lowers blood pressure).

Other medicinal properties of the drug include:

dilates blood vessels,
reduces the resistance of vessels at the periphery,
relieves stress on the myocardium,
lowers the pressure in the zone of the small circle of blood circulation,
increases the ability to withstand physical activity,
reduces deformations in the left ventricle,
improves the picture of the glomerular hemodynamics in the kidneys (preventing diabetic nephropathy).

The drug promotes the expansion of the arteries to a greater extent than the veins, without a reflex jump in heart rate readings. The maximum result is formed after a lapse of 6-8 hours from the moment of admission and lasts for a day. A stable therapeutic effect is formed after several weeks of therapy. The results of treatment can be read in the reviews posted at the end of the text.

About 60% of the amount of the dose taken is rapidly absorbed from the gastrointestinal tract. Metabolism of the drug occurs in the liver. From the body it is excreted in the main body by the kidneys, as well as by the intestine.

Indications for use

Enalapril tablets are prescribed to control and stabilize blood pressure under the following conditions:

symptomatic arterial hypertension;
kidney diseases accompanied by increased blood pressure;
secondary hyperaldosteronism;
ischemic heart disease;
bronchospastic states;
left ventricular dysfunction;
in the complex treatment of heart failure, angina pectoris and in the post-infarction period.

In the therapy of heart failure, enalapril treatment can reduce the burden on the heart and avoid complications.

At what pressure do you designate?

Enalapril is prescribed for hypertensive arterial hypertension with increased arterial pressure. Also, the drug is used for complex combined treatment of chronic heart failure.

Contraindications

Hypersensitivity to ACE inhibitors, stenosis of the renal arteries, azotemia, hyperaldosteronism, hyperkalemia, renal dysfunction, Quincke's edema (hereditary nature), stenosis of the aortic estuary, children's age. Enalapril is not prescribed for pregnant women.

Intended use for pregnancy and lactation

The instructions say that the use of Enalapril during pregnancy is contraindicated. If it has come, you should immediately stop taking the drug, except in cases where it is not possible to replace therapy with an alternative option. When taking medication in the second and third trimesters, fetotoxic effects and neonatal toxicity were recorded.

If the reception of Enalapril failed to cancel, the ultrasound of the fetus is required. According to the mothers who take the drug during the gestation, the newborns are monitored for blood pressure. During lactation, the active substance penetrates into the milk, so breastfeeding should be stopped. This threatens to have a negative effect on the kidneys and heart.

Dosage and route of administration

As indicated in the instructions for use during ingestion, the initial dose of Enalapril is 2.5-5 mg 1 time / day. The average dose is 10-20 mg / day in 2 divided doses.

With the / in the introduction - for 1.25 mg every 6 hours. To detect excessive hypotension in patients with sodium deficiency and dehydration caused by previous therapy diuretics, patients receiving diuretics, and also in case of renal insufficiency, an initial dose of 625 mg is administered. With an inadequate clinical response, this dose can be repeated after 1 hour and continue treatment at a dose of 1.25 mg every 6 hours.

The maximum daily intake for oral administration is 80 mg.

Adverse Reactions

Against the background of taking Enalapril tablets, it is possible to develop negative reactions from various organs and systems:

Reproductive system - when prescribed in high therapeutic doses, men may develop impotence.
The respiratory system is a periodic dry cough, which can have a paroxysmal character.
Blood and red bone marrow - a decrease in the number of neutrophils (neutropenia) in the blood.
Skin and subcutaneous tissue - very rarely, mainly when using high doses of the drug, it is possible to develop alopecia (hair loss).
Nervous system - headache, periodic dizziness, fatigue, rarely develop sleep disorder, imbalance, tinnitus.
Cardiovascular system - a syncope, decrease in level of system arterial pressure at transition from a horizontal position of a body in the vertical (orthostatic hypotension), the appearance of palpitations, less often can develop "hot flashes", pain in the heart.
Digestive system - nausea, rarely vomiting, dry mouth, diarrhea, abdominal pain, increased bilirubin concentration, as well as the activity of enzymes of hepatic transaminases in the blood, inflammation of the liver (hepatitis) or pancreas (pancreatitis).
Urinary system - there is rarely a protein in the urine (proteinuria), as well as impaired renal function.
Allergic reactions - a rash on the skin, its itching, urticaria (changes that in appearance resemble a nettle burn), angioedema Quincke's edema (marked edema of peripheral soft tissues, mainly in the face and external genital organs).

The appearance of signs of development of negative reactions is the basis for stopping the intake of Enalapril tablets and contacting a medical specialist for advice.

Overdose Symptoms

In case of an overdose of the drug, the following symptoms are possible: a strong decrease in blood pressure until the development of an infarction myocardium, collapse, thromboembolic complications or cerebral circulation, stupor, convulsions.

If these phenomena are found, the patient should be placed in a horizontal position. In the case of an easy overdose, the stomach is washed and saline solution is taken. In more severe cases, procedures are used to stabilize blood pressure (intravenous injection of plasma substitutes or saline, hemodialysis, angiotensin II).

special instructions

Before you start using the drug, read the special instructions:

Before the study of parathyroid function, enalapril should be discontinued.
With long-term treatment with enalapril, you need to periodically monitor the picture of peripheral blood. The sudden discontinuation of enalapril does not cause a sharp increase in blood pressure.
During surgical interventions during the treatment with enalapril, it is possible to develop arterial hypotension, which should be corrected by the introduction of a sufficient amount of fluid.

