The first thing you need to familiarize yourself with if you have been prescribed the Enap drug - with instructions for use and reviews of those who have already taken this drug. The main indication for prescribing this medication is arterial hypertension. In the course of treatment, many patients experienced serious side effects. Enap is not always easily tolerated, but, according to doctors, is a very effective and affordable drug.
Who is prescribed the medicine
Enap is a hypotensive drug, but it is used not only to lower blood pressure. Indications for use of the drug are a number of heart diseases:
- chronic heart failure;
- essential hypertension;
- unstable angina pectoris.
A cardiologist or therapist can prescribe Enap to restore myocardial function and prevent coronary artery ischemia. In some cases, a medication is prescribed to diabetics to maintain kidney function. If you believe the reviews, side effects from Enap, in the case of parallel use with other drugs to lower blood pressure, are rare. An overdose or the use of the drug in the presence of contraindications can provoke negative reactions of the body.
Composition and form of release
The main active ingredient is enalapril maleate, which belongs to the group of ACE inhibitors. The drug is produced in tablet form. Excipients in the composition of the tablets are corn starch, talc, lactose monohydrate, magnesium stearate, sodium bicarbonate, hyprolose. According to the instructions and reviews, Enap contains a different amount of active substance:
- 2.5 mg - sold in packs of 20 and 60 tablets (the approximate cost in Russian pharmacies is 77-130 rubles);
- 5 mg - in a package of two or six blisters, 10 tablets in each (the price for 20 tablets is 176-180 rubles);
- 10 mg - red-brown pills, 20 or 60 pieces per pack (91-201 rubles);
- 20 mg - light orange tablets, are sold in a pharmacy for 20 or 60 pieces (134-347 rubles per package).
What effect does the body have?
Side effects of Enap is an unfavorable individual reaction to the effects of angiotensin type II enzyme, which affects the adrenal receptors. Angiotensin II is a natural hormone that stimulates the production of another vital substance - aldosterone. This hormone is responsible for the body retaining water, salts and filling the lack of fluid in the vessels.
Enalapril is able to reduce systolic and diastolic blood pressure. The substance begins to act quickly - 15-20 minutes after administration, and the effect lasts for 1-4 hours. However, the duration of the therapeutic effect depends on the dosage, which is set by the doctor. The optimal period of action of the drug is 5-6 hours. The Enapa tablet provokes an increase in renal blood flow and helps normalize blood pressure.
This antihypertensive drug dilates the peripheral vessels, resulting in an increase in the lumen of arteries and veins, there is more space for pumping blood and pressure decreases. The use of "Enap" means a reduction in the volume of fluid in the blood and an active withdrawal through the kidneys. Almost 90% of the drug leaves the body with urine within a day after taking the pill, and in the initial concentration, enalapril is present in the body for at least 12 hours, taking into account half-life.
In reviews of the use of Enap, many patients with hypertension note that taking the drug for 48 weeks or more led to the accumulation of potassium in the body and the ensuing consequences (frequent urination, renal colic, tachycardia, nervous irritability, irritability, sweating, muscle paresis ) That is why "Enap" is recommended to be taken in combination with thiazide diuretics.
In patients with chronic heart failure, an improvement in the status of pulmonary capillaries is noted. Those who use enalapril-based drugs notice an increased level of physical endurance, a decrease in the severity of symptoms characteristic of heart failure. If you start treatment with Enap in the initial stages of the disease, the patient will have good chances of slowing the progression of the disease and stopping the process of dilatation of the left ventricle. This medicine helps patients with left atrial dysfunction, reducing the risk of myocardial infarction, angina attacks.
Method of application and optimal dosage
Instructions for use "Enapa" (analogues can be taken according to a different scheme, so treatment must be read the annotation) does not establish a strict schedule for taking pills. They are taken orally, before or after a meal. The only recommendation that should be followed is to take Enap at the same time of day. Tablets must be washed down with water.
As a rule, it is necessary to start taking antihypertensive drugs with a minimum dosage. In this sense, the instruction for the use of Enap is no exception. What dose is better to start treatment with? With first degree hypertension, it is recommended to take 5 mg of enalapril per day. As the period of action of the tablets decreases and the disease progresses, the dose can be gradually increased.
Blood pressure in patients with severe activation of the hormonal system may drop below normal. If such a side effect is observed, Enap is recommended to be taken in an amount of not more than 5 mg per day under the supervision of specialists.
