Renitek is a remedy aimed at eliminating the symptoms of high blood pressure. The preparation is based on enalapril maleate, which is the active ingredient.
Antihypertensive effect of the drug develops during the first hour, and its peak is noted 4-6 hours after taking the drug. The duration of action is determined by the dose taken.
When using the therapeutic doses listed in the instructions for use, the antihypertensive effect is maintained throughout the day.
Clinical and pharmacological group
Terms of sale from pharmacies
It is possible to buy under the prescription of the doctor.
How much does Renitek cost in pharmacies? The average price is at the level of80 rubles..
Composition and form of release
The drug Renitek is available in the form of a tablet for oral administration (oral administration). They have a triangular shape and several colors, depending on the dosage of the main active ingredient - white (5 mg), pink (10 mg) and light pink with a yellowish tinge (20 mg) color.
Composition of 1 tablet:
- active ingredient: enalapril maleate - 5, 10 or 20 mg;
- auxiliary components (5/10/20 mg): sodium bicarbonate -, (5/10 mg; lactose monohydrate - 19, / 16, / 15, mg; pregelatinized starch -, 6 /, /, mg; corn starch - 2, 7/22/22 mg; magnesium stearate -, (1), mg; yellow iron oxide (E172) - 0/0, 3 mg; red iron oxide (E172) - 0 /, /, 5 mg.
Tablets are packaged in a blister pack of 7 pcs. Cardboard pack contains 1, 2 and 4 blisters with tablets, as well as instructions for the preparation. For a dosage of 10 and 20 mg, there is also a packing of tablets in a vial of dark glass in an amount of 100 pieces. In this case, the cardboard pack contains 1 vial of tablets.
Renitek and Co-Renitek - what's the difference?
A more effective drug, similar in effect to Renitek, is the combined antihypertensive drug Ko-Renitek. In its composition, in addition to elanapril 20 mg, there is a diuretic hydrochlorothiazide (1, mg).
Combined action of the drug is based on a combination of vasodilating and diuretic effect. Co-Renitek is usually prescribed in severe form of hypertension to reduce the burden on the heart and blood vessels.
The drug is an antihypertensive agent. The active component of the drug is converted into the body in enalaprilat, which inhibits ACE (angiotensin-converting enzyme). This prevents the conversion of angiotensin I into angiotensin II and the synthesis of aldosterone, and also increases the plasma renin activity. In addition, the drug increases the level of prostaglandin E and nitric oxide, reduces the excretion of potassium ions in insignificantly, accelerates the excretion of sodium ions, and also reduces the level of circulating catecholamines.
Active substance RENITEK helps reduce blood pressure. In people with essential hypertension, it also interferes with overall peripheral vascular resistance and contributes to increased cardiac output. In patients with renal function problems and proteinuria, albuminuria, urinary excretion of IgG and a common urine protein are observed. And in the case of heart failure, the frequency of ventricular arrhythmias decreases.
Enalaprilat helps in regression of left ventricular hypertrophy with the maintenance of systolic function.
After the application of the tablets, the effect is developed within 1-4 hours, they remain effective throughout the day. The drug is quickly absorbed, and then split to enalaprilat. The time of food intake does not affect their effect.
The maximum decrease in blood pressure is observed after about 5 hours after application of the drug.
Indications for use
- Renovascular hypertension;
- essential hypertension;
- any stage of CH.
In the presence of clinical manifestations, Renitec is also appointed to achieve the following goals:
- increased survival of patients;
- decrease in the frequency of hospitalizations associated with heart failure;
- slowing the progression of heart failure.
In the absence of clinical symptoms of heart failure in patients with impaired left ventricular function, Renitek is assigned to achieve the following goals (prevention of development of clinically pronounced HF):
- decrease in the frequency of hospitalizations associated with heart failure;
- slowing the onset of clinical manifestations of heart failure.
With left ventricular dysfunction, Renitek is assigned to achieve the following goals (prevention of coronary ischemia):
- reduction in the frequency of hospitalizations associated with unstable angina;
- decrease in the incidence of myocardial infarction.
At what pressure do they take the medicine?
Since the medicine Renitek is declared as an antihypertensive drug, it should be used only according to the instructions on the application, in which arterial hypertension is indicated, as the target group of diseases in the treatment with the drug Renitek.
Arterial hypertension is diagnosed when the pressure has the property to reach and exceed the indices of 140/90 mm Hg. Art. Therefore, it is possible to say exactly at what pressure the instruction on application to Renitek recommends the use of the drug.
Medical contraindications to the use of Renitek tablets are several pathological and physiological conditions of the body, which include:
- Individual intolerance to any of the components of the drug.
- The development of angioedema, triggered by the intake of any drugs of the pharmacological group, ACE inhibitors, including in the past.
