"Enalapril": instructions for use and feedback. Analogues of "Enalapril"

In the event of problems with blood pressure, many receive advice from the treating doctors to take the drug Enalapril (pills). What helps to get rid of this medicine? From the consequences of the disease (that is, directly from the increase in blood pressure), or does it act in several ways, restoring the normal activity of the cardiovascular system, resulting in BP coming to normal? To understand how the tablets act from the pressure of Enalapril, it is worth familiarizing yourself with the official instruction on the use of this medication. In addition, we will consider a number of analogues of this drug for the active substance and the effect it provides.

Description of the preparation, form of release, storage features and conditions of leave from pharmacies

Tablets from the pressure of "Enalapril " are manufactured by many pharmaceutical companies all over the world. The main active substance of this drug is enalapril maleate, which, according to its group affiliation, belongs to the ACE blockers. Currently, there are tablets with an active substance content of 5, 10 and 20 mg. Due to the fact that the drug from the pressure of "Enalapril" directly affects the functioning of the SSS and a number of other systems in the body, its leave from pharmacies is carried out according to the doctor's prescription.

The timing of implementation and use of this drug is limited to 3 years from the date of its production. In this case, the tablets do not lose their therapeutic properties while observing the storage rules. Manufacturers recommend keeping the medicine in a dry place, protected from direct sunlight, at a temperature of not less than 15 and not more than 25 degrees.

Analogues of "Enalapril" have the same properties, so the recommendations applicable to the drug can be observed and stored.

Pharmacodynamics of the drug

Enalapril maleate (active substance tablets) by itself does not affect the processes occurring in the human body processes. The matter is that this compound is considered a kind of "prodrug", which as a result of a few hydrolysis reactions forms a completely new substance - enalaprilat.

It is it that acts depressingly on active ACE, which provokes a significant decrease in the amount of aldosterone in the human body. In a word, the action of "Enalapril" is to lower blood pressure (both diastolic and systolic) and reduce the load on the heart muscle (myocardium).

As a result of long-term observations it was possible to find out that, despite the decrease in arterial pressure, after receiving the drug "Enalapril", patients did not have an insufficient level of blood circulation in the brain. In addition, the reception of tablets contributed to the enhancement of renal and coronary blood flow.

Prolonged use of the drug showed high efficiency in relation to hypertrophied tissues, localized in the left ventricle of the cardiac muscle, thus contributing to preventing the progress of heart failure. In addition, therapy with Enalapril for 6 months improved the condition of patients with dilatation of the left ventricle and impaired circulation in the myocardium resulting from ischemia.

The active substance of the drug is detected in the blood plasma 1 hour after taking the tablets and reaches a maximum after 4-6 hours. The hypotensive effect lasts up to 24 hours.

The same pharmacological properties are possessed by analogues of "Enalapril" according to the active substance.

Pharmacokinetics of the drug

As mentioned above, the assimilation of the active substance of the drug occurs fairly quickly. Only about 60% of enalapril maleate is absorbed, and practically the whole volume comes into contact with plasma proteins. Specialists draw the attention of consumers to the fact that the absorption of the compound does not depend on the intake of food.

A high degree of penetration of enalapril through the GHB barriers is due to the molecular structure of the active substance. It is also able to overcome placental barriers and is found in the tissues of the breast and milk in lactating women.

The drug is excreted mainly by the kidneys (60%). At the same time, in the unchanged form of output about 20%, and 40% - in the form of a metabolite. Residues of the active substance exit through the intestine, while the ratio of enalapril / enalaprilat has a value of 6-8% / 25-27%.

Indications and contraindications for use

Indication for the use of the drug Enalapril is a persistent increase in blood pressure caused by diseases such as scleroderma and CHF. In addition, the drug is often used in preventive therapy in patients with diagnosed coronary ischemia, LV dysfunction (including asymptomatic). Here such is the preparation of "Enalapril" indications for use, but self-medication is not recommended in any case. Only a specialist can draw up a correct treatment regimen and determine the dosage.

During the examination, the doctor will also be able to establish the presence or absence of possible contraindications. These include the following diseases and malfunctions of organs:

1. An increased level of sensitivity to the active substance of the drug (analogues of "Enalapril" in this case also need to be canceled, since in most cases they have a composition similar to this drug).
2. Pregnancy, lactation and children under 18 years of age.
3. Previous angioedema occurred during treatment with drugs from the group of ACE inhibitors.
4. Insufficiency of cerebral circulation, as well as other cerebrovascular diseases.
5. Disorders of cerebral hematopoiesis.
6. Kidney disease, including stenosis of the renal arteries (bilateral or unilateral), renal failure, the presence of a transplanted organ.
7. Diseases of the liver.
8. Diseases of the gastrointestinal tract, accompanied by diarrhea and vomiting.
9. Scleroderma and other autoimmune diseases affecting connective tissues.
10. Disorders of metabolic processes in the body, including hyperkalemia.
11. Diabetes.

Reception of "Enalapril" in all situations described above, should be canceled, or the therapy is conducted under the constant supervision of specialists.

The medicine "Enalapril": list of side effects

Despite the great benefit of the drug, when it is taken in patients, there can be a variety of side effects that affect almost all organ systems. Information on adverse events is contained in the table below.

First of all, these phenomena are provoked by direct influence on the body of the main active substance of the drug Enalapril. Analogues (instructions on how to use them contain detailed information on this issue) can also cause such violations. It is important for the patient and his attending physician to notice signs of side effects in time, since their ignoring can lead to serious disturbances in the functioning of the body.

