Enalapril, instructions for the use of which contains complete data on the preparation, is an efficient and safe means.

The drug is released by the prescription.

According to the instructions for use, the Enalapril medicine is pills that have a white color and convex configuration. On one side of the tablet there is a risk. It allows you to easily and precisely split the disk in half.

Depending on the number of active substance, ENALAPRIL, the dosage of which is determined by the specialist, is divided into:

• Enalapril tablets 5 mg;
• Enalapril 10 mg (instructions for use contains a complete list of components);
• 20 mg.

Instructions Enalapril allocates two types of components:

• active substance;
• auxiliary components.

Table 1. Enalapril (the composition of the drug is given according to the instructions for use)

Active substance Enalapril
Enalapril Maleat	It has a vasodilant effect, leads to a decrease in pressure, has a pronounced cardioprotective effect with a prolonged application
Auxiliary components
Milk sugar	Tableted Filler, is a source of energy
Magnesium Carbonate	Thickener, stabilizer, contribute to assimilation
Gelatin	Thickener
Crosspovidon	Allows you to keep shape, releases active Component
Stearinic acid	Stabilizer, preservative

What anealapril tablets look like, from which they help, spelled out in instructions for use.

Mechanism of action

Many concerns the question of how much medicine acts. The drug ENALAPRIL reduces the pressure of approximately 15-40 minutes. The instructions for use reports that the largest amount of funds in the blood is found in 3-6 hours.

Table 2. Enalapril action mechanism

Name	Effect	The use of Enalapril
Angiotensin	Special hormone, the type of which leads to a narrowing of the lumen of the vessels and stimulates the production of aldosterone	The process of turning into a "dangerous" form slows down, the release into blood is reduced. Arteries and veins are expanding, which leads to a decrease in pressure
Aldosterone	Increases pressure due to the narrowing of the lumen of vessels and increasing the volume of circulating blood	Synthesis and emissions decrease
Bradykin	Peptide with a vasodilant effect. Characterized by rapid decay	Debris time increases

Thus, it is possible to conclude, for which ENALAPRIL and that is the result of its application. Thanks to the drug:

• vessels expand;
• arterial pressure decreases;
• heartbeat does not increase;
• muscle tissues of the heart are restored (in particular leads to the regression of hypertrophy), etc.

What helps?

For a full understanding of action, it is worth familiar with the information about what Enalapril is and from which the tool helps.

Tablets according to the instructions for use are prescribed at:

• regular increase in pressure for various reasons over 140-90 mm. mercury pillar;
• as pharmacological treatment a number of heart disease;
• to prevent the development of diseases of the heart / vessels caused by the fatal outcome.

Enalapril, the dose of which is determined on the basis of the diagnosis, is appointed exclusively by a specialist.

Indications for use

Establishing an accurate diagnosis is pledged successful treatment. Enalapril, the testimony for the use of which is prescribed in the instructions, recommended when:

1. Arterial hypertension. Enalapril (the recipe can be obtained by a doctor) is effective in the primary form of the disease caused by the violation of the system regulating pressure. It is also assigned to secondary hypertension, which caused other pathologies. Instructions for use notes that it is effective with the renovascular form of hypertension.
2. Essential hypertension. A special form of hypertension, a characteristic feature of which is to exhaust the renal depressor function.
3. Chronic sh. Enalapril (instructions for use of the tablet recommends include in the composition of complex treatment) is effective in violations of the heart of the heart.
4. Conducting the prevention of CH and some forms.

A full-fledged source of information on what is an Enalapril pill, from which, and their application in what cases is recommended, is the instruction.

Annotation Enalapril does not stipulate with what pressure is optimally taken to take the drug. The drug must be drunk regularly, and not from the case of the case. Enalapril ( pharmacological group -), has a cardioprotective impact only under course appointment.

The most common causes of hypertension

Contraindications

Despite the safety of the medicine, according to the instructions for applying to some patients, it is forbidden to drink it. Enalapril, contraindications to which are quite extensive, is not recommended at:

• anaphylactic shock in history;
• arterial stenosis of the only / both kidney;
• overabiary of potassium in Oraganism:
• various forms of porphyria;
• allergies to components;
• together with Aliskeren;
• renal / liver failure, etc.

The entire list is indicated in the instructions for use.

Instructions for use

The release form of Enalapril, dosage, the time of action and features of the reception specified in the instructions for use. It also contains information on some categories of patients with additional restrictions:

1. Children and teenagers. For this category of research, confirming the safety of the tools are absent. Up to 18 years old does not apply the drug.
2. Elderly people. Treatment of patients 60-65 years requires special caution. The first reception is recommended in the hospital.

Drinking in the morning hours does not matter before or after meals. Enalapril 5 mg Instructions for use recommends Take in the initial stages of 1 tablet. In some cases, the dose is reduced to 2.5 mg (for the elderly, patients with concealments of the kidney, etc.). Average daily dose It is 10 or 20 mg (instructions for use involves a two-time reception).

For emergency pressure reduction, a means in ampoules is used. It is introduced 1.25 mg every 6 hours. After therapy with diuretics or with pronounced disorders, the kidney function of the dose decreases to 0.625 mg.

