Enam - antihypertensive
Structure and Composition Enam
The drug is released in the form of tablets in a dosage of 2, 5 mg, 5 mg and 10 mg. The active ingredient of the drug - Enalapril maleate.
The blisters of 10 tablets. 20 tablets in a cardboard package (two packages).
According to the instructions Enam is antihypertensive drugs. Active ingredient is rapidly absorbed into the body, forming a pharmacologically active substance - enalaprilat. Application Enam inhibits angiotensin-converting enzyme in the body, preventing the conversion of angiotensin I into angiotensin II, thereby reducing the total peripheral vascular resistance, reduces the level of aldosterone and raises the level of bradykinin, the system activates the depressor and pressor oppressing system.
Admission Enam on the testimony leads to a decrease in diastolic and systolic pressure, not developing at the same reflex tachycardia.
In the opinion of Enam reduces left ventricular hypertrophy and reduces myocardial oxygen demand. Under hypoxic conditions improves the heart muscle. The drug inhibits development of diabetic nephropathy, renal blood flow increases, which leads to a reduction in cardiac mortality. Enam no effect on carbohydrate and lipid metabolism.
According to the instructions Enam indicated for the treatment of patients with hypertension in various forms, including essential arterial and renovascular hypertension.
In addition, Enam is an indication for chronic heart failure (in combination therapy).
Use the drug for the prevention of coronary ischemia and severe heart failure patients with reduced left ventricular function.
Dosing and dosing regimen Enam
According to the instructions Enam intended for ingestion. Taking the drug without food, usually once daily at approximately the same time. Dosage depends on the age of the patient and the indications for Enam.
In essential hypertension in adult, usually, the dosage is 2 mg per day 5-5. The maximum dose of the drug is 40 mg per day.
Before taking enalapril recommended that patients taking diuretics, stop taking them at least three days. Begin therapy Enam with minimal dose and gradually increase it to the optimum.
In heart failure in the adult starting dose is 2, 5 mg per day with gradual increase it to 20 mg.
With reduced kidney function the dosage of enalapril in need of constant correction. The maximum daily dosage for humans with a reduced creatinine clearance of 30 to 80 ml / min is 10 mg, and creatinine clearance of 10 to 30 ml / min - 5 mg. For patients on hemodialysis, the maximum daily dose is 2, 5 mg.
Increasing intervals between doses should be at least two weeks.
For children older than six years with hypertension Enam initial dosage is 2, 5 mg per day. The maximum daily dosage for children is calculated on the basis of 0, 58 mg per kg of body weight.
The instructions to Enam contain the following contraindications:
- hypersensitivity to enalapril and other ingredients;
- aortic and mitral stenosis;
- during pregnancy and breastfeeding;
- reduced renal function (creatinine clearance less than 30 mL / min);
- idiopathic or hereditary angioedema;
In the opinion of Enam
not recommended for patients with a syndrome of glucose-galactose malabsorption, lactase deficiency galactosemia, and as part of the drug is present in the lactose.
Enam prescribed with caution in:
- violation of cerebral blood flow;
- coronary heart disease;
- violation of water-salt balance;
- congestive heart failure;
- reduced kidney function;
- renal artery stenosis.
Side effects Enam
Enam Review mostly well tolerated by patients. At the beginning of treatment, a slight reduction in blood pressure, fatigue and dizziness. In addition, the drug may cause the following side effects:
- Respiratory system: rhinorrhea, pharyngitis, glossitis, dyspnea, nonproductive cough. If you have a cough should be repealed enalapril and appoint an alternative therapy.
- Cardiovascular system: bradycardia, myocardial infarction, angina pectoris, tachycardia.
- Gastrointestinal tract: indigestion and stools, nausea, dryness of the oral mucosa, pancreatitis, epigastric pain, increased liver transaminases, decrease in liver function. In addition, reviews of Enam can cause stomatitis, ileus, loss of appetite and altered taste.
- Central nervous system depression, headache, cramps, insomnia, impaired motor coordination, tinnitus, paresthesia.
- Hematopoietic system: hypoglycemia, neutropenia, reduction of leucocyte, hematocrit and hemoglobin, proteinuria, increased plasma concentrations of bilirubin and potassium.
- Allergies: bronchospasm, urticaria, pruritus. Occasionally you may experience angioedema face, lips and tongue, larynx. In this case requires emergency care.
- Other side effects include agranulocytosis, erectile dysfunction, alopecia, Raynaud's syndrome, hot flashes, renal failure, increased sweating.
In addition to these symptoms can cause the application of Enam simpatokompleksa development, which included present: vasculitis, flushing, pain in joints and muscles, eosinophilia, leukocytosis, increased erythrocyte sedimentation rate, and the presence in the body of antinuclear bodies.
Use of the drug Enam during pregnancy and breastfeeding
Enam is contraindicated during pregnancy. Before initiating therapy with enalapril it is recommended to exclude the possibility of pregnancy and during the reception to use reliable contraception. If pregnancy is still occurred, reception Enam must stop.
When you use during lactation should decide the issue of termination of breastfeeding.
In the opinion of Enam in too high doses leads to hypotension.
In case of overdose should be done and gastric lavage to carry out the symptomatic treatment.
Enam stored in a dry place at room temperature for no longer than 36 months.