According to the annotation, the mechanism of action is the inhibition of angiotensin-converting enzyme (ACE) by enalapril, from which the decrease in the biosynthesis of angiotepsin II leads to vasodilation, the production of PGE2 and bradykinin, which are powerful vasodilators.
In patients with heart failure with prolonged use (6 months or more), an increase in the tolerance of physical exertion by the heart is noted, the size of the heart decreases, and the number of deaths decreases. Under the influence of the drug, a small circle of blood circulation is unloaded, the pressure in the pulmonary capillaries decreases, the heart rate decreases, cardiac output increases (heart rate does not increase at the same time).
The absorption of the drug Enalapril reaches 60%, regardless of the intake and availability of food in the digestive tract. The maximum concentration of the active substance enalaprilat is observed 1 hour after application. In the liver, it is biotransformed to enalaprilat. It easily passes through the placenta, histohematological barriers. It is excreted by the kidneys.
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Enalapril tablets, instructions for use (method and dosage)
The medicine is taken orally. The initial dosage is 5 mg per day, the drug is taken 1 time per day. With pathology of the renal system, taking diuretics, the dose is reduced to 2,5 mg. To achieve the effect, depending on individual characteristics, the dose of the drug can be increased to 10-40 mg per day (can be divided into 2 doses).
The drug is used regardless of the meal.
For hypertension, 5 mg of enalapril maleate should be taken in the morning. The maintenance dose is 10 mg. You should not take more than 40 mg of the drug per day.
In chronic heart failure, take 2 mg of the drug in the morning. The maintenance dose is 5-5 mg. You should not take more than 10 mg of the drug per day.
With left ventricular dysfunction, take 2,5 mg twice a day. The maintenance dose is 10 mg twice daily.
How to take with impaired renal function? In this situation, consume 2,5 mg per day. The maintenance dose is usually 5-10 mg. The maximum dose is 20 mg per day.
Anytime. First take 2,5-5 mg once every 24 hours. The maintenance dose is 10–20 mg once every 24 hours. The maximum dose is 40 mg in 1–2 doses.
Similar to the dosage method of the previous drug.
1-2 tablets once every 24 hours, regardless of the meal.
Excessive drop in blood pressure, myocardial infarction, stroke, thromboembolic complications as a result of a sharp decrease in blood pressure. Treatment: iv administration of NaCl (isotonic solution). There is no specific antidote.
Enalapril tablets are washed down with a small amount of water. You can take both before meals and after. Dosages are set individually for each patient, taking into account the stage of the disease and the specifics of the body.
The instructions indicate recommended dosages:
- Moderate hypertension – 5 mg once a day (half a tablet). If necessary, the dosage is gradually increased, but not more than 40 mg per day.
- Severe form of hypertension – initially taken at 2,5 mg once a day. The dose is gradually increasing. In severe cases of the disease, the drug is administered intravenously.
- In the treatment of chronic heart failure, the first days should take 2,5 medicines. Gradually, the dose is increased to 5-40 mg.
- After a heart attack, the drug is prescribed on the third day of treatment. It is taken three times a day, the dosage is 1/2 tablet (10 mg). Then the dosage is increased to the maximum.
- For patients with kidney disease, the drug is prescribed in a dosage of 40 ml (divided into three doses). If lung disease is severe, the daily dose should not exceed 12,5 mg.
For people over the age of 65, treatment is recommended to start with a minimum amount of the drug – 1,25 mg.
With an overdose, there is a sharp decrease in pressure, sudden weakness, confusion. A gastric lavage is carried out, antihistamines are given. In severe cases, hospitalization is necessary.
Reception during pregnancy and lactation
Enalapril is contraindicated in pregnancy at any time. Studies have shown that taking an ACE inhibitor disrupts the course of pregnancy and causes fetal development pathologies. If the pregnant woman took the drug, it is necessary to conduct a complete clinical study and ultrasound to assess the condition of the body of a woman and a child.
When breast milk is fed, the active substance enters the baby’s body. The result is a violation of the stool, nausea, colic, fainting, low blood pressure and other complications.
The drug has the following side effects: fatigue, dizziness, headache, cramps, nervousness, insomnia, glossitis, tinnitus, dry cough, nausea, orthostatic hypotension, palpitations, dyspeptic disorders, proteinuria, impotence, impaired liver, kidney function, hyperkalemia, Quincke’s edema, neutropenia, increased levels of bilirubin in the blood, hair loss, pain in the heart, increased concentration of hepatic transaminases.
- emetic urges;
- the tide;
- oppressed state;
- laryngeal edema;
- upset stool;
- sore stomach;
- redness of the skin;
- decreased vision;
- soreness in the chest;
- increased calcium concentration;
- angina pectoris;
- a sharp increase in blood pressure;
- hypersensitivity to the sun;
- with problems with falling asleep;
- dry mouth;
- violation of taste sensations;
- peptic ulcer;
- sharp weight loss;
- circulatory disorders in the brain;
- bleeding gums;
If side effects occur, the drug is discontinued.
The absorption of enalapril while taking diuretics, beta-blockers begins to increase.
It is forbidden to take other drugs together, the action of which is aimed at lowering the pressure. While taking NSAIDs, the effect of enalapril is reduced.
Hematologic type disorders are caused by simultaneous treatment with immunosuppressants.
The drug increases the therapeutic effect of funds containing potassium, which causes negative reactions.
Hepatotoxicity increases while taking cytostatics.
If the patient is taking other drugs, a doctor’s consultation is necessary.
The absorption of the drug is independent of food intake. While taking beta-adrenoreceptor blockers, nitrates, methyldopa, calcium antagonists, prazosin, hydralazines, enalapril potentiates the hypotensive effect. Cimetidine increases T1 / 2 of the drug. NSAIDs increase nephrotoxicity, reduce the effectiveness of enalapril.
If the tablets are prescribed regularly or for a long time, there is a need to conduct a kidney test.
If a dry cough begins after administration, the administration must be stopped. Otherwise, it can cause pneumonia.
The drug in high doses can cause an anaphylactic reaction.
Concomitant use with alcohol is prohibited.
The tool can cause dizziness, confusion, a tendency to fall asleep. Therefore, it is forbidden to engage in activities requiring increased attention, and drive cars.
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