In essence, this is another tradename drug. What is different from hexal:

1. Different manufacturers. This tool produces the company "Hexal", located in Germany, and the second drug is the Russian firm. There is no one about what manufacturer is better not. Both brands have proven themselves from a positive side.
2. Technologies. Funds are manufactured on various technical conditions and on different equipment.
3. Structure. International name It is identical, since the manufacture of both means is used by Enalapril Maleat. However, manufacturers apply different auxiliary substances.

What is better, Enalapril or Hexal, it's hard to say. Pharmacodynamics and pharmacokinetics of both drugs are similar, so they are interchangeable.

Funds are analogues and have identical indications for use. Produced by various companies. The preparation of acry is manufactured in Russia by Akrichin.

The recipe of Enalapril in Latin is the same in both means, but the auxiliary substances are somewhat different. Before taking, it is recommended to familiarize yourself with the instructions for use.

The medicine is produced by the Moscow Pharmaceutical Enterprise "Obolensk". The composition and effect of drugs are identical. The FPO is similar when it starts to act, in what cases the reception is prohibited when it is necessary to drink tablets with caution. The usual pressure from pressure can be replaced by FPO without fears.

Recommended for increased pressure and heart failure. It differs exclusively with the list of additional substances. Refers to ACE inhibitors and can be used as within complex therapyand in monolation. It has identical side effects and recommendations for use.

Refers to comprehensive therapy drugs. Includes two active ingredients at once: an inhibitor of the ACE Enalapril Maleat and a diuretic hydrochlorothiazide. It is recommended in cases where the monolation does not help. Effectively reduces pressure even with pronounced arterial hypertension.

Available in 10 mg dosage. It is used as a means for reducing pressure, treatment and prevention of heart failure. Effectively reduces the number of hospitalizations when unstable angina, risk of death due to cardiovascular diseases.

Available in the form of a solution, which allows the use of the drug in emergency cases. Quickly reduces pressure at risk or hypertensive crisis. Used exclusively by the doctor ambulance or within the hospital. Uninterrupted injections may cause complications or patient death.

Manufacturer drug is an Indian company. The drug is available in a tablet form in a dosage of 2.5, 10, 20, as well as 5 mg (readings for use for all forms can be found in annotations).

The drug lowering the pressure contains 20 mg of the active substance. Acts 15 minutes after reception. The maximum concentration in the blood is found after 3-6 hours. With a properly selected dosage, the hypotensive effect is maintained within 24 hours. Before applying, it is recommended to familiarize yourself with the instructions for use.

Single therapeutic effect And similar composition allow us to be considered synonymous. They will be divided:

1. Excipients. The ENAP includes several other components used to obtain the necessary consistency and physicochemical characteristics.
2. Manufacturers. ENAP is produced in Slovakia and is different high levels protection against falsification.
3. Price. ENAP is more expensive than analogue 2-3 times.

On a festive day or for a special occasion, some people want to have a sturdy drink. Patients are concerned about the compatibility of medication with alcohol, the consequences of which are not always predictable. According to the instructions for use:

1. Alcohol provokes an excessive pressure drop. Coeming can cause low blood pressure. It can be dangerous to health and life.
2. The drug with alcohol leads to an increase in the toxic effects of ethanol.

During pregnancy

Enalapril during pregnancy is very dangerous. It leads to a violation of the growth and development of the fetus. When pregnancy in the early deadlines, discovered after the assignment of the tools, it is worth the use of immediately. Women planning a conception that is carrying a child or nursing breasts is prohibited.

Side effects

Instructions for use describes a number of negative phenomena, which can be caused by taking tablets.

Table 3. Side Effects Enalapril

The cardiovascular system	Pressure reduction, tachycardia, arrhythmia, myocardial infarction
Nervous system	Pain in the head, dizziness, sleep disorders and workability, irritability
Respiratory system	Dry cough, pneumonia, rhinitis, anaphylactic shock
Skin Covers	Swelling of quinque, urticaria, itching, burning, eczema
BCT organs	Vomiting, nausea, diarrhea, heartburn, skin yellowing
Sense organs	Specific anti-flavor, appearance of foreign sounds
Other	Increased sweating, decreased libido, impotence

Does the potency affect?

The reduction in sexual attraction is included in the list of possible side Effects. However, if we talk about men, it is proved that ACE inhibitors enhance the products of male hormones, improving potency. In any case, it does not mean the treatment of arterial hypertension does not make sense. That's why:

• in itself leads to impotence due to the narrowing of vessels and the lack of blood supply to the genital organs;
• also significantly increases the risk of sudden death.

A man with arterial hypertension should worry not only the question of whether the drug affects the potency, but also the importance of the therapy. Without proper treatment, male strength will weaken, and the risk of death will be colossal.

ATH code: C09AA02

Trade name: Enalapril International unpatient name: ENALAPRIL Release form: Tablets 5 mg, 10 mg and 20mg. Description: White tablets with a yellowish color tinge, flat-cylindrical, with a chamfer. Ingredients: one tablet contains: the active substance - the ENALAPRIL Maleate - 5 mg, 10 mg or 20 mg; Auxiliary substances: lactose monohydrate, starch 1500 (corn starch partially prevaitinized), corn starch, sodium hydrocarbonate, magnesium stearate. Pharmacotherapeutic Group: Means affecting the renin angiotensin system. An angiotensin surgery enzyme inhibitor.

