Enam

Enam – anti-hypertensive drug.

Structure and form of release of Enam

Drug produce in the form of tablets in a dosage 2,5 mg, 5 mg and 10 mg. Active agent of drug – enalapril a maleate.

In blister strip packagings on 10 tablets. On 20 tablets in a cardboard pack (on two packagings).

Pharmacological action

According to the instruction Enam is anti-hypertensive drug. The operating component quickly is soaked up in an organism, forming pharmacological active agent – enalaprilat. Enam's use brakes an angiotensin-converting enzyme in an organism, preventing transformation of angiotensin I into angiotensin II that promotes decrease in the general peripheric resistance of vessels, reduces the level of Aldosteronum and increases the level of bradikinin, activates depressor systems and oppresses pressor systems.

Enam's reception according to indications leads to decrease in diastolic and systolic pressure, without developing at the same time reflex tachycardia.

According to reviews Enam reduces a hypertrophy of a left ventricle and reduces the need of a myocardium for oxygen. In the conditions of a hypoxia improves a condition of a cardiac muscle. Drug interferes with development of a diabetic nephropathy, strengthens a renal blood stream that leads to reduction of cordial mortality. Enam does not exert impact on carbohydrate and lipidic metabolism.

Indications to Enam's use

According to the instruction Enam appoint for treatment of the patients having arterial hypertension in various form including essential arterial and renovascular hypertensia.

Besides, the indication to Enam is chronic heart failure (as a part of a combination therapy).

Use drug for prevention of coronary ischemia and the expressed heart failure at patients with reduced function of a left ventricle.

Route of administration of Enam and mode of dosing

According to the instruction Enam is intended for intake. Accept drug irrespective of meal, as a rule, once a day approximately in identical time. The dosage of drug depends on age of the patient and indications to Enam.

At essential hypertensia at adults, as a rule, the dosage makes 2,5-5 mg a day. The maximum dosage of drug makes 40 mg a day.

Before reception of enalapril it is recommended to the patients accepting diuretics to stop their reception at least for three days. Begin therapy by Enam with the minimum dosage, gradually increasing it to optimum.

At heart failure at adults the initial dosage makes 2,5 mg a day with its gradual increase up to 20 mg.

At reduced function of kidneys the dosage of enalapril needs constant correction. The maximum daily dosage for people with reduced clearance of creatinine from 30 to 80 ml/min. equals 10 mg, and at clearance of creatinine from 10 to 30 ml/min. – 5 mg. For the patients who are on a hemodialysis, the maximum daily dosage makes 2,5 mg.

Between increase in dosages intervals have to make not less than two weeks.

For children over six years at arterial hypertension the initial dosage of Enam makes 2,5 mg a day. The maximum daily dosage for children is calculated, proceeding from 0,58 mg on weight kg.

Contraindications

In the instruction to Enam the following contraindications are specified:

• hypersensitivity to enalapril and other components of drug;
• aortal and mitral stenosis;
• period of pregnancy and breastfeeding;
• reduced function of kidneys (clearance of creatinine less than 30 ml/min.);
• idiopathic or hereditary Quincke's disease;

According to reviews Enam is not recommended to accept to patients with a glyukozo-galactose sprue, a galactosemia and a lactose intolerance as as a part of drug there is a lactose.

Enam appoint with care at:

• hypovolemia;
• disturbance of a cerebral blood-groove;
• coronary heart disease;
• disturbance of water-salt balance;
• heart failure;
• the lowered function of kidneys;
• stenosis of renal arteries.

Side effects of Enam

Enam according to reviews is preferential well had by patients. In the initiation of treatment perhaps insignificant lowering of arterial pressure, increased fatigue and dizziness. Besides, drug can cause the following by-effects:

• Respiratory system: rhinorrhea, pharyngitis, glossitis, short wind, unproductive cough. When developing cough it is recommended to cancel reception of enalapril and to appoint alternative therapy.
• Cardiovascular system: bradycardia, myocardial infarction, stenocardia, tachycardia.
• Digestive tract: disturbance of digestion and a chair, nausea, a xerostomia, pancreatitis, pain in epigastric area, increase in activity of hepatic transaminases, liver depression of function. In addition, Enam according to reviews can cause stomatitis, intestinal impassability, a loss of appetite and change of flavoring feelings.
• Central nervous system: depression, headache, spasms, sleeplessness, incoordination of movements, sonitus, paresthesias.
• System of a hemopoiesis: a hypoglycemia, a neutropenia, reduction of level of leukocytes, a hematocrit and hemoglobin, a proteinuria, increase in concentration in a blood plasma of bilirubin and potassium.
• Allergies: bronchospasm, urticaria, skin itch. There can seldom be Quincke's diseases of the person, lips and language, a throat. In this case acute management is required.
• Other side effects: an agranulocytosis, disturbance of an erection, an alopecia, Reynaud's syndrome, inflows, a renal failure, the increased perspiration.

In addition to above-mentioned symptoms Enam's use can cause development of simpatokompleks as a part of which are present: vasculitis, hyperemia, joint pain and muscles, eosinophilia, leukocytosis, increase in a blood sedimentation rate and presence at an organism of antinuclear bodies.

Drug use Enam during pregnancy and breastfeeding

Enam is contraindicated during pregnancy. Before beginning therapy with enalapril, it is recommended to exclude probability of pregnancy, and during reception to use well-tried remedies of contraception. If pregnancy nevertheless occurred, Enam's reception needs to be stopped.

When using drug in the period of a lactation it is necessary to resolve an issue of the breastfeeding termination.

Overdose

According to reviews Enam in too high dosages leads to developing of arterial hypotension.

In case of overdose it is necessary to make a gastric lavage and to carry out a symptomatic treatment.

Storage conditions

Enam store in the dry place at the room temperature not longer than 36 months.