Enalapril N, pills 25mg + 10mg, 20pcs

Composition

Hydrochlorothiazide+Enalapril:  25 mg+10 mg

. excipients:

lactose monohydrate,

potato starch,

microcrystalline cellulose,

povidone,

sodium bicarbonate,

sodium carboxymethyl starch (sodium starch glycolate),

talc,

magnesium stearate.

Pharmacological action

Pharmacogroup:

antihypertensive combined agent (ACE inhibitor+diuretic).

Pharmaceutical action:

Combined drug, the action of which is due to the components that make up its composition; has a hypotensive effect.

Hydrochlorothiazide is a medium-acting diuretic that increases urinary excretion of Na+, Cl -, water, and bicarbonate. A decrease in the concentration of Na+ in the vascular wall leads to their dilation, reduces sensitivity to vasoconstrictor factors.

Enalapril inhibits ACE, which promotes the conversion of angiotensin I to angiotensin II, reduces the concentration of aldosterone in the blood, increases the release of renin, improves the functioning of the kallikrein-kinin vasodepressive system, stimulates the release of Pg and NO, and depresses the sympathetic nervous system. Together, these effects eliminate spasm and dilate peripheral arteries, reduce OPSS, SBP and DBP, and post-and preload on the myocardium.

Hydrochlorothiazide reduces the concentration of K+ in the blood, enalapril causes its delay; with the combined use of these drugs, normal maintenance of the concentration of K+ in the blood is ensured.

Indications

Arterial hypertension.

Contraindications

Hypersensitivity (including to other sulfonamide derivatives), anuria, a history of angioedema associated with ACE inhibitors, hereditary or idiopathic angioedema, pregnancy, lactation, childhood.

With caution. Renal/hepatic insufficiency, severe systemic connective tissue diseases (including SLE, scleroderma), bilateral renal artery stenosis, single kidney artery stenosis, post-kidney transplant condition, aortic stenosis, CHF, CHD, bone marrow hematopoiesis depression, cerebrovascular diseases (including cerebral circulatory failure), diabetes mellitus, hyperkalemia, Na+ restricted diet, conditions accompanied by a decrease in blood pressure, aortic stenosis, chronic heart failure, coronary heart disease, BCC (including diarrhea, vomiting), old age.

Side effects

Most often: dizziness, increased fatigue.

1-2%: muscle cramps, nausea, asthenia, orthostatic hypotension, headache, cough, impotence.

From the cardiovascular system: syncope, decreased blood pressure, palpitations, tachycardia, chest pain.

Allergic reactions: angioedema (face, tongue, lips, vocal cords, larynx, limbs, intestines), malignant exudative erythema (Stevens-Johnson syndrome).

Nervous system disorders: dizziness, insomnia or drowsiness, paresthesia, hyperexcitability.

Respiratory system disorders: shortness of breath.

From the digestive system: dryness of the oral mucosa, dyspepsia (including nausea, vomiting, flatulence), diarrhea or constipation, abdominal pain, pancreatitis.

From the genitourinary system: impaired renal function, renal failure, decreased libido.

From the skin: skin rash, itching, sweating.

Laboratory parameters: hyperglycemia, hyper-or hypokalemia, increased serum urea concentration, hypercreatininemia, hyperuricemia, increased activity of “hepatic” transaminases, hyperbilirubinemia, decreased Hb and hematocrit.

Other: gout, tinnitus, arthralgia, lupus-like syndrome (fever, serositis, vasculitis, myalgia/myositis, arthralgia/arthritis, positive antinuclear antibody test, increased ESR, eosinophilia, leukocytosis, skin rash, photosensitization).

How to take, course of use and dosage

Inside, regardless of food intake,1-2 tablets 1 time a day (in patients with reduced glomerular filtration rate up to 30 ml/min, individual dose selection is required, in terms of enalapril-5-10 mg / day).

Overdose

Symptoms: excessive decrease in blood pressure up to the development of collapse, myocardial infarction, acute cerebrovascular accident or thromboembolic complications; convulsions, stupor.

Treatment: gastric lavage, ingestion of saline solution, intravenous use of plasma substitutes, angiotensin II, hemodialysis (elimination rate-62 ml / min).

Special instructions

Therapy should be discontinued before examining the function of the parathyroid glands. Undergoes dialysis. Dose adjustment on days when dialysis is not performed should be carried out depending on blood pressure. Blood pressure, renal function, and K+ plasma concentrations should be monitored before and during treatment.

Caution should be exercised when prescribing to patients with reduced BCC (as a result of diuretic therapy, when limiting salt intake, hemodialysis, diarrhea and vomiting) due to the increased risk of sudden hypotension after even the initial dose. Transient arterial hypotension is not a contraindication for continuing treatment with the drug after blood pressure stabilization. In case of repeated occurrence of severe hypotension, the dose should be reduced or the drug should be discontinued.

In case of excessive arterial hypotension, the patient is transferred to a horizontal position with a low headboard, if necessary,0.9% NaCl solution is administered (to increase the plasma volume). Patients with decompensated CHF, CHD, and vascular diseases of the brain should be monitored, and a sharp decrease in blood pressure may lead to myocardial infarction or stroke, or impaired renal function.

The use of AN69 dialysis membranes in combination with ACE inhibitors is not recommended.

Composition

Tablet Form of production

Active ingredient

Hydrochlorothiazide, Enalapril

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For adults as directed by your doctor

Indications

Heart Failure, Hypertension