1 tablet contains:active substance: Enalapril Maleat 5 mg / 10 mg / 20 mg;excipients: Cellulose Microcrystalline 73.00 mg / 68 mg / 70 mg, corn starch preheatenized 30.00 mg / 30 mg / 43 mg, Talc 3.00 mg /3.0 mg / 4.10 mg, silicon colloidal dioxide 1.00 mg / 1.00 mg / 1.40 mg, magnesium stearate 1.0 mg / 1.00 mg / 1.40 mg, iron oxide red - / 2.00 mg / 0.10 mg.

Tablets 5 mg: Round tablets, double-colored shapes from white to white with a yellowish color shade.

Tablets 10 mg: Round tablets, double-brown two-brown shapes with light and dark splashes on the surface and on the cross section.

Tablets 20 mg: Tablets round, double-colored shapes from light pink to pink color with light and dark splashes on the surface and on the cross section

Enalapril - a hypotensive agent, the mechanism of action of which is associated with the oppression of the activity of the agiotenzipreting enzyme (ACE), leading to a decrease in the formation of angiotensin II.As a result of enalapril hydrolysis, analiairila is formed, which inhibits ACE. The mechanism of action is associated with a decrease in the formation of angiotensin II.from angiotensin I,reducing the concentration of which leads to a direct decrease in the secretion of aldosterone. At the same time, the total peripheral vascular resistance, systolic and diastolic blood pressure (blood pressure), post- and preload on myocardium decreased. Expands to a greater degree of artery than veins, while not a reflex increase in heart rate frequency. Reduces bradykinin degradation, increases the synthesis of prostaglandins. Antihypertensive effect It is more pronounced at high renin activity than with normal or reduced activity. Reducing blood pressure in therapeutic limits does not affect the brain circulation. Blengths in brain vessels supported on sufficient level and Pa Foya reduced blood pressure. Enhances the coronary and renal blood flow.

Like all vasodilators, ACE inhibitors should be used with caution in patients with left ventricular hypertrophy and valve obstruction and refrain from applying in cases of cardiogenic shock and hemodynamically significant obstruction. In case of violation of the kidney function (QC less than 80 ml / min), careful monitoring of potassium content and serum creatinine is needed. Patients S. renal failure There may be a need to reduce the dose and / or frequency of drug intake. In some patients with bilateral stenosis of renal arteries or stenosis of the arteries of the only kidney, an increase in the concentration of urea and creatinine in serum is observed. Changes are usually reversible and returned to the norm after the cessation of treatment.

In some patients who had no kidney disease prior to treatment, a minor and transient increase in urea concentration and creatinine in serum was observed when used simultaneously with diuretics. In such cases, it may be necessary to reduce the dose and / or cancellation of enalairil and / or diuretic.

The experience of using Enalapril in patients who have recently carrying the trime of the kidney has no. Therefore, applications in such patients this drug Not recommended.

Hypercalemia can develop against the background of therapy of ACE inhibitors, including enalapril. Hypercalemia risk factors are renal failure, | elderly age (over 65 years old) diabetes, some concomitant states (decrease in the BCC. Acute heart failure in the decompensation stage, metabolic acidosis), simultaneous intake of potassium diuretics (such as, triamtenene, amylorride), as well as potassium preparations or potassium-containing food salt substitutes and the use of other drugs that contribute to the increase in potassium content in blood plasma (for example, heparin). The use of potassium preparations, potassium-saving diuretics or potassium-containing food substitutes, especially in patients with renal failure, can lead to a significant increase in the content of potassium in blood plasma. Hypercalemia can lead to serious heart rhythm disorders, sometimes with fatal outcome. The simultaneous use of the drug Enalairil with any of the above preparations should be carried out with caution and must be accompanied by regular control of potassium content in blood plasma. The simultaneous use of drugs of lithium and the drug is usually not recommended.

