Enap, pills 20mg, 20pcs

Composition

1 tablet contains:

enalapril maleate 10 mg.

Auxiliary substances:

lactose monohydrate,

hydroxypropyl cellulose,

corn starch,

sodium bicarbonate,

talc,

magnesium stearate.

Pharmacological action

Enap is an antihypertensive drug, the mechanism of action of which is associated with inhibition of the activity of angiotensin-converting enzyme, leading to a decrease in the formation of angiotensin-II.

Enalapril is a “prodrug”: as a result of its hydrolysis, enalaprilate is formed, which inhibits ACE. The mechanism of its action is associated with a decrease in the formation of angiotensin II from angiotensin I, a decrease in the content of which leads to a direct decrease in the release of aldosterone. This reduces the total peripheral vascular resistance, systolic and diastolic blood pressure( BP), post-and preload on the myocardium.

Dilates the arteries to a greater extent than the veins, while there is no reflex increase in heart rate.

The hypotensive effect is more pronounced with high plasma renin levels than with normal or reduced renin levels. Reducing blood pressure (BP) within therapeutic limits does not affect cerebral circulation, blood flow in the brain vessels is maintained at a sufficient level and against the background of reduced blood pressure. Increases coronary and renal blood flow.

With prolonged use, hypertrophy of the left ventricle of the myocardium and myocytes of the walls of resistive arteries decreases, prevents the progression of heart failure and slows down the development of left ventricular dilation. Improves blood supply to the ischemic myocardium. Reduces platelet aggregation.

It has some diuretic effect.

The time of onset of the hypotensive effect when taken orally is 1 hour, reaches a maximum in 4-6 hours and persists for up to 24 hours. In some patients, therapy for several weeks is necessary to achieve optimal blood pressure levels. With heart failure, a noticeable clinical effect is observed with prolonged use-6 months or more.

Indications

• arterial hypertension,
• heart failure,
• asymptomatic left ventricular dysfunction (as part of combination therapy).

Contraindications

• hypersensitivity to amlodipine or other components of the drug,
• hypersensitivity to other ACE inhibitors,
• a history of angioedema, including those associated with the use of ACE inhibitors (an allergic reaction with a sharp swelling of the lips, face, neck and, might of arms and legs, accompanied by dyspnea and hoarseness),
• porphyria,
• patients who have ever observed angioedema.

Side effects

• dry cough,
• pharyngitis,
• laryngitis,
• dizziness when sitting upright, palpitations, chest pain,
• impaired kidney function and blood picture,
• nausea, vomiting, abdominal pain,
• allergic skin reactions,
• headache, depression, sleep disorders,
• increased potassium in the blood.

Interaction

The patient should refrain from taking alcoholic beverages, as ethanol increases the reduction in blood pressure (BP) by enalapril.

Concomitant use of enalapril and diuretics or other antihypertensive agents increases the effectiveness of these drugs.

Interactions with drugs used to treat heart failure (cardiac glycosides) are not clinically relevant.

Before surgery, the doctor should be informed that the patient is taking enalapril, as there is a risk of hypotension during general anesthesia.

Concomitant use of enalapril and nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (aspirin), as well as estrogens, may reduce the effectiveness of enalapril and increase the risk of impaired renal function.

Concomitant use of certain diuretics (spironolactone, amiloride, or triamterene) and / or additional use of potassium-containing tablets may cause an increase in serum potassium levels (hyperkalemia).

Drugs that cause bone marrow suppression increase the risk of developing neutropenia and / or agranulocytosis.

Immunosuppressants, allopurinol, cytostatics increase hematotoxicity.

Enalapril weakens the effect of drugs containing theophylline. Concomitant use of lithium medications may increase the side effects of lithium.

Concomitant use of Enap with cimetidine increases the half-life (T 1/2) of Enap. If the patient is already taking the above medications or is advised to take any of them, they should inform their doctor that they are taking Enap.

How to take, course of use and dosage

Medication Enap is prescribed orally, regardless of the time of food intake. The initial dose of Enap is 10-20 mg per day (once).

In the future, the dose is selected individually for each patient-usually 20 mg per day once.

The maximum daily dose should not exceed 40 mg.

In case of heart failure, it is prescribed starting from 2.5 mg, then the dose is gradually increased to 10-20 mg (in one or two doses).

Overdose

If the patient has taken too many pills at one time, call a doctor immediately. Symptoms:  excessive decrease in blood pressure (BP) up to the development of collapse, myocardial infarction, acute cerebrovascular accident or thromboembolic complications, convulsions, stupor.

Treatment:  the patient is placed in a horizontal position with a low headboard. In mild cases, gastric lavage and ingestion of saline solution are indicated, in more serious cases-measures aimed at stabilizing blood pressure (BP), intravenous use of saline solution, plasma substitutes, if necessary – intravenous use of angiotensin II, hemodialysis (the rate of elimination of enalaprilat is 62 ml/min).

Special instructions

Use with caution Enap for car drivers. When used concomitantly with diuretics, beta-blockers effect of the drug Enap is enhanced, and with nonsteroidal anti-inflammatory drugs, the effect is reduced.

Hypotension (a sharp decrease in blood pressure) may occur (even a few hours after the first dose) in patients with severe heart failure or severe renal impairment, as well as in patients with impaired water and electrolyte balance due to diuretic treatment, a salt-free diet, diarrhea, vomiting, or who are on hemodialysis. A marked decrease in blood pressure (BP) usually manifests itself in the form of nausea, increased heart rate (HR), and fainting.

If hypotension develops, the patient should take a horizontal position, with a low headboard, and call a doctor.

Form of production

Enap tablets are light orange in color, flat-cylindrical, with a risk and chamfer; white and brown-maroon inclusions are allowed on the surface and in the mass of the tablet.

Storage conditions

In a place protected from moisture, at a temperature not exceeding 25 °C

Shelf life

3 years

Active ingredient

Enalapril

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For adults as directed by your doctor

Indications

Heart Failure, Hypertension