"Enalapril": instructions for use and reviews. Analogues of enalapril

If there are problems with blood pressure, many receive recommendations from attending physicians to take Enalapril (tablets). What does this medicine help get rid of? From the consequences of the disease (that is, directly from the increase in blood pressure), or does it act in several directions, restoring the normal activity of the cardiovascular system, as a result of which blood pressure returns to normal? To understand how Enalapril pressure pills work, you should read the official instructions for use of this medication. In addition, we will consider a number of analogues of this drug for the active substance and the effect.

Description of the drug, form of release, storage features and conditions of dispensing from pharmacies

Enalapril pressure pills are available from many pharmaceutical companies around the world. The main active ingredient of this drug is enalapril maleate, which by its group affiliation belongs to ACE blockers. Currently, there are tablets with an active substance content of 5, 10 and 20 mg. Due to the fact that the drug for pressure “Enalapril” directly affects the functioning of the CCC and a number of other systems in the body, it is dispensed from pharmacies by prescription.

The timing of the sale and use of this drug is limited to 3 years from the date of its manufacture. In this case, the tablets do not lose their therapeutic properties, subject to storage rules. Manufacturers recommend keeping the medicine in a dry place, protected from direct sunlight, at a temperature of at least 15 and no more than 25 degrees.

Analogues of Enalapril have the same properties, therefore, the recommendations applicable to the drug can be observed during their storage.

Pharmacodynamics of the drug

Enalapril maleate (the active substance of the tablets) by itself does not affect the processes occurring in the human body. The fact is that this compound is considered a kind of “prodrug”, which, as a result of a few hydrolysis reactions, forms a completely new substance - enalaprilat.

It is it that inhibits active ACE, which provokes a significant decrease in the amount of aldosterone in the human body. In short, the effect of Enalapril is to lower blood pressure (both diastolic and systolic) and reduce the load on the heart muscle (myocardium).

As a result of long-term observations, it was possible to find out that, despite the decrease in blood pressure, after taking the drug "Enalapril" in patients there was not an insufficient level of blood circulation in the brain. In addition, taking pills contributed to increased renal and coronary blood flow.

Long-term use of the drug showed high efficiency against hypertrophic tissues localized in the left ventricle of the heart muscle, which helped to prevent the progress of heart failure. In addition, the Enalapril therapy for 6 months improved the condition of patients with dilatation of the left ventricle and impaired blood circulation in the myocardium resulting from ischemia.

The active substance of the drug is found in blood plasma 1 hour after taking the tablets and reaches a maximum after 4-6 hours. Antihypertensive effect lasts up to 24 hours.

Analogues of Enalapril in the active substance also have the same pharmacological properties.

Pharmacokinetics of the drug

As mentioned above, the absorption of the active substance of the drug occurs quite quickly. Only about 60% of enalapril maleate is absorbed, while almost the entire volume comes into contact with plasma proteins. Specialists draw the attention of consumers to the fact that the absorption of the compound is independent of food intake.

The high degree of penetration of enalapril through HGB-barriers is due to the molecular structure of the active substance. It is also able to overcome placental barriers and is found in breast tissue and milk in lactating women.

Withdrawal of the drug is carried out mainly by the kidneys (60%). At the same time, about 20% is excreted unchanged, and 40% - in the form of a metabolite. The remains of the active substance leave through the intestines, while the ratio of enalapril / enalaprilat has indicators of 6-8% / 25-27%.

Indications and contraindications for use

Indication for the use of the drug "Enalapril" is a persistent increase in blood pressure caused by diseases such as scleroderma and heart failure. In addition, the drug is very often used in preventive therapy in patients with diagnosed coronary ischemia, LV dysfunction (including asymptomatic). These are the indications for use of the drug "Enalapril", however, self-medication is not recommended in any case. Only a specialist can draw up the correct treatment regimen and determine the dosage.