The drug, like other ACE inhibitors, has a less pronounced antihypertex effect in patients of the Negroid race compared with representatives of other races. Perhaps due to the low activity of renin in patients with arterial hypertension in this population.

A sudden cessation of enalapril taking does not lead to the development of the "Cancellation" syndrome.

When applying the drug, care must be taken when controlling vehicles and occupying other potentially hazardous species Activities requiring increased concentration and speed of psychomotor reactions due to the possibility of dizziness and drowsiness.

Tablets 5 mg, 10 mg, 20 mg.

10 in the contour cellular packaging from the film of polyvinyl chloride and foil aluminum printed lacquered.

Active ingredient: ENALAPRIL;
1 tablet contains Eanalapril Maleat in terms of 100% substance of 10 mg or 20 mg;

Eanalapril tablets - reduce pressure, expand clearance blood vessels, Cardioprotective and sodium-formistic effects.

Enalapril - First Representative of ACE Inhibitors long actionAfter the tests of which in numerous studies, these drugs are firmly established as the preparations of the first line for the treatment of hypertension and heart failure.

Enalapril also has some diuretic result associated with a moderate oppression of aldosterone synthesis. Along with a decrease in blood pressure, the drug reduces the pre- and post-loading on myocardium during heart failure, makes better blood circulation in a small circle and the respiratory function, lowers resistance in the kidney vessels, which contributes to the normalization of blood exchange in them.

It has some diuretic effect. The time of the hypotensive effect when taking inside - 1 hour, reaches a maximum after 4-6 hours and is preserved up to 24 hours.

In some patients, therapy for several weeks of heart failure is needed to achieve the optimal level of hell. A noticeable clinical effect is observed when long use - 6 months and more.

Elanpril Application Indications

1. Hypertonic disease;
2. Chronic heart failure (as part of combined therapy);
3. Renovascular hypertension;
4. Prevention of coronary ischemia and heart failure in patients with left ventricle dysfunction.

With what pressure apply Enalapril? Instructions for use of Tablets Enalapril date clear answer - when increased pressure By appointing a doctor. The excess of the necessary therapeutic dose can lead to an excessive pressure drop (AD).

Enalapril diuretic? Tablets have a diuretic effect, it is dependent on the dosage of the drug. The more dosage - the more pronounced ureraction effect. Enalapril is a means for reducing pressure and helping the heart (cardioprotector), and not diuretic in the usual understanding.

Instructions for use Enalapril, dosage

Tablets take inside without ralling, drinking enough water. Checking or grinding a tablet will speed up the absorption of the active substance in a high dose, as a result - an excessive drop of blood pressure is possible.

Standard Instructions for Enalapril

Initial dose for adults - 2.5-5 mg 1 time / day. The average dose is 10-20 mg / day in 2 reception.
Maximum daily dosage - 80 mg / day.

With monotherapy arterial hypertension Initial dose - 5 mg 1 time per day. If a therapeutic effect Insufficient, after 1-2 weeks, the dosage is raised by 5 mg. After receiving the initial dose, patients must be under medical supervision until the hell stabilizes (1-3 hours).

With the renal-vascular form of arterial hypotension, the initial dose of enalapril is 5 mg, it is later possible to increase to 20 mg of Enalapril per day.

With stagnation of heart failure, it is starting therapy with small dosages - 2.5 mg, depending on the effect, increase the dose to 20 mg (1-2 receptions per day).

In heart failure, it is prescribed from an enalapril 2.5 mg (1/2 or 1/4 tablets), then the dose gradually increase to 10-20 mg (1 to 2 tablets), in one or two receptions.

The use of the drug is possible for monotherapy and in a complex with other antihypertensive means.

With renovascular hypertension, a drug is prescribed in smaller doses (due to higher sensitivity to the inhibiting angiotensink-converting enzyme). Standard initial dosage enalapril 5 mg per day. Then the therapy is selected individually, but daily dose should not exceed 20 mg (once a day). In all cases with an excessive decline arterial pressure Dosage reduce.