How to take Enalapril tablets: methods and dosage

To stabilize blood pressure, experts recommend long-term use of the drug (including its analogues, for example, the drug "Enalapril hexal"). At the initial stage of treatment of hypertension, it is recommended to take the drug at a dose of 5 mg per day. With a systematic increase in pressure during a two-week therapy, the dosage is increased by 5 mg. It is worth noting that the first 2-3 hours after the start of treatment the patient should be under the supervision of a doctor. This helps to identify side effects at the very beginning of their development. The maximum dose of the drug should not exceed 40 mg per day, but even the use of this amount of medication is possible only if absolutely necessary and the drug is well tolerated.

After 2-3 weeks after the start of monotherapy with Enalapril, patients are transferred to the maintenance regimen of the drug. During this period, the daily dose of the drug is 10-40 mg. You need to take the pill 1-2 times a day. It is recommended to regularly measure blood pressure during treatment.

The above recommendations are applicable to those patients who do not suffer from concomitant diseases such as hyponatremia and renovascular hypertension. In what doses should I take the drug to them? Typically, this depends on the individual characteristics of the patient and the degree of development of the disease. The initial dose in any case can be calculated only by the attending physician.

The duration of taking the drug depends on several factors, including the patient's condition and the results of laboratory tests. Experts say that a sharp drug cancellation can lead to negative consequences. Therefore, even with excessive lowering of blood pressure on the background of taking the drug "Enalapril", it is necessary to gradually reduce the dosage.

Symptoms and treatment of drug overdose

So, we examined the main characteristics of the drug Enalapril (pills): what they help and what can their reception lead to in the end. It's time to move on to discussing such an issue as an overdose with this drug. Often, patients tend to take large doses of drugs in the hope of quickly getting rid of unpleasant symptoms. In the event that this happens with the person taking the medicine "Enalapril", the consequences can be very serious. Against the background of lowering blood pressure in patients, there may be a collapse, which often leads to myocardial infarction or serious impairment of cerebral circulation.

As a rule, the first symptoms of an overdose are loss of consciousness, a state of stupor or the appearance of seizures. Also, there may be other signs of damage to the cerebral circulation and cardiac disorders: pallor of the skin, severe headache, chest pain.

Treatment of a patient with an overdose of the drug "Enalapril" is symptomatic. At a slight degree of poisoning shows the reception of saline and gastric lavage. In more severe cases, intravenous saline and plasma substitutes may be required, as well as hemodialysis.

Drug Interactions

Tablets "Enalapril" are able to act atypically when taken together with other medicines. Non-steroidal anti-inflammatory drugs ("Ibuprofin", etc.) and estrogen-containing preparations significantly reduce its hypotensive effect. Adrenoblockers, nitrate-containing drugs, anesthetics and ethanol enhance the action of the drug Enalapril. Diuretics, taken together with tablets to reduce pressure, can cause the development of hyperkalemia. With extreme caution should be treated with drugs from the group of immunosuppressants, as they when taken together with enalapril-containing drugs significantly increase its hematotoxicity.

Reviews about the drug

For today about a preparation it is possible to hear both positive, and negative responses. The first significant advantage of "Enalapril" tablets is the price (20-25 rubles per package), which can not be attributed to high. In addition, it is also valued in the preparation and its effectiveness. In the role of the main disadvantages are numerous adverse reactions and a high risk of complications in the presence of concomitant diseases.

For most patients, Enalapril tablets helped to get rid of a systematic increase in blood pressure. Those consumers whose reception caused disturbances in the functioning of various organs had to abandon not only this drug but also its analogues, since in most cases they contain the same active substance or similar enalapril indapamide. That's why experts strongly do not recommend taking several drugs simultaneously to lower blood pressure.

Analogues of "Enalapril": differences, merits and demerits

In the world pharmaceutical market, there are many drugs, the action of which is similar to the drug Enalapril. Most often they have a higher cost, which does not always guarantee the absence of adverse reactions or higher efficacy of drugs. Consider a list of drugs that have an active ingredient in the composition, similar to that found in tablets "Enalapril". As a rule, pharmaceutical laboratories in the West use as an essential component amlodipine enalapril, whose difference from enalapril maleate is only in the molecular structure. In the rest it has the same characteristics and properties.

The following analogues of Enalapril are found on the Russian pharmaceutical market:

1. Tablets and ampoules for injection "Enap" from the Slovenian company KRKA. Their cost starts from 280 and comes to 4000 rubles for packing tablets, and 500 rubles for 10 ampoules with a solution. Apparently, unlike the drug "Enalapril", the price for them is quite high, which makes the drugs of this brand inaccessible to a large number of consumers. At the same time, experts note the high quality of this analogue.
2. Tablets "Enalapril Hexal" from the German manufacturer SANDOZ. Domestic drug is not inferior to this medication by its effectiveness. The cost of the analogue is slightly higher than the price for "Enalapril" and is about 78-100 rubles per package.
3. Berlipril tablets produced by the German pharmaceutical company Berlin-Chemie. The main active substance of the drug is enalapril amlodipine. Due to the fact that obtaining this compound is more complicated and expensive, the cost of tablets is about 140-180 rubles per package.
4. Tablets "Renitek" from MERCK, whose cost is in the middle price range and is 80-150 rubles per pack.

Also in pharmacies, it is possible to find analogues of "Enalapril" similar in composition and action with the drug, such as Kalpiren, Miopril, Envas, Vazopren and Myopril. Specialists, however, note that not always mentioned medicines can be used as a substitute for a domestic drug that has not approached the patient for any reason. The fact is that in their composition they almost completely repeat our "Enalapril", which means that they can also cause a variety of complications. Also, doctors advise paying attention to the composition of medicines produced abroad. Amplodipine enalapril, whose difference from enalapril maleate is small, can also act on the body in an unfavorable manner. In any case, before using as the main drug of any of the above-mentioned analogs, it is worth consulting with the treating doctor.