Enalapril NL pills 12.5mg + 10mg 20pcs

Composition

Tablets are round, white or white with a beige tint, cylindrical, biconvex in shape, with a risk on one side.

1 tab. hydrochlorothiazide 12.5 mg enalapril maleate 20 mg

Excipients:

lactose 129.5 mg,

microcrystalline cellulose 20 mg,

povidone 6 mg,

croscarmellose sodium 8 mg,

colloidal silicon dioxide 2 mg,

magnesium stearate 2 mg

Pharmacological action

Enalapril inhibits ACE, which promotes the conversion of angiotensin I to angiotensin II, reduces the concentration of aldosterone in blood plasma, increases the release of renin, improves the functioning of the kallikrein-kinin system, stimulates the release of prostaglandins and endothelial relaxing factor, and inhibits the sympathetic nervous system. Together, these effects eliminate spasm and dilate peripheral arteries, reduce total peripheral vascular resistance, systolic and diastolic blood pressure( BP), and post-and preload on the myocardium. Dilates the arteries to a greater extent than the veins, while there is no reflex increase in the heart rate (HR).

The antihypertensive effect is more pronounced at high plasma renin concentrations than at normal or reduced levels. Lowering blood pressure within therapeutic limits does not affect cerebral circulation. Improves blood supply to the ischemic myocardium. Increases renal blood flow, while the glomerular filtration rate does not change. In patients with initially reduced glomerular filtration rate, its rate usually increases.

The maximum effect of enalapril develops in 6-8 hours and persists up to 24 hours after oral use. Hydrochlorothiazide is a medium-acting thiazide diuretic.

Reduces the reabsorption of sodium ions at the level of the cortical segment of the Henle loop, without affecting its section passing in the medulla of the kidney. Blocks carbonic anhydrase in the proximal part of the convoluted tubules, increases the excretion of potassium ions, bicarbonates and phosphates by the kidneys.

Practically does not affect the acid-base state. Increases the elimination of magnesium ions. Detains calcium ions in the body. The diuretic effect develops in 1-2 hours, reaches a maximum in 4 hours, and persists for 10-12 hours. The effect decreases when the glomerular filtration rate decreases and stops when its value is less than 30 ml / min.

Reduces blood pressure by reducing the volume of circulating blood (BCC), changes in the reactivity of the vascular wall. The use of a combination of enalapril and hydrochlorothiazide leads to a more pronounced decrease in blood pressure compared to monotherapy with each of the drugs separately and allows maintaining the antihypertensive effect of Enalapril H, Enalapril NL and Enalapril NL for at least 24 hours.

Indications

Arterial hypertension (patients who are indicated for combination therapy).

Contraindications

Hypersensitivity to enalapril or other ACE inhibitors, hydrochlorothiazide or other sulfonamide derivatives, or other components of the drug; lactose intolerance, lactase deficiency, or glucose-galactose malabsorption syndrome; anuria; a history of angioedema (including those associated with the use of ACE inhibitors); hereditary and/or idiopathic angioedema; severe liver function disorders (more than 9 points on the test score). Child-Pugh score); severe renal impairment (creatinine clearance less than 30 ml/min); pregnancy; lactation; age up to 18 years (efficacy and safety of the drug have not been established).

How to take, course of use and dosage

Enalapril N, Enalapril NL and Enalapril NL 20 should be taken regularly at the same time, preferably in the morning, regardless of the meal time, without chewing, with a small amount of liquid,1 time a day. The recommended dose is 1 tablet per day, which is the maximum daily dose of Enalapril N. For Enalapril NL and Enalapril NL 20, if necessary, the dose can be increased to 2 tablets taken once a day, this dose is the maximum daily dose.

In patients taking diuretics, it is recommended to cancel them or reduce the dose at least 3 days before starting treatment with Enalapril H, Enalapril NL or Enalapril NL 20 to prevent the development of symptomatic hypotension. Impaired renal function: Enalapril N, Enalapril NL and Enalapril NL 20 are contraindicated in patients with severe renal insufficiency (creatinine clearance < 30 ml / min).

In patients with renal insufficiency with creatinine clearance greater than 30 ml/min, Enalapril H, Enalapril NL and Enalapril NL 20 can be used only after blood pressure stabilization during treatment with enalapril and hydrochlorothiazide in separate dosage forms and selection of their doses. The recommended initial dose of Enalapril NL is 1/2 tablet once a day. Potassium and creatinine levels should be monitored regularly (every 2 months)..

Active ingredient

Hydrochlorothiazide, Enalapril

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For adults as directed by your doctor

Indications

Hypertension, Heart Failure