Enalapril is an antihypertensive drug from the group of ACE inhibitors.
It has a hypotensive, cardioprotective, vasodilating and natriuretic effect on the body. The drug reduces the total peripheral vascular resistance, systolic and diastolic blood pressure. Prolonged use of Enalapril significantly reduces left ventricular hypertrophy of the myocardium, preventing the development of chronic heart failure.
The drug has a slight diuretic effect. The use of medication improves kidney and coronary blood flow. The antihypertensive effect of the drug appears 1 hour after it has been taken and lasts for 24 hours.
Terms of sale from pharmacies
You can buy by prescription.
How much does enalapril cost in pharmacies? The average price is at 15 rubles.
Composition and release form
Enalapril from pressure is available in a single dosage form - in the form of small white tablets, they contain the main active ingredientenalapril in three main dosages - 5, 10 and 20 mg. In addition to the active ingredient, the tablets contain auxiliary components (lactose, stearin, magnesium stearate, crospovidone, etc.). Generic Enalapril can have a dosage of 2.5 mg (for example, drugs such as Enap or Ednit).
Tablets of 10 pieces packed in blisters and packaged in cardboard packs. Each pack contains 2 or 3 blisters.
Enalapril has a hypotensive effect (gradually lowers blood pressure).
Other medicinal properties of the drug include:
- dilates blood vessels
- reduces the resistance of vessels in the periphery,
- weakens the load on the myocardium,
- lowers the pressure in the area of the small circle of blood circulation,
- increases the ability to withstand physical exertion
- reduces the strain in the left ventricle,
- improves the picture of glomerular hemodynamics in the kidneys (preventing diabetic nephropathy).
The drug contributes to the expansion of the arteries to a greater extent than the veins, without a reflex jump pulse readings. The maximum result is formed after 6-8 hours from the moment of reception and lasts for a day. A sustained therapeutic effect is formed after several weeks of therapy. The results of the treatment can be found in reviews posted at the end of the text.
About 60% of the dose received undergoes rapid absorption from the gastrointestinal tract. Drug metabolism occurs in the liver. From the body, it is excreted in the bulk by the kidneys, as well as the intestines.
Indications for use
Enalapril tablets are prescribed to control and stabilize blood pressure in the following conditions:
- symptomatic hypertension;
- kidney disease, accompanied by increased blood pressure;
- secondary hyperaldosteronism;
- coronary heart disease;
- bronchospastic conditions;
- left ventricular dysfunction;
- in the complex treatment of heart failure, exertional angina, and in the post-infarction period.
What pressure is prescribed?
Enalapril is prescribed for high blood pressure in case of renal arterial hypertension. Also, the drug is used for complex combined treatment of chronic heart failure.
Hypersensitivity to ACE inhibitors, renal artery stenosis, azotemia, hyper aldosteronism, hyperkalemia, renal dysfunction, angioedema (hereditary), aortic stenosis, childhood. Enalapril is not prescribed to pregnant women.
Appointment during pregnancy and lactation
The instructions say that the use of enalapril during pregnancy is contraindicated. If it has come, it is necessary to immediately stop taking the drug, except in those cases where it is impossible to replace the therapy with an alternative option. When taking the medication in the second and third trimesters, a fetotoxic effect and neonatal toxicity were recorded.
If enalapril cannot be stopped, a fetal ultrasound is required. According to reviews of mothers taking the drug while carrying a child, blood pressure is controlled in newborns. During lactation, the active substance penetrates the milk, so breastfeeding should be stopped. This threatens to have a negative effect on the kidneys and the heart.
Dosage and method of use
As indicated in the instructions for use with oral administration, the initial dose of Enalapril is 2.5-5 mg 1 time / day. The average dose is 10-20 mg / day in 2 doses.
When on / in the introduction - 1.25 mg every 6 hours. To identify excessive hypotension in patients with sodium deficiency and dehydration due to previous diuretic therapy, patients receiving diuretics, as well as renal insufficiency, are administered an initial dose of 625 mg. With an inadequate clinical response, this dose can be repeated after 1 hour and continue treatment at a dose of 1.25 mg every 6 hours.