In the case of asymptomatic violations of the activity of the left ventricle of myocardium, treatment begins with 5 mg ENALAPRIL 2.5 x 2 times a day. If necessary, therapy is adjusted.

The elderly, the more pronounced effect of reducing the pressure of the drug is more often observed, as well as the elongation of the action of the drug - this is due to a decrease in the rate of removal of the active substance of the tablet, therefore the recommended initial dose is an elderly - 1.25 mg.
With asymptomatic violation of the function of LV - 2.5 mg 2 times a day. The dose is fasted taking into account tolerability up to 20 mg / day, divided into 2 receptions.

A sudden cancellation of treatment does not lead to the "cancellation" syndrome (acknowledged AD), but it is recommended to reduce the dosage gradually.

Enalapril increases renal blood flow, improves the kidney function, prevents the development of diabetic nephropathy. Does not affect the metabolism of glucose and lipoproteins.

The systematic use of enalapril improves the quality of life and reduces mortality in stagnant heart failure.

When identifying disorders of the kidney function, the dose of the drug should be reduced depending on the clearance of creatinine. In the period when hemodialysis is not carried out, the dose of Enalapril must be selected taking into account the blood pressure.

Contraindications Enalapril

Increased sensitivity to any component or a valid substance. With an angioedema edema, which is associated with the use of ACE inhibitors or hereditary angioedema edema.

Pathology or status:

• Two-way stenosis of renal arteries.
• Individual intolerance to the components of the drug.
• Pregnancy, breastfeeding period.
• Children's age up to 18 years.

Since during treatment with enalapril, hypercalemia is possible (especially with accompanying CPN), the simultaneous purpose of the potassium-saving diuretics is not recommended.

The safety and efficacy of enalapril in children are not installed. Use in the Russian Federation for children is prohibited.

With simultaneous use with alcohol, the risk of arterial hypotension is increasing (excessive pressure drop).

Overdose

With an overdose of Enalapril, the following are possible. side effects - a pronounced reduction in blood pressure, up to the development of collapse, myocardial infarction, acute violation of cerebral circulation or thromboembolic complications; cramps and stupor.

In suspected overdose of Enalapril, the patient is translated into horizontal position Low headboard. In light cases, the washing of the stomach and the intake of the salt solution are shown.

In severe cases - activities aimed at stabilization of blood pressure: intravenous administration physiological solution, plasma substitutes, if necessary, the introduction of angiotensin II, hemodialysis (the elimination rate of Enalaprilla - 62 ml / min).

Side Effects of Enalapril

Dizziness are possible, headache, Increased fatigue, nausea, diarrhea, hypotension, orthostatic reactions, muscle spasms, dry cough, skin rash, angioedema edema, anemia, thrombocytopenia, leukopenia, agranulocytosis, change in taste sensations, changing voice timbre.

Rarely - an increase in urea level (gout), creatinine and transaminase in blood serum, proteinuria, cholestatic jaundice.

Prior to and during treatment, periodic control of blood pressure, blood indicators, the presence of protein in the urine is required in inhibitors.

Analogs of Enalapril, list of drugs

It is possible to use analogs of enalapril on the active substance. These are drugs (list):

• Bagrat
• Berlipril
• Vero Enalapril
• Invoril
• Mioto
• Renipril
• Rheniete
• Ednit
• Enalak
• Enalapril
• Enarel
• Envipril

Before replacing the medication assigned to you, it is necessary to consult with your doctor. Important - Instructions for use, the price and reviews of Enalapril and analogs may not coincide. You should not use this instruction and other information (reviews, etc.) for similar drugs. They can be squeezed as a concentration of AV, auxiliary substances, etc. Choosing how to replace the enalapril need to obtain a consultation of the attending physician, without this, it is impossible to replace the drug on analogue!

Conditions of vacation from pharmacies
The drug is released by the prescription.

