Probably every person feels high blood pressure throughout his life. For some, it is restored on its own, and for this, pharmaceuticals are needed to help. One such remedy is enalapril.

Composition, release form and packaging

The pharmaceutical industry produces medicine in tablet form in white. The main active substance in the composition has the same name with the drug. In pharmacies you can find cardboard packaging, inside of which are tablets of 5, 10 and 20 mg. Auxiliary components are lactose with stearin, crospovidone with magnesium stearate and other ingredients. Packaging - 2 or 3 plates of 10 pieces.

Pharmacological action, pharmacodynamics and pharmacokinetics

Enalapril tablets have a lowering effect on blood pressure, widen the lumen of blood vessels, cause active urination and restore myocardial function.

The purpose of the drug extends to primary arterial hypertension, regardless of severity. Tablets can be taken both independently and together with other means of a similar property. The medication is also used in the treatment and prevention of heart failure.

Enalapril is characterized by rapid absorption in the body and hydrolysis to enalaprilat (an active ACE inhibitor without sulfhydryl group). Under the action of the drug, arteries expand without increasing heart rate.The active substance blocks the destruction of the peptide with a pronounced vasodilating effect.

In patients with arterial hypertension, the drug reduces high rates regardless of the position in which they are standing or sitting. At the same time, postural hypotension is a very rare phenomenon in the treatment of this agent.

After 2-4 hours after a single tablet, inhibition of ACE activity begins. A decrease in pressure can be observed after 4-6 hours. The dose affects the duration of the drug. Efficiency persists throughout the day. There are cases when the optimal decrease in blood pressure is observed after several weeks of treatment. When interrupting therapy, blood pressure does not rise sharply.

Treatment with this drug stops the process of left ventricular hypertrophy, while maintaining systolic function. With a diagnosis of essential hypertension and a decrease in blood pressure, OPSS becomes lower. At the same time, cardiac output increases, but the heart rate does not change.

Taking enalapril increases blood flow in the kidneys without changing GFR and without delaying sodium with fluid. If you drink the medicine for a long time to people suffering from insufficient kidney function, then the organs begin to function better. This eliminates albuminuria and decreases the total protein in the urine.

Enalapril does not adversely affect the amount of uric acid in blood plasma. The active substance reaches the blood serum after an hour after administration, absorbed by 60%. The next step is hydrolysis. It occurs after 4 hours. The medicine is excreted through the kidneys and intestines.

What helps enalapril

Enalapril intake is limited to diseases of the cardiovascular system, extending to hypertension in its primary forms, as well as:

  • arterial hypertension (secondary), where the initial stage was accompanied by renal pathologies;
  • Renovascular hypertension;
  • disturbed work of the left ventricle even in the absence of symptoms;
  • insufficient heart activity in a chronic form;
  • nephropathy (diabetic).

Coronary heart disease is also on the list of indications for the appointment of a medication. Stagnant processes in heart failure are also included. The drug proved to be excellent in conditions where bronchospasm was noticed.

Instructions for use and dosage

The medicine is taken only inside, which is not affected by food intake. At the initial therapeutic stage, the recommended dose is 5 mg per day. In the absence of the proper effect, the amount of the drug increases to 10.

If the patient tolerates the active substance well, then the permissible dosage is 40 mg taken 2 times a day. After 2-3 weeks, this amount decreases to 10-40. If hypertension is moderate, then it is enough to drink 10 mg per day.

How to take with hyponatremia - the doctor will explain. The initial dose is 2.5 mg, and with a diagnosed renovascular hypertension it can go up to 5. The severe form of the disease gives reason to administer the drug intravenously, which is done in a hospital.

Important: the decision on the need for enalapril is taken only by the doctor - self-medication is unacceptable.

Chronic heart failure patients are advised to give 2.5 mg, increasing the dosage by the same amount every 3 or 4 days. The maximum amount per day should not exceed 40 mg.

Older people can be prescribed 1.25 mg. If the left ventricle is disturbed without the presence of symptoms, the recommended dose is 5 mg, divided into 2 2.5 mg. The daily dose should also not exceed 40 mg.

During pregnancy and lactation

Pregnancy and lactation are the times when taking enalapril is contraindicated.It has been scientifically proven that the active component in the drug has a teratogenic effect, due to which, with prolonged use, the fetus can develop serious pathologies up to the death.

If a woman took the remedy during the period of gestation, the baby will need to be monitored by doctors to assess blood flow in the brain and kidneys.

Important: accurate information that a pregnancy has come provides a basis for stopping the drug. If it is vital, specialist advice will be required.

If it is impossible to do without such drugs, then Enalapril will need to be replaced with another, safer at elevated pressure.