To avoid the risk of dehydration and hypotension, enalipril should be started no earlier than a few weeks after the end of prolonged use of diuretics. If "Enapu" was preceded by a course of diuretics, the recommended dose is 5 mg per day. In this case, in the course of treatment, it is necessary to monitor the condition of the kidneys and the concentration of potassium in the blood.
Patients with chronic hypertension are allowed to use Enap in a daily maintenance dose of 20 mg. If necessary, it can be doubled. For example, with a sharp jump in pressure or increased symptoms of other cardiovascular diseases. Moreover, it is not specifically indicated in the instructions for the use of Enap, at what pressure it is prescribed. At a minimum dosage, the drug is recommended for patients with a first degree of arterial hypertension with rates greater than 140/90 mm Hg. Art., in the maximum - with a severe stage of hypertension, when the pressure rises to 180/110 mm RT. Art. and higher.
In case of chronic heart failure and left ventricular dysfunction, Enap should be drunk in a daily dosage of 2.5 mg. To do this, one tablet containing 5 mg of enalipril must be divided in half. At the same time as Enap, diuretics, beta-blockers and glycosides are prescribed. Patients of advanced age are recommended to start therapy with a dose of 1.25 mg, that is, a quarter of Enap tablet 5 mg, since the rate of excretion of the active substance in the elderly is significantly slowed down.
Is overdose dangerous, what to do
During treatment, there is a risk of developing renal failure and arterial hypotension, therefore it is necessary to constantly monitor the indicators of pressure and kidney function, periodically conduct diagnostic monitoring. After the first dose of Enap, a side effect often becomes the development of hypotension, which is not the basis for drug withdrawal.
Patients suffering from kidney pathologies should increase the time intervals between taking pills or reduce the dosage. If a person forgot to take the medicine on time, you need to drink Enap in the near future, but not in double, but in the usual dose. You can buy pills in any pharmacy without a prescription, but self-medication is contraindicated. The consequences of an overdose can be:
- dizziness due to a sharp drop in blood pressure;
- stupor;
- cardiopalmus;
- bradycardia;
- feeling of anxiety;
- weakness.
Overdose leads to severe hypotension. In severe cases, collapse, acute cerebrovascular accident or myocardial infarction may occur. In case of an overdose, the patient is recommended an urgent hemodialysis procedure and intravenous infusion of plasma excipients. Violations become noticeable 4-6 hours after taking an excess dose of the drug. According to reviews, the side effects of Enap include lack of urination, a feeling of intense thirst and other disturbances in the water-electrolyte balance, convulsions, and a fainting state.
If an overdose occurs, you need to call an ambulance. While the team of specialists is on the way, the patient must be laid on a flat surface, you do not need to raise your head - it should be at body level. With a slight overdose, the patient will be washed in the stomach and given adsorbent agents. If the symptoms of an overdose are severe, it is recommended to introduce an intravenous solution of sodium chloride 0.9%, a plasma substitute, catecholamines. The toxic effect of enalapril can be neutralized by hemodialysis, in which the body is cleansed at about 62 ml per minute.
Features of the use of antihypertensive drugs
People who have had a kidney transplant should not take Enap. Contraindications and side effects are noted in the annotation from the manufacturer. However, it does not say anything about the likelihood of developing hepatic syndrome, which begins with cholestatic jaundice or hepatitis, and later can lead to liver necrosis. If jaundice has become a side effect after prolonged use of Enap, the medication is stopped and a comprehensive examination is performed.
In practice, there are many cases of the development of neutropenia or agranulocytosis, provoked by the use of ACE inhibitors. Judging by the reviews of Enap and analogues, such drugs should be used with caution in patients with connective tissue pathologies and those undergoing immunosuppressive or chemotherapy. Otherwise, the risk of joining severe infections resistant to antibiotics and antiviral drugs increases. That is why with long-term use of Enap, such patients need to periodically take blood tests and monitor the level of white blood cells in the blood.
People with arterial hypertension are at increased risk for angioedema. At the first symptoms, it is urgent to stop taking the medicine and consult a doctor. Patients with a history of an episode of angioedema are at risk. Anaphylactic reactions can occur in patients prone to allergic reactions.
With prolonged use, side effects from Enap are found in surgical interventions accompanied by general anesthesia. That is why the patient should warn the doctor about treatment with antihypertensive drugs. Enalapril reduces the concentration of attention when driving and other mechanisms.
What is the difference between "Enap" from drugs with a similar name
Often patients doubt whether Enalapril can be taken instead of Enap, and is there a difference between the two drugs? In fact, there are no fundamental differences between them. The composition of the medicines is almost identical, and the main difference is who the manufacturer is.