With extreme caution apply in patients with autoimmune diseases, diabetes mellitus, impaired liver function, severe form stenosis of the aorta, subaortic muscular stenosis of unknown origin, hypertrophic cardiomyopathy, loss of fluid and salts. In the case of prior treatment with saluretic drugs, in particular in patients with chronic heart failure, the risk of developing orthostatic hypotension, so before starting treatment with enalapril it is necessary to compensate for the loss of fluid and salts.

Compatibility with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

With the simultaneous use of insulin, hypoglycemic agents of sulfonylureas, hypoglycemia may develop.
With the simultaneous use of ACE inhibitors and interleukin-3, there is a risk of developing arterial hypotension.
With simultaneous application with clozapine there are reports of the development of syncope.
With simultaneous use with clomipramine, the effect of clomipramine and the development of toxic effects are reported.
With simultaneous application with co-trimoxazole, cases of hyperkalemia development are described.
When lithium is applied simultaneously with carbonate, the concentration of lithium in the serum increases, which is accompanied by symptoms of lithium intoxication.
With simultaneous use with orlistat reduces the antihypertensive effect of enalapril, which can lead to a significant increase in blood pressure, the development of hypertensive crisis.
It is believed that with simultaneous use with procainamide, there may be an increased risk of developing leukopenia.
With simultaneous use with enalapril, the effect of drugs containing theophylline is reduced.
There are reports of the development of acute renal failure in patients after kidney transplantation with simultaneous application with cyclosporine.
With simultaneous application with cimetidine, T1 / 2 enalapril increases and its concentration in the blood plasma increases.
It is believed that it is possible to reduce the effectiveness of antihypertensive agents when used simultaneously with erythropoietins.
With simultaneous use with ethanol, the risk of developing arterial hypotension increases.
With simultaneous use with immunosuppressants, cytostatics increases the risk of developing leukopenia.
With the simultaneous use of potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements to food containing potassium, the development of hyperkalemia (especially in patients with impaired renal function) is possible. ACE inhibitors reduce the content aldosterone, which leads to a delay in potassium in the body against a background of limiting the excretion of potassium or its additional intake into the body.
With the simultaneous use of opioid analgesics and anesthesia, the antihypertensive effect of enalapril is enhanced.
With the simultaneous use of "loop" diuretics, thiazide diuretics, the antihypertensive effect is enhanced. There is a risk of hypokalemia. Increased risk of impaired renal function.
With simultaneous use with azathioprine, the development of anemia is possible, which is due to the inhibition of erythropoietin activity under the influence of ACE inhibitors and azathioprine.
A case of development of anaphylactic reaction and myocardial infarction with allopurinol in a patient receiving enalapril is described.
Acetylsalicylic acid in high doses can reduce the antihypertensive effect of enalapril.
Finally, it is not established whether acetylsalicylic acid reduces the therapeutic efficacy of ACE inhibitors in patients with ischemic heart disease and heart failure. The nature of this interaction depends on the course of the disease.
Acetylsalicylic acid, by inhibiting COX and the synthesis of prostaglandins, can cause vasoconstriction, which leads to a decrease cardiac output and worsening of patients with heart failure receiving ACE inhibitors.
With the simultaneous use of beta-blockers, methyldopa, nitrates, calcium channel blockers, hydralazine, prazosin, an increase in antihypertensive effect is possible.
When used simultaneously with NSAIDs (including indomethacin), the antihypertensive effect of enalapril decreases, apparently due to inhibition under the influence of NSAID synthesis of prostaglandins (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors). Increased risk of renal dysfunction; rarely observed hyperkalemia.

Patient Reviews

We offer you to read reviews of people who used Enalapril:

Tatyana. I accept enalapril on 10 mg. The whole day the pressure is up to 140, by the evening it can rise, but insignificantly. It's only a cough that has completely tortured, it looks like whooping cough. Has canceled tablets, in 5 days the cough has ceased, but pressure jumps up to 190. Previously, the doctor appointed Noliprel - it's generally a nightmare, a cough such that the guard. Attacks 4 times per hour, severe perspiration in the throat. Now, after a week of abolition of enalapril, I drink it again, I'm waiting for the cough to start ...
Elvira. My father has high blood pressure for many years, he regularly took Enalapril tablets. And recently I had to get acquainted with this drug. Nevertheless, the hereditary factor makes itself felt, I also began to have problems with blood pressure, so I bought a tonometer, and the doctor advised the drug I already knew - Enalapril from pressure. Now I take pills twice a day after that, I need to lie down a bit, and the condition quickly returns to normal. The drug is good and inexpensive, and no side effects yet.
Tatyana. I can not say anything bad about this drug. I was advised by his mother. She takes it regularly. I often get nervous, I worry. The result is increased blood pressure, headaches, poor health, nausea. And enalapril is always at hand. Sex pills and the pressure quickly normalizes, the condition improves. I do not observe addictions. Therefore, I think, and the rest, too, will do.

Analogues

Structural analogs for the active substance:

Bagopril;
Berlipril 10;
Berlipril 20;
Berlipril 5;
Vazolapril;
Vero-Enalapril;
Involor;
The Korandil;
Myopril;
Renipril;
Renitek;
Ednit;
Enazil 10;
Enalacor;
Enalapril HEXAL;
Enalapril-Aggio;
Enalapril-AKOS;
Enalapril-Acry;
Enalapril-UBF;
Enalapril-FPO;
Enalapril maleate;
Enam;
Enap;
Enarenal;
Enafarm;
Envas;
Envipril.

Before buying an analogue, consult your doctor.

Shelf life and storage conditions

Shelf life of Enalapril tablets is 3 years. The drug should be stored in a dark, dry place inaccessible to children at an air temperature of +15 to + 25 ° C.