Taking the medicine in late pregnancy leads to the appearance of poor kidney function, arterial hypotension, various developmental delays and other health problems in the baby.

In some quantities, the active substance enters the milk of a nursing mother, therefore, during the treatment period, it will be necessary to switch to artificial feeding.

Drug interaction

Non-steroidal drugs with anti-inflammatory effects, as well as hormonal and sympathomimetics, have a reducing effect on enalapril.

Medicines with lithium salts in the composition, taken with Enalpril, lead to a delay in the excretion of the first. And this leads to the accumulation of toxins.

A long reception with a medication of potassium-sparing diuretics makes this mineral accumulate in the body, which subsequently leads to hyperkalemia.

Suitable for co-administration of aspirin-based drugs. They help to more effectively deal with pathologies of the cardiovascular system.

Special instructions for admission

If you have to follow a low-salt diet or eat completely without salt, then you will need to take the medicine with caution, with constant monitoring of blood pressure and kidney function. You also need to constantly check the number of transaminases with alkaline phosphatase in the bloodstream.

Constant medical monitoring is required for impaired renal function, for which a blood test is done.

2-3 days before taking the medicine, stop using diuretics, if any.

Contraindications, side effects and overdose

To normalize the pressure with this tool without fear, you need to know about pathologies and problems in which it will need to be replaced with another.

The limitations include:

  1. Individual intolerance and sensitivity to angiotesin-converting enzymes.
  2. Quincke's edema previously transferred, including cases with unexplained causes of its appearance.
  3. The negative reaction of the body to lactose.
  4. Age to 18 years.

Continuous medical supervision will be required for kidney failure and liver disease. This also includes a problem with blood flow in the region of the heart and brain, the recovery period after undergoing kidney surgery, as well as connective tissue disease.

A dosage adjustment will be required in people aged 65-70 years while taking it with drugs for the treatment of ischemia, if disorders in the endocrine sphere are diagnosed, with an increased amount of potassium in the blood test and hyponatremia.

Undesirable side effects occur in rare cases, but still, 5-10% may cause the appearance of headache with dizziness, depression, and general malaise with enalapril, including:

  • a strong decrease in blood pressure with orthostatic hypotension and arrhythmia;
  • pain behind the sternum and abdomen, nausea with an upset stool;
  • distortion of taste;
  • the appearance of a rash on the skin and swelling of the face;
  • dry mouth and cough.

In medical practice, such negative consequences from taking the drug as hypoglycemia and poor sleep with nightmares, fainting conditions and tinnitus with blurred vision are even less common.

Sometimes the work of the kidneys is impaired and the urinary tract is spasmodic with an upset urination process. In men, in rare cases, a disorder in the genital area was observed. Increased sweating is also one of the infrequent manifestations of enalapril.

It is noted that with regular treatment with these pills, the number of respiratory and urogenital diseases increases. There are complaints about the appearance of herpes, although the direct connection of these pathologies with the administration of enalapril has not been proven.

If it happens to take more than the prescribed amount, then overdose symptoms may appear 5-6 hours after this:

  1. Blood pressure decreases and bradycardia appears.
  2. The patient feels severe weakness, which in some cases reaches a collapse.

In the absence of timely medical care, myocardial infarction with renal failure may develop. The hardest result is a fatal outcome.

Analogues of the drug

Identical in terms of the mechanism of action and the most popular analogues of Enalapril are Bagopril or Evas, Enarenal or Enam, as well as Renitek.

If a dry cough became a side effect after taking the medicine, but tablets can not be dispensed with, then the best substitutes will be the medicines from Slovenia - Enar N and Enap HL.

And here is a list of new generation analogues:

  1. Renin inhibitors, Alskiren with Rasilez and Cardosal, do not cough like enalapril. Normalize blood pressure for a day.
  2. Olmesartan is more effective and faster on the body.
  3. For diabetics, the diuretic substitute for the drug is Trifas.
  4. Fosinopril is similar in action and equally effective.
  5. Advanced alpha and beta blocker Nebivolol.
  6. Long-term hypotensive effect in the medicines Equator and Amlodipine.

The German pharmaceutical industry produces Enalapril Hexal. It is important to know how it differs from enalapril? The first is different production technologies, and the second is the difference in the additional ingredients in the composition. But for the purpose of this or that drug, this does not matter, since their effect is similar.

Elanapril or Lisinopril - which is better? This question is often asked by doctors. They have various main active components, which is the only difference between them. It is impossible to answer the question of which one works more efficiently - each person has his own perception of drugs.

The reason for replacing the medication is the appearance of side effects and lack of effectiveness. But only the attending physician should prescribe or change this or that medicine.

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