Enam is another popular analog of Enap. The instructions for this drug indicate a similar composition, where the main substance is enalapril maleate. If, in addition to it, the hydrochlorothiazide content is indicated in the composition of the antihypertensive drug, this will mean that such a medicine also has a diuretic effect. These combined products include Enap N and Enap HL. Side effects in these varieties of the drug are similar.
Other analogues of the drug are:
- Burlipril.
- "Vazolapril."
- Invoril.
- Miopril.
- "Renipril."
- Renetek.
- "Ednit."
- "Enapharm".
Negative body reactions
Speaking about contraindications and side effects of Enap, it should be recalled that taking these high-pressure pills is necessary only after consulting a doctor. In the treatment of hypertension, negative reactions from various organs and systems can occur. For example, prolonged treatment can lead to problems with blood formation. According to the results of blood tests, patients are diagnosed with:
- anemia
- neutropenia
- agranulocytosis;
- thrombocytopenia;
- inhibition of hematopoiesis;
- pancytopenia;
- lymphadenopathy.
The accumulation of enalapril in the body can cause side effects from Enap with prolonged use. The result of prolonged treatment often becomes hypoglycemia and other metabolic disorders. If you believe the reviews, very common adverse reactions are:
- headache;
- confusion of consciousness;
- drowsiness;
- excitability;
- depression.
Antihypertensive ACE inhibitors adversely affect the work of the cardiovascular and nervous system, up to the development of hypotension, arrhythmia, stroke or myocardial infarction. Patients complain of worsening sense of smell, tinnitus, temporary loss of visual acuity. Disorders are also observed from the digestive system.
Most often, patients are disturbed by dyspeptic disorders, abdominal pain, dry mucous membranes in the mouth, which causes glossitis, stomatitis and aphthous ulcers. Against the background of prolonged use of Enap, chronic diseases of the gastrointestinal tract (gastritis, peptic ulcer, pancreatitis, cholecystitis) are exacerbated, which are accompanied by nausea, diarrhea, vomiting, constipation, anorexia and liver dysfunctions.
When taking a hypotensive drug, skin can also suffer. Some patients develop a rash, hives, erythema, dermatitis, epidermal necrolysis. In the instructions to Enap N, severe sweating, itching, pemphigus, and other manifestations of hypersensitivity to the drug are also indicated as side effects.
The possibility of muscle cramps, fever, myalgia, myositis, arthritis, vasculitis, leukocytosis cannot be completely ruled out. In the results of laboratory studies, the reception of Enap is reflected in hyperkalemia, an increase in creatinine, hyponatremia and an increase in the concentration of urea and bilirubin in the blood.
Why does cough appear
Like any other medicine, Enap has a number of side effects that affect the work of the respiratory system. Among the adverse reactions of the body to the drug, it is worth noting a dry cough, sore throat, hoarseness. Judging by the reviews, coughing from this drug is not a rare phenomenon, although it often baffles people.
First of all, it is worth noting that the circulatory system is closely interconnected with the work of the respiratory system, therefore there is a logical explanation for the appearance of this symptom. Most ACE inhibitors cause coughing, although pharmacies sell similar drugs that do not cause side effects.
The cough from Enap is caused by a slowdown in the catabolism of bradykinin, a powerful vasodilator that is involved in many hormonal biochemical reactions. This component causes a negative effect on the respiratory system. Bradykinin accumulates in the pulmonary vessels and causes irritation of nerve fibers. If coughing causes significant discomfort, you should consult your doctor about changing the drug.
"Men's" problems against the background of "Enapa"
It is not yet possible to say exactly about the side effects of Enap for men. Specialists can not come to a consensus and understand how enalapril affects the genitourinary system of the stronger sex. Based on the reviews, we can conclude that Enap interferes with the work of the kidneys, causes proteinuria, renal failure, does not affect the erectile function in the best way, causes gynecomastia, oliguria. Allegedly, problems in men arose precisely during the period of use of an ACE inhibitor with enalapril.
At the same time, doctors argue that this drug is not able to affect male power, and the development of impotence is a secondary disorder against a background of cardiovascular disease. Any deviations in the functioning of the heart muscle and blood vessels subsequently affect the blood supply to the pelvic organs. Weak blood circulation leads to weakening of sexual function.
