Renipril - a drug to lower blood pressure.
Reniprila composition and dosage form
The drug is a combination of action, active substances are enalapril (an ACE inhibitor) and hydrochlorothiazide (a diuretic). Available in 20mg tablets, white with separating facet.
One tablet contains 10 mg Reniprila enalapril maleate + 12, 5 mg of hydrochlorothiazide and excipients: Povidone, potato starch, colloidal silicon dioxide, lactose, calcium stearate.
The main active ingredient is Reniprila enalapril, an angiotensin-converting enzyme (ACE)
. The mechanism of action involves blocking Reniprila angiotensin synthesis, which leads to a reduction in total peripheral vascular resistance, load on the heart muscle, as well as the reduction of blood pressure in systole and diastole
. Effect on Reniprila vein is more pronounced than in the artery
. Increases prostaglandin synthesis, while preventing the destruction of bradykinin
. Increases blood circulation to the heart and kidneys, has no effect on cerebral blood circulation
. Prolonged use Reniprila reduces left ventricular hypertrophy, dilation slows its growth, thereby stopping the progression of heart failure
. Renipril improves blood circulation in the heart muscle on the background of ischemia, reduces platelet aggregation, so effective in post-infarction states
Action Reniprila the kidneys caused by the content of the second active substance hydrochlorothiazide: intraglomerular helps reduce hypertension, glomerular sclerosis and preventing the development of chronic renal failure, stimulates diuresis.
The medicament includes preparations indirect action: it is hydrolyzed in the body to form enalaprilat, an inhibitor of ACE. Reviews Reniprile from specialists suggest that the antihypertensive effect occurs within an hour after ingestion per os, reaching a peak after 4-6 hours, persists for days. The therapeutic effect in the treatment of chronic heart failure occurs with prolonged use Reniprila - at least 6 months.
In accordance with the instruction Renipril shown in the following conditions:
- Essential hypertension;
- Renovascular hypertension;
- Chronic heart failure I-III degrees;
- Left ventricular dysfunction;
- According to the reviews of Reniprile, it can be effective for the prevention and treatment of coronary artery disease in patients with hypertension.
Instructions for use Reniprila
In accordance with the instruction Renipril be taken orally, regardless of mealtime, drink plenty of water.
In patients with hypertension: the initial dose is 5 mg once a day for a week. Two or three hours after taking the drug the patient should be under medical supervision because of possible large fluctuations in blood pressure. In the absence of clinical effect in a week the daily dose is increased by another 5 mg. Thus, the daily dose Reniprila readings may be adjusted to 40mg for 1 or 2 divided doses. 40 mg per day - the maximum allowable daily intake. For the treatment of hypertension moderate severity sufficient average dose is 10 mg per day. Depending on the indication, in 2-3 weeks reduce the dose, switching to maintenance dose.
If renovascular hypertension: the initial dose is 2, 5 to 5 mg per day, the maximum dose - 20 mg per day.
In the treatment of chronic heart failure according to the instructions Renipril administered in an initial dose of 2, 5 mg 1 time per day, increasing the dose by 2, 5 mg every 3-4 days, picking up with the optimal dosage. The maximum permitted daily dose should not exceed 40 mg per day, 1 or 2 doses. If systolic pressure of 110 mm Hg and lower initial dose of 1, 25 mg, the same limit for elderly patients, as they enalapril has a longer excretion.
If any function of the left ventricle Renipril take a dosage 2, 5 mg 2 times per day. If necessary, the dosage is gradually increased, bringing to 20 mg, divided into 2 doses.
Treatment Reniprilom should be constantly monitoring your blood pressure at reducing its excessive dosage of the drug is reduced.
According to the reviews of Reniprile, in its application were reported the following adverse effects:
- Cardio-vascular system - a sharp and significant decrease in blood pressure, arrhythmia until atrial fibrillation, angina pectoris, orthostatic collapse, flushing, pulmonary artery and its branches, heart attack;
- From the blood - decrease in hemoglobin levels, reduced hematocrit, increased erythrocyte sedimentation rate, increased levels of urea, hyperbilirubinemia, hyponatremia, hyperkalemia, eosinophilia, neutropenia, thrombocytopenia, agranulocytosis;
- From the nervous system and sensory organs - headache, weakness, dizziness, fainting, paresthesia, sleep disorders, anxiety, depression, disorders of the vestibular apparatus, hearing loss, noise in the ears, blurred vision, decreased libido;
- On the part of the digestive system - decreased appetite, salivation deterioration, dyspepsia, pancreatitis, liver and gall bladder;
- The respiratory system - shortness of breath, bronchospasm, pharyngitis, rhinorrhea, interstitial pneumonitis, dry cough;
- Immune system - urticaria, angioedema, dermatitis, erythema multiforme, Lyell's syndrome, the appearance of photosensitivity (an allergic reaction to ultraviolet radiation, including solar), vasculitis, arthralgia, development or exacerbation of autoimmune diseases;
- From the urinary system: renal dysfunction;
- Other - hair loss.
In accordance with the instructions Renipril prescribed with caution in conjunction with other drugs, because it can amplify, attenuate, or otherwise modify their action.
Acute symptoms of overdose may be seizures, confusion, collapse, myocardial infarction, atrial fibrillation or death. A large overdose of Reniprila require emergency care in hospital. Assign hemodialysis, intravenous administration of plasma substitutes, drugs that stabilize blood pressure.
In accordance with the instructions Renipril contraindicated in the following conditions:
- Hypersensitivity to enalapril and other ACE inhibitors;
- Allergic status;
- Cerebrovascular accident;
- Aortic stenosis;
- Autoimmune pathology;
- Renal dysfunction;
- Liver failure;
- Salt-free diet;
- Age 18 years.
Be wary appoint Renipril during pregnancy, breastfeeding and elderly patients.
Keep out of reach of direct light, in a dry place at room temperature for three years.
Keep away from children!