Arterial hypertension various shapes and severity (including renovascular hypertension);
- heart failure of the I - III stage as part of complex therapy, including asymptomatic dysfunction of the left ventricle;
- Prevention of coronary ischemia in patients with left ventricle dysfunction.

Increased sensitivity to enalapril and other ACE inhibitors, a history of angioedema edema, porphyria, pregnancy, lactation period.
With caution to apply with primary hyperaldosteroneism, bilateral stenosis of renal arteries, stenosis of the artery of the only kidney, hyperkalemia, condition after the kidney transplantation; aortal stenosis, mitral stenosis (with impaired hemodynamics), idiopathic hypertrophic subaartal stenosis, systemic diseases connective tissue, ischemic Disease Hearts, cerebrovascular diseases, diabetes, renal failure (proteinuria more than 1 g / day), liver failure, in patients who keep a diet with a restriction of salt or hemodialysis, with simultaneous reception with immunosuppressants and saluretics, in older people (over 65 years old).
The simultaneous use of inhibitors of angiotensin glossy enzyme or ATII receptor blockers with alicarer in patients with diabetes or moderate / severe renal failure (SCF less than 60 ml / min / 1.73 m2) is contraindicated.

Inside, regardless of meals.
Arterial hypertension
The initial dose at a light degree of arterial hypertension (AG) is 5 mg 1 time per day. With other degrees of hypertension, the initial dose is 10 mg 1 time per day. In the absence of the effect, the dosage of the drug increases by 5 mg with an interval of 1 week. Supporting dose - 20 mg 1 time per day. The dose should not exceed 40 mg per day.
Renovascular hypertension
Therapy begins with a lower initial dose - 2.5 mg. The dose is selected according to the needs of the patient. Maximum daily dose - 40 mg of enalapril with daily reception.
Concomitant treatment of arterial hypertension diuretics
After the first admission of Enalapril, arterial hypotension can develop. The drug is recommended to assign with caution. Diuretics treatment should be discontinued 2-3 days before the start of treatment with Enalapril. If possible, the initial dose of ENALAPRIL should be reduced (up to 5 mg or less) to determine the initial effect of the drug.
Heart failure / asymptomatic left ventricle dysfunction
The initial dose of enalapril in patients with chronic heart failure is 2.5 mg per day, the purpose of the drug should be carried out under careful medical control to establish the initial effect of the drug. Enalapril can be used in conjunction with diuretics and, when necessary, with heart glycosides. The dose should be raised with an interval of 1 week by 5 mg to a conventional supporting daily dose of 20 mg, which is assigned once or divided into two receptions depending on the patient tolerability. Selection of doses should be carried out within 2-4 weeks.
Application in pediatrics
Experience in the use of enalapril in children with arterial hypertension in clinical studies limited. For children who can swallow tablets, the dose should be selected individually, depending on the patient's condition and on the degree of blood pressure decrease. The recommended initial dose is 2.5 mg for patients with body weight from 20 to< 50 кг и 5 мг для пациентов с массой тела > 50 kg. Enalapril takes 1 time per day.

The site provides reference information solely to familiarize yourself. Diagnosis and treatment of diseases must be under the supervision of a specialist. All drugs have contraindications. Consultation of a specialist is obligatory!

Preparation Enalapril

Enalapril - a hypotensive drug related to the class aPF inhibitors. The effect of Enalapril is due to its influence on a renin angiotensin-aldosterone system, which plays an important role in regulating blood pressure.

The visible effect of the medication is developing after its reception within 2-4 hours, and the initial action is within an hour. Maximum pressure decreases after 4-5 hours. When using Enalapril in the recommended doses, its hypotensive effect holds about a day.

The drug is rapidly absorbed into the gastrointestinal tract with a suction degree of about 60%. An Enalapril is excreted mainly through the kidneys and through the intestines.

Forms of release

Enalapril is produced in tablets of 5, 10, 20 mg, packaged in blisters of 10 pieces. In the cardboard package two or three blisters.

Dutch and English Rniepte contains 14 tablets in one pack.

Side effects when taking Enalapril most often reversible. Therefore, in case of their appearance, the drug is immediately terminated.

Treatment with Enalapril

How to take Enalapril?
In accordance with the appointment of a doctor, the drug takes 1-2 times a day, regardless of meals. Combined drugs of enalapril containing diuretic, it is better to take in the morning. Treatment with the drug is obtained for a long time, with good tolerability - throughout life.

As a result of the simultaneous intake of enalapril with drugs of lithium salts, lithium removal can slow down, and its toxic effect increases. Therefore, it is not recommended to prescribe these drugs together.

The sharing of enalapril with potassium-saving diuretics can lead to delay in potassium and hypercalemia. Therefore, it is possible to take them simultaneously under the control of laboratory tests.

There is evidence that the simultaneous purpose of insulin, as well as other hypoglycemic drugs and enalapril, can lead to hypokalemia. Most often it happens at the beginning of treatment in patients with renal pathology.

