Enalapril

General characteristics. Structure:

Active ingredient: 10 mg of enalapril of a maleate.

Pharmacological properties:

Pharmacodynamics. Enalapril — angiotensin-converting enzyme inhibitor. Suppresses formation of angiotensin II and eliminates its vasoconstrictive action, increases cordial emission, reduces the vascular resistance, pressure in a small circle of blood circulation. Promotes increase in level of potassium in blood serum.

Lowering of arterial pressure is shown in 1 hour after reception, reaches a maximum in 6 hours and continues within 1 days. At heart failure long (within 6 months) treatment increases portability of exercise stresses, promotes reduction of the sizes of heart, reduces a lethality.

Pharmacokinetics. After intake about 60% of the accepted dose are soaked up (irrespective of meal). The maximum concentration in blood is reached within 1 hour. Enalapril is exposed to biotransformation with formation of an active metabolite — enalaprilat which maximum concentration in blood is reached in 4 hours. Enalaprilat easily passes through gistogematichesky barriers, excepting a blood-brain barrier, gets through a placenta. The elimination half-life of T1/2 makes 11 hours. Within 24 hours about 90% of the accepted dose eliminirutsya. It is excreted preferential by kidneys (to 40% it is removed in the form of enalaprilat).

Indications to use:

Arterial hypertension, including renovascular, chronic heart failure.

Route of administration and doses:

Drug is used inside. The dosing mode — individual. The initial dose makes 2,5 — 5 mg of 1 times a day. An average dose — 10 — 20 mg a day in two steps. The maximum recommended dose — 40 mg a day (in rare instances — to 80 mg a day).

Features of use:

With extra care it is necessary to apply enalapril at patients with reduced function of kidneys, a liver; along with immunodepressants; at a bilateral stenosis of renal arteries.

Precautionary measures. With extra care it is necessary to apply enalapril at patients with reduced function of kidneys, a liver; along with immunodepressants; at a bilateral stenosis of renal arteries.

Side effects:

The majority of side effects has temporality and does not demand drug withdrawal. Dizziness, nausea, a headache, increased fatigue, dry cough are possible. There can seldom be heartbeat, orthostatic hypotonia, pains in heart. From digestive tract — an abdominal pain, diarrhea; abnormal liver function, kidneys; hyperpotassemia, increase in level of hepatic transaminases, bilirubin; muscular spasms. Very seldom at the maximum dosage there can be frustration of a dream, rash on skin, nervousness, a depression, disturbances of balance, paresthesia, a sonitus, a sight ambiguity.

Interaction with other medicines:

At a concomitant use with NPVS decrease in their effect is possible, at appointment with kaliysberegayushchy diuretics the risk of development of a hyperpotassemia, with lithium salts — lithium removal delay increases. Enalapril strengthens effect of alcohol.

Contraindications:

Quincke's disease in the anamnesis. Pregnancy, lactation, children's age. Hypersensitivity to enalapril and other APF inhibitors.

Overdose:

Symptoms: hypotonia, development of a myocardial infarction, an acute disorder of cerebral circulation and tromboembolic episodes against the background of a sharp lowering of arterial pressure.

Treatment: intravenous administration of isotonic solution of sodium of chloride and symptomatic therapy.

Issue conditions:

According to the recipe

Packaging:

Tablets on 10 mg in packaging No. 30.