Description overdue on 25.10.2011

The drug lowers blood pressure, expands the lumen of blood vessels, having cardioprotective   and natriuretic   action.

The mechanism of action is to inhibit the angiotensin converting enzyme (ACE) inhibitors. Reduced biosynthesis angiotepzina II results in vasodilation, development of bradykinin and PGE2, which are powerful sosudorasshiritelyami.

Enalapril drug absorption reaches 60% regardless of the reception and the presence of food in the gastrointestinal tract. The maximum concentration of the active substance enalaprilate observed after 1 hour after application. The liver biotransformiroetsa up enalaprilate . It easily passes through the placenta, blood-tissue barriers. Excreted by the kidneys. The hypotensive effect is recorded through 1h after the administration of drugs last night. For best results, blood pressure takes a few weeks of regular receiving enalapril.

In patients with heart failure, chronic administration (6 months or more), there is an increase portability heart exercise, reduced heart size, reduced the number of deaths. Under the influence of the drug relieved the pulmonary circulation, decreasing the pressure in the pulmonary capillaries, reduces peripheral vascular resistance, increased   cardiac output   (Heart rate is not increased).

Indications:

Hypertensive heart disease, Raynaud's disease, heart failure, symptomatic hypertension, diabetic   nephropathy . scleroderma Secondary hyperaldosteronism . Enalapril administered as part of combination therapy in the treatment of angina   voltage, myocardial infarction , Chronic renal failure.

Contraindications:

Hypersensitivity to ACE inhibitors, renal artery stenosis, azotemia , Hyperaldosteronism, hyperkalemia , Renal dysfunction, angioedema   (hereditary), aortic stenosis, infancy. Enalapril is not prescribed to pregnant women.

Side effect:

Fatigue, dizziness, headache, cramps, nervousness, insomnia, glossitis, tinnitus, dry cough , Nausea, orthostatic hypotension, palpitations, dyspepsia,   proteinuria . impotence , Disorders of the liver, kidneys, hyperkalemia, angioedema , Neutropenia, increased levels of bilirubin in the blood, hair loss, pain in the heart, increasing the concentration of liver transaminases.

Mode of application:

Enalapril is taken orally. The initial dose is 5 mg per day, the drug take 1 time per day. In the pathology of the renal system, taking diuretics reduce the dose to 2, 5 mg. To achieve the effect, depending on the individual characteristics of the dose can be increased up to 10-40 mg per day (can be divided into 2 admission).

Overdose:

Excessive drop in blood pressure, myocardial infarction , Stroke, thromboembolic complications as a result of a sharp decrease in blood pressure. Treatment: in / in a NaCl (isotonic solution). No specific antidote.

Special instructions:

In the early hours of the enalapril can lead to a marked decrease in blood pressure. This is particularly evident in people for the first time taking antihypertensive medication in patients with chronic renal failure, heart failure strongly expressed, hypovolemia, hyponatremia. To prevent a sharp decline in blood pressure for 2-3 days prior to receiving Enalapril cancel diuretics and salt-free diet. With the development of angioedema of the face, neck need to stop taking drugs, appoint antihistamines. In severe cases, intubation, tracheotomy. Not recommended to appoint a potassium-sparing diuretics. It should be regularly tested hemostasis.   Enalapril is not prescribed for women planning pregnancy.

Drug Interactions:

Absorption of the drug is independent of food intake. At simultaneous intake with beta-blockers, nitrates , Methyldopa, calcium antagonists, prazosin, hydralazine, enalapril potentiates the hypotensive effect. Cimetidine   increases T1 / 2 of the drug. NSAIDs   increased nephrotoxicity, reduce the effectiveness of enalapril. Preparations of potassium and potassium-sparing diuretics when taken with drugs lead to hyperkalemia. Enalapril reduces the half-life theophylline It reduces clearance of lithium. PM does not react with   cardiac glycosides .