Enalapril weakens the effect of theophylline.

It is safe to appoint enalapril with aspirin in a cardiology dosage, with beta adrenoblockers and thrombolytic.

Analogs of Enalapril

To the analogues (synonyms) of the drug, which in its composition enalapril as the main active substance, relate:

• ENAP;
• Vasolapril;
• Invoril;
• Berlipril;
• EDNIT;
• Enam;
• Bagrat;
• Mioto;
• Enarel;
• Renietec;
• Envas;
• Corandyl;
• Enalac and others.

Exist combined drugs, such as Slovenian ENAP H and ENAP HL, Russian Enafarm H and the like. In addition to enalapril, these drugs contain a substance of hydrochlorothiazide, which has a diuretic effect, which increases the hypotensive effect of the drug.

Analogs of Enalapril, which have a similar effect, but having another chemical compositionare preparations of captopril, leasing, ramipril, zofensoid, perindopril, trandolapril, hinapril, fozinopril.

ENAP® P solution for intravenous administration 1.25 mg / ml-ampoule 1 ml, blister 5, tutu cardboard 1- EAN code: 3838989500542- No. N015813 / 01, 2009-06-25 from KRKA (Slovenia)

Latin name

ENAP® R.

Active substance

Enalaprilatum * (ENALAPRILATUM)

ATX

C09AA APF inhibitors

Pharmacological group

APF inhibitors

Nonological Classification (ICD-10)

G93.4 Encephalopathy UncomfortableI10 Essential (primary) HypertensionI15 Secondary hypertensionI15.0 Renovascular hypertension

Composition and form of release

Solution for intravenous administration1 AMP.Enalaprilat1, 25 MEASPMOUS MATERIALS: benzyl alcohol sodium sodium chloride Hydroxide- Water for injection

in ampoules 1 ml - in a blister 5 ampoules, in a pack of cardboard 1 blister or in a carton box 50 blisters.

pharmachologic effect

Pharmacological action - hypotensive.

Method of application and dose

V / B, slowly, for at least 5 minutes or drip, in dilution in 20-50 ml of 5% declaration solution (glucose), 0.9% solution of sodium chloride, 1.25 mg (1 ml - 1 amp. ), every 6 h.

The usual dose is 1, 25 mg (1 ml) of the drug every 6 hours, including patients who previously taking the ENAP® preparation for intro (tablets).

In patients receiving diuretics, the initial dose of the drug decreases to 0.625 mg (0.5 ml - 1/2 AMP). If 1 hour after administration the therapeutic effect is unsatisfactory, the same dose can be reused, and after 6 hours, treatment is continued in a dose of 1.25 mg every 6 hours.

Dosage in renal failure

With moderately severe chronic renal failure for patients with Creatinine Creatinine more than 0.5 ml / s (30 ml / min, the creatinine in serum does not exceed 265 μmol / l) dose is 1.25 mg (1 ml-1 amp) of the drug Every 6 h, the dose correction is not required. If 1 hour after administration the therapeutic effect is unsatisfactory, dose of 1.25 mg (1 ml - 1 amp) can be reused, and after 6 hours, treatment is continued in a dose of 1.25 mg (1 AMP) every 6 hours .

For patients C creatinine less than 0.5 ml / s (30 ml / min, serum creatinine exceeds 265 μmol / l) The initial dose is 0.625 mg (0.5 ml-1/2 AMP), followed by the control of the indicators AD for 1 hour to detect the risk of excessive decline in blood pressure. In the absence of an effect after 1 hour, the drug administration in a dose of 0.625 mg (0.5 ml) is repeated and the treatment is continued in a dose of 1.25 mg (1 ml - 1 amp) every 6 hours.

For patients with hemodialysis, the dose of ENAP® P drug is 0.625 mg (0.5 ml) every 6 hours for 48 hours.

When transitioning to the drug inside, the recommended initial dose of enalapril is 5 mg / day for patients who previously introduced the usual (1.25 mg / ml) dose of Enap® R. If necessary, the dose can be increased. For patients, the treatment of which was twice as a reduced initial dose of 0.625 mg (0.5 ml) of the drug ENAP® P, the recommended initial dose of enalapril during the transition to reception is 2.5 mg / day.

Conditions for the storage of the drug ENAP® R

At a temperature not higher than 25 ° C.

Keep out of the reach of children.

Shelf life of the drug ENAP® R

3 years.

Last update of description by the manufacturer

23.09.2011

Other options for packaging preparation - Enap® R.

ENAP® P solution for intravenous administration 1.25 mg / ml ampules 1 ml, blister 5, pack cardboard 1- code EAN: 3838989500542- No. N015813 / 01, 2009-06-25 from KRKA (Slovenia) ENAP® R solution for intravenous Introduction 1.25 mg / ml-ampoule 1 ml, blister 5, box (box) cardboard 50- No. N015813 / 01, 2009-06-25 from KRKA (Slovenia)

Drugs related to the group inhibitors of an angiotensin glider enzyme began to be widely used in medical practice more than 40 years ago and to this day are one of the most effective tools To combat arterial hypertension. A widely used representative of this group is Enalapril. Instructions for use of Enalapril includes detailed description Indications, contraindications, method of use of medication, its side effects and other features of use.