The instructions for use of "Enap" noted that the action of this drug can enhance ethanol and beta-blockers. And synthetic estrogens and non-steroidal anti-inflammatory drugs, on the contrary, can weaken the effect of an ACE inhibitor. Other compatibility options were noted. But not one of them prohibits the use of stimulants together with Enap. For men, side effects are more dangerous "Viagra", "Cialis", "Levitra" and their analogues, rather than antihypertensives.
The main contraindications
In some cases, using "Enap" in the treatment of hypertension is unacceptable. This drug is contraindicated in individuals with individual intolerance to any component of this agent. If a patient has a history of heart attacks, Quincke's edema, and angioedema, it is not possible to use enalapril-based drugs. The same applies to patients with hereditary or idiopathic angioedema.
Diabetes mellitus is not an absolute contraindication, however, special care should be taken when treating with Enap. It is better to refuse the use of this antihypertensive drug to patients suffering from:
- porphyria;
- glucose-galactose malabsorption syndrome;
- lactose intolerance, lactase deficiency;
- renal artery stenosis;
- hyperkalemia
- hyperaldosteronism;
- hypertrophic cardiomyopathy;
- mitral or aortic valve stenosis;
- coronary heart disease;
- lupus erythematosus.
To take this medicine for pressure, you need to abandon the salt-free diet. The drug is dangerous for patients undergoing hemodialysis, chemotherapy. Patients over 65 years of age should always consult a doctor about the appropriateness of using Enap. This drug is contraindicated in children and adolescents under 18 years of age.
Patient Reviews
If you take into account the comments of people who took "Enap", there may be an ambiguous idea about this drug. Doctors believe that with the right dosage and following all the recommendations, this antihypertensive drug can become a faithful companion until the end of life. It is also prescribed to patients because of its cost, it is one of the most affordable ACE inhibitors in the group.
Moreover, patients themselves do not always leave flattering reviews about Enap tablets. In general, there are much more negative comments about him than positive ones. Primarily the cause of patient dissatisfaction is side effects. Almost every user who has left his response about Enap notes the appearance of a dry, irritating cough, nausea, and dizziness. The most difficult for patients is precisely in the first weeks after the start of admission. In fact, it is the side effects of the drug that serve as a common reason for its abolition.
Recommendations of doctors on the use of the drug
As already noted, it is advisable to take tablets at the same time, once a day, or to break the daily dose into several doses. The pills are swallowed completely without chewing or damaging the membrane. It is advisable to drink the tablets with plain water, and not tea or fruit juice, especially citrus.
In the treatment of high pressure "Enap" you can not drink alcohol. This combination can be dangerous, since alcohol can enhance the hypotensive properties of the drug. Also, caution must be exercised when combining Enap with Aloprenol and lithium salts, antitussive, cold-fighting, anti-inflammatory drugs.
Patients with diabetes mellitus should choose antihypertensive drugs after a preliminary consultation with a doctor, because such drugs can significantly reduce blood sugar levels, as a result of which an adjustment of the diabetes treatment regimen will be required. Taking "Enap" in the hot season, you need to drink more fluids - this will avoid dehydration.
If the medicine causes irritation and upset stomach, it can be taken sublingually, that is, put under the tongue and slowly dissolve. The duration of treatment with the drug should be determined by the doctor. By discontinuing the course prematurely, the patient runs the risk of experiencing the symptoms of hypertension again after some time.
Enap for children, pregnant and lactating women
During pregnancy, taking this medicine is prohibited. It is able to penetrate the placenta and provoke abnormalities in the development of the fetus. You can not take Enap even in the late stages of gestation, since the risk of developing premature birth increases. Under the ban, this drug is for women during lactation, as the active substance passes into breast milk. If you can’t refuse treatment, you should stop natural feeding.
After confirming pregnancy, the drug is immediately canceled. If a woman, for whatever reason, continues to take an ACE inhibitor, ultrasound monitoring is required to monitor the condition and development of the fetus, the level of amniotic fluid.
Despite the fact that in the instructions for use "Enapa" children's age is an absolute contraindication, some experts still prescribe this remedy for children suffering from hypertension. Experience with this medicine in treating juvenile patients is very limited. The use of Enap for children involves dosage adjustment. So, for example, for patients with a body weight of 20-50 kg, the recommended initial dose is 2.5 mg. If the child weighs more than 50 kg, he can be given 5 mg of enalapril.
It is not allowed to buy the drug at the pharmacy and give it to the child, but if the attending physician considers it appropriate to use Enap in childhood, all the instructions of the specialist must be followed.