- Hereditary (due to a genetic defect transmitted from parents to children) or idiopathic (the cause of the pathological process can not be established) angioedema - the output of blood plasma in the intercellular substance of soft tissues due to increased permeability of the walls vessels.
- Age under 18 years, as the effectiveness and safety of the drug in this situation is not reliably proven.
Before starting taking Renitek tablets, it is important to make sure there are no contraindications to their use.
Dosage and route of administration
As indicated in the instructions for use, Renitec is taken internally, regardless of food intake, as the absorption of tablets depends on the intake of food.
The initial dose is 10-20 mg, depending on the severity of hypertension and is prescribed 1 time / day. With a mild degree of arterial hypertension, the recommended initial dose is 10 mg / day. At other degrees of arterial hypertension, the initial dose is 20 mg / day with a single dose. Maintenance dose - 1 tab. 20 mg once a day. Dosage is selected individually for each patient, but the dose should not exceed 40 mg / day.
Since in patients in this group, blood pressure and renal function may be particularly sensitive to ACE inhibition, therapy starts with a low initial dose of 5 mg or less. Then the dose is selected according to the patient's needs. Usually an effective dose of 20 mg / day with daily intake. Care should be taken when treating patients who have received diuretic treatment shortly before.
Concomitant treatment of arterial hypertension with diuretics
After the first reception of Renitek, hypotension may develop. This effect is most likely in patients who are treated with diuretics. The drug is recommended to be administered with caution. such patients may have a deficiency of fluid or sodium. Treatment with diuretics should be discontinued 2-3 days before treatment Renitek. If this is not possible, the initial dose of Renitech should be reduced (to 5 mg or less) to determine the primary effect of the drug. Then the dosage should be selected taking into account the patient's condition.
The initial daily dose of Renitec, depending on the creatinine clearance:
- 30-80 ml / min (minor disorders): 5-10 mg;
- 10-30 ml / min (moderate disorders):, -5 mg;
- <10 ml / min (severe disorders, such patients are usually on hemodialysis):, mg on days dialysis (correction of the dose on days when hemodialysis is not carried out, should be carried out depending on the level HELL).
Cardiac insufficiency / asymptomatic dysfunction of the left ventricle
The initial dose of Renitek in patients with heart failure or with asymptomatic left ventricular dysfunction is 2.5 mg, with the purpose of the drug should be carried out under close medical supervision to establish the primary effect of the drug on HELL. Renitec can be used to treat heart failure with severe clinical manifestations, usually in conjunction with diuretics and, when necessary, cardiac glycosides. In the absence of symptomatic hypotension (caused by Renitek treatment) or after appropriate correction, the dose should be gradually increase to the usual maintenance dose of 20 mg, which is assigned either once, or divided into 2 doses, depending on the tolerance of the drug patient. The dose can be selected within 2-4 weeks or in shorter periods if there are residual signs and symptoms of heart failure. Such a therapeutic regimen effectively reduces the mortality rates of patients with clinically significant heart failure.
Both before and after the initiation of Renitek treatment, careful monitoring of blood pressure and renal function should be performed in patients with heart failure, because there were reports of development as a result of taking the drug arterial hypotension followed by (which is much less common) the occurrence of renal insufficiency. In patients receiving diuretics, the dose of diuretics should be reduced as far as possible before treatment with Renitek. The development of arterial hypotension after taking the first dose of Reniteka does not mean that the arterial hypotension will persist with long-term treatment, and does not indicate the need for discontinuation preparation. When treating Renitek, you should also monitor the potassium level in the serum.
The drug is usually well tolerated by patients, most side effects are mild and do not require drug withdrawal.
- From the hemopoietic system: thrombocytopenia, neutropenia, agranulocytosis.
From the urinary system: a violation of kidney function, oliguria, acute renal failure.
- From the cardiovascular system: arterial hypotension, including orthostatic hypotension, palpitation, arrhythmia, angina pectoris, chest pain. In isolated cases, mainly in patients at risk, it is possible to develop a myocardial infarction or stroke.
- From the gastrointestinal tract and liver: nausea, vomiting, stool discomfort, pain in the epigastric region, decreased appetite. In isolated cases, there was a development of hepatitis, jaundice, intestinal obstruction, pancreatitis.
- From the central and peripheral nervous system: headache, dizziness, increased fatigue, tinnitus, cramps, asthenia, emotional lability, disturbed sleep and wakefulness, paresthesia. In isolated cases, development of depression and confusion of consciousness is possible.
- On the part of laboratory indicators: an increase in the level of urea, creatinine, bilirubin and liver enzymes in the blood plasma. In isolated cases, it is possible to develop an increase in the level of potassium and reduce the level of sodium in the blood, as well as reduce the hematocrit and hemoglobin. Allergic reactions: skin rash, itching, urticaria, Quincke's edema, bronchospasm, allergic rhinitis, Stevens-Johnson syndrome.