Description and clinical properties

Enalapril is made in the form of tablets for oral application. Externally, tablets have a white or grayish tint, produced in a dosage of 5, 10 and 20 mg. Packs tool in blister. Cardboard packaging contains 2-3 plates.

The main active ingredient of the drug - Enalapril Maleat. Its concentration in one tablet depends on the form of production, is 0.005, 0.01 and 0.02 g, respectively.

Indication for appointment

Instructions for the use of Enalapril includes rather limited readings for use. It is explained by this specific and pretty strong effect Medicines, as well as a large list of side effects and contraindications.

In medical practice, the drug is prescribed to patients with the following states:

• various stages of hypertensive heart disease. The force of the drug is adjusted by reducing or increasing the dosage individually for each patient;
• arterial hypertension various etiology. Many years of experience shows that it is Enalapril that is one of the most effective funds in the field of high pressure control;
• chronic heart failure, as well as severe forms of pathology, in particular, during the recovery period after the myocardial infarction for restoring the functioning of the left ventricle of the heart;
• heart failure accompanied by stagnant processes;
• ENALAPRIL is used as a complex treatment at bronchospast states;
• treatment of left ventricle dysfunction flowing in latent form;
• IHD, accompanied by the attacks of angina and other manifestations.

Mode of application

How to take Enalapril? Tablets are designed for oral administration, that is, eating inside. The drug should be made only with clean water, as in the union with juices, tea, coffee and other drinks, the agent is sometimes gives a negative effect.

To achieve a faster result, the tablet is allowed to put under the tongue, keep it until complete dissolution. Usually this method is shown in patients with hypertensive crisis for fast decline blood pressure.

After how much is the means

The therapeutic effect of the use of Enalapril occurs approximately 60 minutes after the reception. It was during this period that the highest concentration of the active component of the drug in the blood is noted.

The duration of hypotensive action is about 24 hours. The period of action of the drug in patients with heart failure, as well as in patients with kidney diseases, liver is increasing.

The effect of medication at twofold reception is intensified. In most cases, the initial dose is from 5 mg, increases in stages at good tolerability.

How much does medicament act? The half-life is up to 5 hours. After that, ENALAPRILE decreases somewhat.

Enharged therapeutic effect The drug while simultaneously use with calcium antagonists and thiazide diuretics.

How many times a day

The number of techniques and dosage of the medication is determined by the leading physician based on the history of the patient and its complaints. Usually, an ENALAPRIL monotherapy is assigned to 10-20 mg twice a day.

For complex treatment A particular state of the doctor prescribes 1 tablet in the morning or in the evening. The duration of treatment is individual for each patient.

Take up

Instructions for the use of Enalapril N and other trademarks medication does not indicate clear restrictions on receiving tablets before or after eating. The drug can be drunk both before meals and after eating. This practically does not affect the therapeutic effect of the means.

With what pressure

Many patients are interested in how pressure should be drinking? The use of enalapril is shown by patients with even a minor increase in blood pressure on the background of essential hypertension, since the blood circulation of the brain and the heart muscle occurs.

With hypertension, it is recommended to take enalapril with increasing rates of mercury post more than 120/90.

If the working pressure of a person is 100/60, the means is used already when increasing the indicators to 120/90.

Dosage preparation

Analopril's abstract indicates that they are taking a means before, after or during meals in the dosage appointed by the doctor, depending on the diagnosis. Treatment with the help of the drug is carried out both in the role of independent and complex therapy.

Independent therapy

In the initial stages of treatment, patients are usually prescribed to 20 mg tablets. If there is no effect during 7-14 days and the pressure is not reduced to normal marks, the dosage is gradually increased. At the same time, the daily dose should not exceed 40 mg of funds.

Comprehensive treatment

In the treatment of heart failure and other states in the role of the means of complex therapy, ENALAPRIL is prescribed by 2.5 mg of once a day. Gradually, the dosage of the means increases, but not more than 2-2.5 mg every 7 days.

In case of insufficiency of the heart of a chronic character, the dosage is at the first stages of 2.5 mg. The rate increases gradually, 1 time per week by 2-2.5 mg.

Under the hyperniews of a renovascular type, the daily rate of the drug may not exceed 20 mg. At the initial stage, the patient shows the reception of the ¼ tablet twice throughout the day.

Compatible with alcohol

Combining enalapril and alcohol is prohibited in any dosages. Such an effect can cause a number of heavy complications dangerous to the health and life of the patient. The fact is that against the background of the admission of alcoholic beverages, the effect of the drug can increase, which will lead to a severe form of arterial hypotension.

Compatibility of enalapril and alcohol is extremely undesirable for patients suffering from kidney and liver diseases. Negative consequences include persistent hypotension, violations by the central nervous, respiratory, cardiovascular system.

In addition, hot drinks increase the risk of developing and the intensity of possible side effects of the means. The patient may encounter strong headaches, nausea, dizziness and other unpleasant manifestations.

With a violation of the kidney function

With severe kidney pathologies, the drug is completely contraindicated. The use of the tool can lead to dangerous complications incompatible with life.

