Enalapril

The pharmacological action of Enalapril

Enalapril is an inhibitor of angiotensin converting enzyme.  Enalapril Tablets
 Enalapril exerts expanding action on arteries and to a lesser extent on the veins. The antihypertensive effect of Enalapril more clearly manifested in the increased concentration of renin in blood plasma. If enalapril improves renal and coronary blood flow. Prolonged use of Enalapril reduces left ventricular hypertrophy myocardium and prevents the development of chronic heart failure. Enalapril has a stimulating effect on the blood supply to the myocardium. Decreases platelet aggregation. Enalapril indicated for slowing the progression of left ventricular dysfunction in patients with myocardial infarction. According to the reviews of enalapril has some diuretic effect.

Enalapril - "prodrug", which produce hydrolysis, forms enalaprilat, which in turn inhibits the angiotensin converting enzyme. The hypotensive effect occurs within 1 hour after administration of enalapril and continued for 24 hours. Some patients require therapy over several weeks to achieve optimum blood pressure readings. Patients with chronic heart failure to receive significant clinical effect treatment requires at least 6 months.

Indications Enalapril

  • prevention of coronary ischemia;
  • arterial hypertension;
  • patients with left ventricular dysfunction of myocardium.

Contraindications

  • pregnancy;
  • Hypersensitivity to enalapril and peers among the angiotensin-converting enzyme;
  • lactation;
  • angioedema;
  • cerebrovascular diseases;
  • coronary insufficiency;
  • aortic stenosis;
  • patients after kidney transplantation;
  • hepatic or renal failure;
  • coronary artery disease;
  • decreased blood volume;
  • elderly patients;
  • patients under 18 years.

Side effects Enalapril

  • Orthostatic hypotension, rarely - palpitations, chest pain, pulmonary embolism, arrhythmias (atrial fibrillation, atrial tachycardia or bradycardia), angina pectoris, myocardial infarction;
  • fainting, dizziness, weakness, headache, paresthesia, insomnia, depression, anxiety, confusion, drowsiness (3.2%), fatigue, rarely in excess dosage - depression, nervousness;
  • dry mouth, impaired function of biliary excretion, dyspepsia (diarrhea or constipation, nausea, vomiting), intestinal obstruction, abdominal pain, pancreatitis, jaundice, hepatitis;
  • sore throat, rhinorrhea, dyspnea, bronchospasm, interstitial pneumonitis, non-productive cough;
  • glossitis, stomatitis, arthritis, arthralgia, myositis, vasculitis, serositis, photosensitivity, urticaria, pruritus, epidermal necrolysis, pemphigus (pemphigus), exudative erythema multiforme, exfoliative dermatitis, dysphonia, angioedema, skin rash person;
  • eosinophilia, agranulocytosis, thrombocytopenia, neutropenia, increased erythrocyte sedimentation rate, decreased Hb and hematocrit, hyponatremia, hyperkalemia, elevated transaminases, hypercreatininemia, hyperbilirubinemia, increased concentrations of urea, proteinuria;
  • decreased libido, alopecia.

Overdose enalapril

With an overdose of Enalapril reviews showed marked reduction of possible blood pressure, up to collapse, myocardial infarction, acute ischemic stroke, seizures, stupor.  Tablets enalapril 5 mg

Treatment: The patient should be given a horizontal position. In mild cases it is recommended gastric lavage with saline technique. In severe cases the therapy directed to the stabilization of blood pressure, including intravenous plasma expander was dissolved 0, 9% NaCl. If necessary - hemodialysis.

Enalapril Dosage and instructions for use

It is taken orally, regardless of the meal. The initial dose in hypertension - 5 mg / day. If the expected effect does not appear possible to increase the dose to 10 mg. With good tolerability acceptable dose increases to 40 mg / day, divided into 1-2 reception. By accident of 2-3 weeks the dose can be reduced to a maintenance level of 10-40 mg / day. The recommended dosage for moderate hypertension is 10 mg / day.

Patients with hyponatremia instruction Enalapril recommended initial daily dose is 2, 5 mg.

The initial dose of renovascular hypertension is 2, 5-5 mg / day. In the case of hypertension severe acceptable intravenous drug in a hospital.

The initial dosage for congestive heart failure of 2, 5 mg. In the future, increasing the dose every 3-4 days for 2, 5-5 mg Enalapril on the testimony of the clinical response, but not more than 40 mg / day, single or double daily administration.

The recommended dose of Enalapril instruction for the elderly is 1, 25 mg.

When asymptomatic left ventricular dysfunction infarction The recommended dosage is 5 mg / day, divided into two equal admission for 2, 5 mg.

The maximum dose of Enalapril - 40 mg / day.

Interaction with other drugs

It slows the excretion of lithium increases the effects of ethanol. It weakens the effect of drugs containing theophylline. Obtained in clinical reviews enalapril showed that its hypotensive effect can be reduced by nonsteroidal anti-inflammatory drugs, and on the contrary strengthened - diuretics, ethanol, drugs general anesthesia.





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