- Others: dry cough, pharyngitis, excessive sweating, alopecia, erectile dysfunction, visual impairment.
At dosages in excess of normal, arterial hypotension appears, which is noticeable six hours after admission and coincides with the blockade of the renin-angiotensin system. There may also be a stupor.
As a therapy, an isotonic solution is administered intravenously. If an overdose has occurred recently, it is recommended to do a gastric lavage. The active substance can also be removed from the systemic circulation by hemodialysis.
The development of clinically pronounced arterial hypotension in patients with uncomplicated arterial hypertension is rare. During therapy in patients with arterial hypertension, this disease often develops against the background of hypovolemia, which is associated with diuretic therapy, salt intake restriction, in hemodialysis patients, as well as with diarrhea or vomiting. Clinically pronounced arterial hypotension can be observed in patients with heart failure with or without renal failure. In the case of development of arterial hypotension, the patient must take a prone position, if necessary, intravenously injected physiological sodium chloride solution.
When you receive Renithek transient arterial hypotension to further treatment is not a contraindication, after replenishing the volume of fluid and normalizing blood pressure, the drug can be continued. In some patients with HF and normal / low blood pressure, the use of Renitek may cause an additional decrease in blood pressure. Such a reaction to the drug is expected, and there is no need to regard it as a reason for discontinuing therapy. In those cases, if the arterial hypotension takes a stable character, a reduction in the dose and / or elimination of the diuretic / Renitec is indicated.
In patients who have a history of angioedema, which is not associated with the use of ACE inhibitors, it is possible to increase the likelihood of its appearance and with the use of Renitec. The frequency of angioedema development in patients of the Negroid race is higher than in representatives of other races.
There are reports of rare cases of life-threatening anaphylactic reactions during the hypensensitization of the allergen from Hymenoptera venom. To avoid such reactions it is possible, if before the beginning of hyposensitization temporarily to cancel Renitek.
There is information about the appearance of cough during the application of the drug. In most cases, cough is unproductive, permanent and after the abolition of Reniteca stops (you need to consider when conducting differential diagnosis of cough).
The main risk factors for hyperkalemia are renal failure, diabetes mellitus, combined use with potassium-sparing diuretics (spironolactone, triamterene or amiloride). Also, the risk increases with the use of potassium-containing additives and salts. It must be taken into account that hyperkalemia can lead to serious (in some cases fatal) violations of the heart rhythm. In cases of need for combined use with the above potassium-containing or increasing content Potassium should be taken with caution and regular monitoring of serum potassium content in blood.
Impact on the ability to drive vehicles
Because of the likelihood of developing dizziness (especially after taking the initial dose of Renitech in patients, taking diuretics), during the period of therapy in the management of motor vehicles, caution.
Interaction with other drugs
Antihypertensive and diuretic drugs in combination with the drug Renitek contribute to the intensification of antihypertensive action. With the combined use of the drug with potassium-sparing diuretics and potassium preparations, the risk of developing hyperkalemia increases. The drug with simultaneous use reduces the excretion of lithium and increases the toxicity of lithium preparations. With the simultaneous use of the drug with non-narcotic analgesics, the risk of developing nephrotoxic action is increased.
We offer you to read reviews of people who used Renitek:
- Elena. I have been taking it since 2006, the dose started was 5 mg in the morning, after 5-6 I switched to 10 mg myself and so on until now, about sometimes I drink and in the evenings. The doctor advised. To get up in the morning with normal pressure. About pobochki written, they can be in rare cases, this is so. I'm just not going to feed, if there is pobochk, and for what. And with this medicine I feel good. I am 62 years old. There was a lot of hypertensive cryosis, oh God of Milov, when they were lying, they were to blame himself, then stopped taking medicine. When you drink every day with small interruptions with good health, the pressure is normal. I have a norm of 170/8, it rarely happens. In case of emergency, I drink a hood.
- Julia. Renitek recommended the doctor to her husband, he sometimes raises blood pressure - up to 150-160. The drug helps, the pressure drops for an hour. Always keep it in the home medicine cabinet and car. Conveniently, the drug can be taken regardless of food intake. Subtracted in the instruction that the same drug can be used to maintain kidney function, I have chronic renal failure. Has consulted with the doctor and now I accept "Renitek" as a preventive agent. The price is low, which is also important.
Structural analogs for the active substance:
- The Korandil;
- Enazil 10;
- Enalapril maleate;
Before buying an analogue, consult your doctor.
Shelf life and storage conditions
The optimum storage temperature of the described preparation is up to 25 degrees. Do not give the drug to children. Keep, years from the date of manufacture. The exact expiration date is indicated on the package of this preparation.
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