For moderate dysfunction The organ is allowed to use enalapril in the initial dosage of 2.5 mg per day. The maximum amount of medication should not exceed 20 mg throughout the day.

With pronounced kidney dysfunction, the patient is prescribed a means in a dosage of 2.5 mg per day, the permissible daily amount of the drug does not exceed 10 mg.

With a congestion of the renal artery of a unilateral or bilateral nature, Enalapril does not apply.

When violating the liver function

Liver diseases are direct contraindication to the use of enalapril. In extremely rare cases, a specialist may decide on the appointment of the drug in limited doses if others medication tools Do not give the necessary healing effect.

Appointment in old age

Patients in old age are prescribed after a full examination in a hospital. At the same time, control over the dynamics of blood pressure indicators, urine tests, blood.

Initial dosage for patients after 65 years should be 2.5 mg. During the day, no more than 10 mg of funds are allowed.

Use during pregnancy and lactation

Instructions for use says that in the period of tooling the baby and breastfeeding The treatment with an ENALAPRIL is strictly contraindicated. If the need to receive the drug nevertheless arose, kids such mothers should be under careful medical control, Regularly pass tests.

Impact on the ability to manage complex mechanisms

Patients undergoing treatment with enalapril should be careful labor activityrequiring increased concentration of attention, fast mental and physical reaction. In some cases, the development of individual reactions of the organism is possible, in particular, after receiving large doses, the combination of medication with alcohol.

Childcare

There is no data on the safety of the drug among children under 18 years, therefore, in pediatrics, the tool is used only with a lot of need for emergency situations.

Medicinal interaction

Including in the Recipe of Enalapril, the specialist must necessarily take into account its interaction with other drugs:

• the hypotensive effect of the drug is reduced when it is combined with analgesic agents, non-steroidal anti-inflammatory drugs;
• in the Union with diuretic pills vasodinating action Enalapril is enhanced;
• vitamin complexes, including potassium, potassium-saving diuretics while simultaneously use with enalapril increase the threat of an excess of potassium in the body - hypercalemia;
• means comprising sodium chloride reduce the hypotensive effect of the drug;
• an antihypertensive effect is enhanced with a combination of drugs with drugs used for anesthesia;
• when using drugs containing insulin, on the background of enalapril, their hypoglycemic effect is enhanced;
• cases of leukopenia are recorded with a combination of the described means with cytostatics, immunosuppressants, some hormones.

Storage and sale conditions from pharmacies

When buying Enalapril in the pharmacy it is necessary to make a recipe. Keep the medicine in the places protected from children at a temperature not higher than 25 degrees. Storage period from the date of production - 3 years. After the end of this period, the tool is categorically not recommended.

Use of bisoprolol with hypertension

Bisoprolol - a selective β - adrenoblocator - was opened in 1967, but also against the background of today's analogues, it is highlighted in high selectivity (selectivity) and the power of influence. Treatment of hypertension or angina drugs this drug gives patients significant advantages.

With comparative analysis of the effects of bisoprolla and similar β-blockers, they equally quickly reduced blood pressure. But during the daily monitoring, it turned out that only Bisoprolol retained his performance as the next morning. It was possible to normalize the indicators of the blood pressure not only in calm state, but also under loads. Stability and uniform impact of a single tablet during the day were provided by bisoprolol well-deserved popularity.

Bisoprolol Pharmacology - action mechanism

The tool has hypotensive (reduces blood pressure), antiarrhythmic (normalizes heart rhythm) and anti-penal (reduces symptoms of ischemic disease) effects. Therapeutic dosage does not have internal symptomatic activity and has no significant membrane-stabilizing capabilities.

Under the influence of minimum doses of the drug (active substance - Bisoprolol Fumarat):

With an increase in the dosage significantly exceeding the norm (from 0.2 g), as indicated in the annotation, the drug may cause the blockade of β 2-adrenergic receptors of the bronchi and smooth muscles of the walls of the vessels. Immediately after use, the cardiac output is reduced.

The therapeutic dosage does not have a cardiodepressive effect, does not affect the assimilation by the glucose organism, does not delay sodium. The maximum effect is manifested in 1-3 hours after use and saves 24 hours.

With blood molecules, the active component is associated with 30%. To some extent bisoprolol fumarate can penetrate the fetus placenta. Partially enters breast milk.

Forms of release of drug

Photo: For an increase, click on the description of the output.

Pharmacokinetics: composition and principle of operation

Each bisoprolol tablet includes 0.005 or 0.01 g of fumarant bisoprollaol and several fillers in the form of magnesium stearate, silicon dioxide, crosspotone, starch and cellulose. In the preparation of bisoprolol, the composition of the shell covering the capsule is alcohol, macrogol, talc, titanium dioxide and several yellow dyes.

A bisoprolol is produced in the form of round beige and yellow tablets of 20.30 or 50 pieces in each package.

The drug is absorbed by 90% regardless of food, half it is transformed into the liver, 98% is excreted by the kidneys, the residue is eliminated with bile.

Bisoprolol: Indications for use

Bisoprolol tablets: What do they really help? Among the common testimony:

• Hypertension (steadily high blood pressure);
• Angina (IBS);
• Heart failure (in a combined version with other medicines).