The maximum daily intake dose is 80 mg.
On the background of taking enalapril tablets, the development of negative reactions from various organs and systems is possible:
- Reproductive system - when prescribed in high therapeutic doses in men, impotence may develop.
- The respiratory system is a periodic dry cough that may have a paroxysmal character.
- Blood and red bone marrow - a decrease in the number of neutrophils (neutropenia) in the blood.
- The skin and subcutaneous tissue is very rare, mainly when using high doses of the drug, the development of alopecia (hair loss) is possible.
- Nervous system - headache, intermittent dizziness, fatigue, rarely develops sleep disturbance, imbalance, tinnitus.
- Cardiovascular system - fainting, decrease in the level of systemic arterial pressure during the transition from a horizontal to vertical position of the body (orthostatic hypotension), the appearance of sensations of heartbeat, less likely to develop "hot flashes", pain in the region of the heart.
- The digestive system - nausea, rarely can vomiting, dry mouth, diarrhea, abdominal pain, increased concentration of bilirubin, as well as the activity of enzymes of hepatic transaminases in the blood, inflammation of the liver (hepatitis) or pancreas (pancreatitis).
- Urinary system - protein rarely appears in the urine (proteinuria), and renal function is also impaired.
- Allergic reactions - a rash on the skin, itching, urticaria (changes that look like nettle burns), angioedema of Quincke (marked edema of peripheral soft tissues, mainly in the area of the face and external genital organs).
The appearance of signs of the development of negative reactions is the basis for stopping enalapril tablets and contacting a medical specialist for advice.
Symptoms of overdose
In case of an overdose of the drug, the following symptoms are possible: a strong decrease in blood pressure up to the development of myocardial infarction, collapse, thromboembolic complications or cerebral circulation, stupor, convulsions.
If you find the above phenomena, the patient should be transferred to a horizontal position. In the case of a light overdose, gastric lavage and saline intake are performed. In more severe cases, the procedures aimed at stabilizing blood pressure (intravenous administration of plasma substitutes or saline solution, hemodialysis, administration of angiotensin II) are practiced.
Before you start using the drug, read the specific instructions:
- Before the study of the function of the parathyroid glands, enalapril should be abolished.
- With long-term treatment with enalapril, it is necessary to periodically monitor the pattern of peripheral blood. Sudden cessation of enalapril does not cause a sharp increase in blood pressure.
- During surgical interventions in the period of treatment with enalapril, hypotension may develop, which should be corrected by administering a sufficient amount of fluid.
It is used with extreme caution in patients with autoimmune diseases, diabetes mellitus, abnormal liver function, severe aortic stenosis, subaortic muscular stenosis of unclear genesis, hypertrophic cardiomyopathy, with loss of fluids and salts. In the case of prior treatment with saluretics, in particular in patients with chronic heart failure, the risk of orthostatic hypotension increases, so before starting treatment with enalapril, it is necessary to compensate for the loss of fluids and salts.
Compatibility with other drugs
When using the drug, you must consider the interaction with other drugs:
- With the simultaneous use of insulin, hypoglycemic agents of sulfonylurea derivatives, hypoglycemia may develop.
- With the simultaneous use of ACE inhibitors and interleukin-3, there is a risk of arterial hypotension.
- When applied simultaneously with clozapine, there are reports of syncope development.
- When applied simultaneously with clomipramine, an increase in the action of clomipramine and the development of toxic effects are reported.
- When applied simultaneously with co-trimoxazole, cases of hyperkalemia are described.
- With simultaneous use of lithium carbonate, the concentration of lithium in the serum increases, which is accompanied by symptoms of lithium intoxication.
- With simultaneous use with orlistat decreases the antihypertensive effect of enalapril, which can lead to a significant increase in blood pressure, the development of hypertensive crisis.
- It is believed that with simultaneous use with procainamide may increase the risk of leukopenia.
- With simultaneous use with enalapril decreases the effect of drugs containing theophylline.
