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Active ingredient: Enalapril
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Enalapril general information

Lowering blood pressure is just a condition that is certainly below the normal expected for a person in a specific environment. In case these changes don’t decrease your blood pressure, you might need medication. In the event your blood pressure isn’t controlled with a diuretic, you might need to bring another medication. It could raise the blood sugar level. Don’t drink alcohol in excessive quantities. This is useful to your own blood.

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Enalapril (Enalapril): instruction, and the use of a formula

The nosological classification (ICD – 10)

Code CAS

Feature substance enalapril

Enalapril maleate ; white or almost white crystalline powder, poorly soluble in water, soluble in alcohols, methyl and ethyl. Molecular weight 492,43.

Pharmacology

Mode of action – the hypotensive, vasodilatory, cardioprotective, natriuretic.

It inhibits ACE. inhibits the biosynthesis of angiotensin II, is a vasoconstriction and induces the formation and release of aldosterone, and prevents destruction of bradykinin and PGE ₂ (potent endogenous vasodilator).

absorbed after oral administration around 60% (regardless of the presence of food in the gastrointestinal tract). C _max is achieved within 1 h biotransformation in the liver to the active metabolite .; enalaprilat, C _max is determined after 4 hours. enalaprilat easily passes through the blood-tissue barriers, eliminating the BBB. It crosses the placenta. T _1/2 is 11 hours. Excreted mainly kidneys (up to 40% is excreted in the form of enalaprilat). Within 24 hours it eliminated to 90% amount administered. Lowering blood pressure seen after 1 h after ingestion, reaches a maximum of 6 hours and lasts for 1 day. In some patients, to achieve optimal blood pressure therapy is required for several weeks. In heart failure, long-term (over 6 months) treatment increases exercise tolerance, reduces the size of the heart, reduces mortality. The antihypertensive effect of enalapril caused a decrease in blood levels of angiotensin II and aldosterone, increased concentration of bradykinin and PGE ₂ . Reducing PR accompanied by an increase in cardiac output without a change in heart rate. lowering the pressure in the pulmonary capillaries and unloading the pulmonary circulation, the consequence of which is to increase exercise tolerance and reducing the size of dilated heart.

Application of the substance enalapril

Essential hypertension, symptomatic hypertension, heart failure, diabetic nephropathy, secondary hyperaldosteronism, Reynaud’s disease, scleroderma, complex therapy of myocardial infarction, angina, chronic renal failure.

Contraindications

Hypersensitivity, pregnancy, lactation, children’s age.

Application of pregnancy and breastfeeding

Category effects on the fetus by FDA ; D.

Side effects of substance enalapril

Inhibition of the CNS. depression, ataxia, seizures, drowsiness or insomnia, peripheral neuropathy, visual disturbances, taste, smell, tinnitus, conjunctivitis, watery eyes, hypotension, myocardial infarction, acute cerebrovascular accident (as a consequence of hypotension), cardiac arrhythmias (atrial tachy – or bradycardia, atrial fibrillation), orthostatic hypotension, angina, thromboembolism of pulmonary artery branches, bronchospasm, dyspnea, nonproductive cough, interstitial pneumonia, bronchitis and other upper respiratory tract infection, rhinorrhea, stomatitis, dry mouth, glossitis, anorexia, dyspepsia, melena, constipation, pancreatitis, hepatic dysfunction (cholestatic hepatitis, hepatocellular necrosis), renal dysfunction, oliguria, urinary tract infection, gynecomastia, impotence, neutropenia, thrombocytopenia, exfoliative dermatitis, toxic epidermal necrolysis, pemphigus, herpes zoster, alopecia, fotodermatit, allergic reactions (Stevens – Johnson syndrome, urticaria, angioedema, anaphylactic shock, and others.).

Interaction

Effects of enalapril increase diuretics, antihypertensive drugs, alcohol, relax ; estrogen, NSAIDS. sympathomimetics. Potassium-sparing diuretics and kalisodergaszczye drugs increase the risk of hyperkalemia.

Overdose

Symptoms: excessive hypotension, myocardial infarction, acute stroke and thromboembolic events against the background of a sharp decline in blood pressure.

Treatment: / in the introduction of isotonic sodium chloride solution and symptomatic therapy.

Dosing and Administration

inside Initial dose .; 5 mg 1 time a day, and in patients with kidney disorders or those taking diuretics ; 2.5 mg 1 time per day. With good tolerability and the need for dose may be increased to 10 – 40 mg once a day or in two.

Precautions substance enalapril

The initial dose is administered in a hospital for constant monitoring of blood pressure for at least 3 hours. In the course of therapy is necessary to periodically monitor the concentration of transaminase and alkaline phosphatase in the bloodstream (by increasing their content cancel treatment). Be wary appointed with impaired renal function (titration should be carried out under the control of the blood concentration of enalapril as the glomerular filtration rate is inversely proportional to its level in plasma).

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