Bisoprolol especially carefully discharge:

1. With psoriasis and everything, who in the family had patients with a diagnosis of "Scaly Lisha".
2. With diabetes (decompensation stage).
3. With predisposition to allergies.
4. Patients whose profession is associated with high reaction rate or can threaten health. At the first stage of treatment, the speed of psychomotor reactions is decreased. A similar effect is observed under the influence of alcohol, since the bisoprolol and alcohol preparation is bad compatibility.

Bisoprolol is prescribed after the end of the course of therapy with α-adrenoblockers after the end of the feochromocytoma.

Bisoprolol during pregnancy

In general, the medication is not recommended to use for pregnant or nursing mothers. An exception may be in a situation where the effectiveness of bisoprolol for the mother exceeds the alleged risk for the child. If the pregnant woman still passes the course of the therapy by bisoprolol, cancel the means no later than three days before delivery.

If this condition fails to comply with this condition, the newborn risks acquiring a bouquet of diseases - hypotension, hypoglycemia, bradycardia, hypoxia. If the health testimony cancellation is not allowed, the state of the newborn has been necessary to control the newborn before the first week of life.

Contraindications for appointment

Bisoprolol is not prescribed if the patient suffers:

• Hypersensitivity to any ingredient composition;
• Acute or chronic form cardiac pathology, when conducting inotropic therapy;
• Cardiogenic shock;
• Weakening the sinus node;
• Neoplasms in the lungs;
• Synoyatrial blockade;
• Severe bradycardia;
• Av-blockade 2 and 3 st;
• Heavy stage of arterial hypertension with the boundaries of systolic blood pressure up to 100 mm Hg. st.;
• Noncompensated diabetes;
• Theochromocytoy (if parallel to α-adreneroblasts are prescribed);
• Bronchial asthma in severe form;
• Metabolic acidosis;
• Impaired peripheral blood flow;
• Refractory hypokaliam, hypercealcemia or hyponatremia;
• Hypolactasia;
• Lactose insufficiency (in the composition of the drug there is lactose).

Research of the effectiveness of medication for patients of minors has not been carried out. The means of patients who are prescribed a course of therapy inhibitors of MAO (with the exception of parallel use with inhibitors of monoaminoxidase in-type).

Side effects

Bisoprolol means: What should I be ashamed? In annotations, some unwanted manifestations in the form of:

• Headache and coordination breaches;
• Feelings of fatigue, decline forces;
• Sharp blood flow to the head, redness of the face;
• Insomnia;
• Psyche disorders of depressive and hallucinogenic type;
• Paresthesia of hands and feet, sensations of cold limbs;
• Reduced secretion of the tear glands;
• Developing conjunctivitis;
• Pain in the abdomen, nausea and vomiting;
• Intestinal disorders;
• Muscle weakness;
• Frequent cramps;
• Orthostatic hypotension;
• Signs of bronchial obstruction (in the presence of susceptibility);
• Reinforced sweating;
• Delayed heartbeat;
• Av-conduction disorders.

It is possible to reduce glucose tolerance (most often - in patients with a diagnosis " diabetes", Including hidden form, which usually does not exhibit yourself). The tool gives a positive reaction to doping control. Bisoprolol The side effect manifests in rare cases, the instruction warns, first of all, physicians, to clarify dosage and compatibility.

Bisoprolol: Instructions for use

The medicine is intended for oral use. Take it in the morning, before breakfast or during meals. They swallow entirely and drove water. Daily rate for adult - 20 mg. If a special instructions It was not, with patients-hypertensive or patients with angina phase, 10 mg of the drug for one-time consumption is enough.

At the very beginning of the course, you can restrict ourselves to a more moderate dose - 5 mg / day. You can exceed the norm only in the most extreme case. With an increase in the daily rate, the reception rule is saved. Standard therapy scheme Bisoprolol in tablets according to the instructions is presented in the table.

The individual treatment regimen is therapist, given the pulse indicators and the reaction of the body. Patients with minor dysfunction of kidneys, adrenal glands or liver, as well as mature ages, do not adjust the dose. In the severe form of the listed pathologies, the daily rate is limited to 10 mg of the drug. A long-term medication is calculated. Will the drug be able to actually control pressure over the years?

Bisoprolol produces many pharmaceutical enterprises, but the origin of the medication does not affect the application. Bisoprolol-Prana instruction has identical analogues of the Lugansk HFZ or Israeli company TEVA.

Overdose

Overdose manifests itself in the form:

• Pronounced bradycardia;
• Arrhythmias;
• Extrasystole gastroincing;
• Av-blockade;
• Significant drop in blood pressure;
• Heart failure;
• Cyanosis (sampling) of hands;
• Shortness;
• Dizziness;
• Bronchospasms;
• Syncopal states;
• Convulsive seizures.