- There are reports of the development of acute renal failure in patients after kidney transplantation, while using cyclosporine.
- With simultaneous use with cimetidine T1 / 2 enalapril increases and its concentration in the blood plasma increases.
- It is believed that it is possible to reduce the effectiveness of antihypertensive agents while using it with erythropoietins.
- With simultaneous use with ethanol increases the risk of arterial hypotension.
- With simultaneous use with immunosuppressants, cytotoxic drugs increases the risk of leukopenia.
- With simultaneous use of potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements containing potassium, hyperkalemia may develop (especially in patients with impaired renal function), because ACE inhibitors reduce the content of aldosterone, which leads to a delay of potassium in the body against the background of the restriction of excretion of potassium or its additional intake.
- With the simultaneous use of opioid analgesics and anesthetics, the antihypertensive effect of enalapril is enhanced.
- With the simultaneous use of “loop” diuretics, thiazide diuretics, the antihypertensive effect is enhanced. There is a risk of hypokalemia. Increased risk of impaired renal function.
- With simultaneous use with azathioprine may develop anemia, due to the inhibition of erythropoietin activity under the influence of ACE inhibitors and azathioprine.
- The case of the development of an anaphylactic reaction and myocardial infarction with the use of allopurinol in a patient receiving enalapril is described.
- High-dose acetylsalicylic acid may reduce the antihypertensive effect of enalapril.
- It has not been finally established whether acetylsalicylic acid reduces the therapeutic efficacy of ACE inhibitors in patients with coronary artery disease and heart failure. The nature of this interaction depends on the course of the disease.
- Acetylsalicylic acid, inhibiting COX and prostaglandin synthesis, can cause vasoconstriction, which leads to a decrease in cardiac output and the deterioration of the condition of heart failure patients receiving ACE inhibitors.
- With simultaneous use of beta-adrenergic blockers, methyldopa, nitrates, calcium channel blockers, hydralazine, prazosin, it is possible to enhance the antihypertensive effect.
- With simultaneous use with NSAIDs (including indomethacin), the antihypertensive effect of enalapril decreases, apparently due to the inhibition of prostaglandin synthesis under the influence of NSAIDs (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors). The risk of developing impaired renal function increases; hyperkalemia is rarely observed.
We offer you to read the reviews of people who used Enalapril:
- Tatyana. I take enalapril 10 mg. All day the pressure to 140, in the evening can rise, but only slightly. Here are just a cough completely tortured, like whooping cough. She canceled the pills, after 5 days the cough subsided, but the pressure jumps to 190. Previously, the doctor prescribed Noliprel - this is generally a nightmare, such a cough that guard. Attacks 4 times an hour, severe sore throat. Now, after the weekly cancellation of enalapril, I drink it again, waiting for the cough to begin ...
- Elvira. My father has high blood pressure for many years, he regularly took Enalapril tablets. And recently I had to get acquainted with this drug. Nevertheless, the hereditary factor makes itself felt, I also had problems with pressure, so I acquired a blood pressure monitor, and the doctor advised a drug I already knew - Enalapril from pressure. Now I take pills twice a day, after that I need to lie down for a while and my condition quickly returns to normal. The drug is good and inexpensive, and the side effects have not yet felt.
- Tatyana. I can’t say anything bad about this drug. I was advised by his mother. She takes it regularly. I am often nervous, worried. The result is increased pressure, headaches, feeling unwell, nausea. And Enalapril is always at hand. The floor of the pill drank and the pressure quickly normalized, the condition improved. I do not observe addiction. Therefore, I think the rest will work too.
Structural analogues of the active substance:
- Berlipril 10;
- Berlipril 20;
- Berlipril 5;
- Enazil 10;
- Enalapril Hexal;
- Enalapril maleate;
Before buying an analogue, consult your doctor.
Shelf life and storage conditions
The shelf life of enalapril tablets is 3 years. The drug should be stored in a dark, dry, out of the reach of children place at air temperature from +15 to + 25 ° C.