Terms and Storage Terms
List B. Store in a dry, inaccessible for children. Place at a temperature of from 15 to 25 ° C. Shelf life - 3 years.

Antihypertensive drugs are reliable control of arterial hypertension and an integral part of the prevention of cardiovascular disasters, the safety of the kidney function and an active lifestyle.

pharmachologic effect

Enalapril is one of the most frequent medicines in tablets, which are used to treat arterial hypertension of various origin. Wide spectrum The effects of the drug allows it not only for diseases of the heart and blood vessels, but also in kidney diseases, which without adequate therapy lead to uncontrolled hypertension and steady deterioration of the kidney function with the development of Uremia. Moreover, enalapril is indispensable as a cardio-, reno- and vasoprotective agent.

The preparation contains the same active substance - enalapril.

Refers to the inhibitors of the angiotensin glittering enzyme of long-acting and means capable of suppressing the renin angiotensin-aldosterone system. Key pharmacological effects Medicinal drug Enalapril:

In its chemical structure, Enalapril is a prodrug. This means that when entering the stomach, the active substance of the drug is quickly absorbed into the walls of the digestive tract and becomes an active molecule - analoprylate. It is this component that provides the whole range of therapeutic effects on the body. Free enalaprilat is strictly specific, has a point exposure to target organs.

Due to the suppression of the angiotensin gluttering enzyme, Enalapril provides:

The advantage of Enalapril is the ability to lead to the expansion of predominantly arterial vessels than venous, which provides the normal rhythm of the middle man without reflexing pulse. At the same time, the decrease in blood pressure is equally effective as in vertical position patients and horizontal.

Ortostatic hypotension during treatment with enalapril is extremely rare, which allows medicine Even in patients prone to orthostatic reactions.

When enalapril is needed

According to the instructions for use, Enalapril helps in the following cases:

In persons with the already splashing deficiency of cordial activity, Enalapril is obligatory for receiving to increase survival and slowdown in the rate of progression of the disease.

How to accept

Enalapril is accepted inside. You can drink the drug before meals and after that.

The effect of the drug begins to develop within an hour after the reception.

The starting dose is most often 10 mg, in some cases - 20 mg. As the antihypertensive effect is treated and the dosage is adjusted. With moderate pressure figures, it is shown to drink 10 mg per day. The maximum allowable daily dose is 40 mg of the drug, which are used with high hypertension.

Contraindications and restrictions

Unalapril is not used in the following cases:

With caution applied enalapril if available:

In such cases, the need to treatment with an Elanpril under strict testimony is carried out under medical supervision. In general, therapy with antihypertensive means of various groups should be lifelong. Only dosages and multiplicity of reception at the attending physician are adjusted.

Unwanted manifestations

During treatment from various organs and systems, development is possible adverse Reactions. Most often found:

As for cough, if it does not bring patients expressed discomfort, the drug does not cancel. Cough when using all ACE inhibitors is episodic, does not accompany patients constantly. If the cough intensity increases, better medicine It is necessary to replace with angiotensin II receptor antagonists in the absence of contraindications.

Dangerous interactions

During combinations of enalapril with some medical means The development of adverse reactions is possible:

It is not allowed to combine all antihypertensive drugs with ethanol, which can lead to a pronounced drop of blood pressure.

Popular Analogues

Below are the most appointed medications, as part of which is contained active substance Enalapril:

The price of each specified means will depend on the dosage of the drug, the number of tablets in the package and manufacturer - domestic or imported.

Compliance with all rules for taking an antihypertensive drug ENALAPRIL ensures reliable protection of the cardiovascular system, reduces the frequency of hospitalization of patients with cardiac pathology and ensures the prevention of sudden cardiac death, coronary events, slows down the progression of kidney diseases with deferred the development of terminal renal failure.

Composition and form of release

in blister 10 pcs.; Blister box.

pharmachologic effect