In the treatment of consequences of overdose, stomach is washed, adsorbing preparations and symptomatic therapy are prescribed:

1. Atropine or epinephrine (1-2 g intravenously) with AB blockade. Sometimes the problem is solved by installing a temporary pacemaker.
2. With the extrasystole of the ventricle - lidocaine (intravenous). Parallel do not use the IA class medicines.
3. When falling, the patient is moved in the Trendelenburg pose (head and shoulders below the pelvic level at 30-45º).
4. Plasma-substituting solutions are introduced into Vienna, if symptoms of pulmonary edema do not appear. No insufficient effectiveness, with further fall, epinephrine, dobutamine add blood pressure.
5. Heart glycosides, diuretics, glucagon.
6. Diazepams are introduced into a vein to relieve convulsive seizures.
7. Inhalation of β-adrenostimulants in bronchial spasme.

This convincing list proves once again that before taking a bisoprolol, it is important not only to explore the instructions, but also to coordinate the dosage with the doctor.

Bisoprolol is absolutely incompatible with phlohantine and sultither. It is not recommended to combine it with calcium antagonists, hypotensive drugs, Mao inhibitors. Carefully combine bisoprolol and preparations:

• Against arrhythmia;
• Calcium antagonists;
• Anticholinesterase agents and β-blockers of local exposure;
• Insulin-based drugs and other drugs for diabetics;
• β-sympathomimetics capable of enhancing the activity of α- and β-adrenergic receptors;
• Cardiac glycosides (based on ingredients);
• Ergotamine derivatives;
• Means for anesthesia;
• Anti-inflammatory nonsteroid drugs;
• Antihypertensive medicines that increase the likelihood of hypotension (antidepressants, barbiturates);
• Baclofen;
• Amifostine;
• Parasympathomimetics.

Normal interaction of bisoprolol with meflohin and corticosteroidal means is noted.

Terms for sale and storage

Bisoprolol, medicine, sold in pharmacies only by the recipe, written in Latin: "RP.: TAB. Bisoprololi 0,005 №20. D.S. 1 tab. On the day (AG, IBS). "

With the same for any of the representatives of the bisoprolo instructions for use, the price of the drug for each manufacturer: for example, bisoprolol-ratiofarm (0.005 g) in Russian pharmacies can be purchased for 350 rubles, similar packaging of generic bisoprolol-prana costs from 32 rubles.

The drug is listed in the list of class B. Store it recommended at temperatures up to 25 ° C in conditions of dry and dark premises, not affordable to children. The term of safe use is 36 months.

Analogs of Bisoprolla

The structural analogues of bisoprolol include Bisogamma medicines, Biprol, Bisoprolol-Prana, Niperthen, Bisoprolol-Ratiopharm, Bisoprolol-Teva, Bisoprolol-Luga, Concorc, Bisomor, Concor Corbish, Corbis, Aritel Corbal, Bioskard, Bidop, Bisomor.

Similar mechanism therapeutic effects They have preparations of Atenolol, Betalki, Betaqard, Ripplel, Binelol, Linar, Egilk, Metokor, Cordanum, Lidalok, Metoprolol, Metozok, Nebivator, Nonbilon, One-Sky, Estecor.

The forums often discuss the question: Which of the medications are better - Bisoprolol or Concorp?

Concorp is the name of the trade brand, under which the original bisoprolol produces. Manufacturer - Merck KGAA from Germany. Unfortunately, the term of the patent for the drug Bisoprolol Concorol has already expired, so in our market today you can meet many alternative options - generics of bisoprolol, fairly effective substitutes available for the price.

Benefits Bisoprolla

In comparison with similar beta-blockers, Bisoprolol has several advantages:

1. For efficient pressure control, it is enough 1 tablet of the drug per day - it retains its activity, both during the day and at night.
2. The tool works both when applying on an empty stomach and after the reception during food.
3. The medication has high selectivity. Compared to the β-blockers of the previous generation, this ensures a smaller percentage of side effects.
4. The medicine does not provide negative influence on male health. Conclusions are made according to the results of a placebo-controlled study, in which the control group was not reported to which the medicine was issued.
5. Bisoprolol - metabolically neutral means without worsening exchange processes (cholesterol, triglycerides and blood glucose).
6. The drug is available to patients with type 2 diabetes and risk representatives for this disease.
7. The medicine is constantly prescribed in adulthood, since the likelihood of side effect is less than that of the analogues.
8. The pharmaceutical market is filled with generic bisoprolla - analogues that produce many competing companies. This makes treatment not only efficient, but also available financially, since the artificial medicine bisoprolol price is much lower.

Bisoprolol: Patient reviews

On thematic forums, the bisoprolol is quite popular. More often, bisoprolol tablets are discussed more often, feedback relate to the duration of treatment and its cancellation. Against the background of a sharp cessation of the drug use, many occur the cancellation syndrome.

His main manifestations: attacks of hypertension, frequent pulse. In some patients, the treatment has noticeably fear against the treatment. But since treatment with the drug is very long, and someone and lifelong, then all the symptoms described may not be involved in the use of bisoprolol. The risk of the appearance of side effects is quite real: some users did not notice obvious disorders, others are expressed noticeable.

Summarizing all opinions, it can be concluded that self-treatment as a serious preparation as a bisoprolol can be extremely dangerous. If you do not guess with a dose, you can get a bunch of side effects, right up to the stop of the heart. Appointment, treatment diagram and the time of cancellation of the drug should be exclusively in the competence of physicians.