During the examination, the doctor will also be able to establish the presence or absence of possible contraindications. These include the following diseases and organ malfunctions:

1. An increased level of sensitivity to the active substance of the drug (Enalapril analogs must also be canceled, since in most cases they have a composition similar to this drug).
2. Pregnancy, lactation and children under 18 years of age.
3. Previously observed angioedema during treatment with drugs from the ACE inhibitor group.
4. Insufficiency of cerebral circulation, as well as other cerebrovascular diseases.
5. Violations of cerebral hematopoiesis.
6. Kidney disease, including renal artery stenosis (bilateral or unilateral), renal failure, the presence of a transplanted organ.
7. Liver disease.
8. Diseases of the gastrointestinal tract, accompanied by diarrhea and vomiting.
9. Scleroderma and other autoimmune diseases affecting connective tissues.
10. Violations of metabolic processes in the body, including hyperkalemia.
11. Diabetes.

The use of Enalapril in all situations described above should be canceled, or the therapy is carried out under the constant supervision of specialists.

Enalapril: a list of side effects

Despite the great usefulness of the drug, when it is taken, patients can experience a variety of side effects that affect almost all organ systems. Information on adverse events is contained in the table below.

First of all, these phenomena are provoked by the direct effect on the body of the main active ingredient of the drug Enalapril. Analogs (instructions for use for them contain detailed information on this issue) can also cause such violations. It is important for the patient and his attending physician to notice in time the signs of side effects, since ignoring them can lead to serious disturbances in the functioning of the body.

How to take Enalapril tablets: methods and dosage

To stabilize blood pressure, experts recommend prolonged use of the drug (including its analogues, for example, the drug "Enalapril Hexal"). At the initial stage of treatment of arterial hypertension, it is recommended to take the drug at a dose of 5 mg per day. With a systematic increase in pressure during two-week therapy, the dosage increases by 5 mg. It is worth noting that the first 2-3 hours after the start of treatment, the patient should be under the supervision of a doctor. This helps to identify side effects at the very beginning of their development. The maximum dose of the drug should not exceed 40 mg per day, but even the use of such an amount of the drug is possible only if absolutely necessary and the tolerance of the medication is satisfactory.

2-3 weeks after the start of monotherapy with the drug "Enalapril", patients are transferred to a maintenance regimen of taking the drug. During this period, the daily dose of the drug is 10-40 mg. You need to drink tablets 1-2 times a day. It is recommended during the treatment to regularly measure blood pressure.

The above recommendations apply to those patients who do not suffer from concomitant diseases such as hyponatremia and renovascular hypertension. In what doses should they take the drug? As a rule, this depends on the individual characteristics of the patient and the degree of development of the disease. The initial dose in any case can only be calculated by the attending physician.

The duration of the drug depends on several factors, which include the patient's condition and the results of laboratory tests. Experts note that a sharp withdrawal of the drug can lead to negative consequences. Therefore, even with an excessive decrease in blood pressure while taking Enalapril, it is necessary to gradually reduce the dosage.

Symptoms and treatment of drug overdose

So, we examined the main characteristics of the drug Enalapril (tablets): what they help from and what their intake may lead to in the end. It's time to move on to discussing such an issue as an overdose of this drug. Often, patients tend to take large doses of drugs in the hope of quickly getting rid of unpleasant symptoms. In the event that this happens to a person taking Enalapril, the consequences can be very serious. Against the background of a decrease in blood pressure, a collapse may occur in patients, which often leads to myocardial infarction or serious cerebrovascular accident.

As a rule, the first symptoms of an overdose are loss of consciousness, a state of stupor or the appearance of seizures. Other signs of damage to the cerebrovascular system and cardiac abnormalities may also be observed: pallor of the skin, severe headache, pain behind the sternum.

Treatment of a patient with an overdose of Enalapril is symptomatic. With a mild degree of poisoning, saline and gastric lavage are indicated. In more severe cases, intravenous administration of saline and plasma substitutes, as well as hemodialysis, may be required.

Drug interaction

Enalapril tablets are able to act atypically while taking along with other medicines. Nonsteroidal anti-inflammatory drugs (Ibuprofin, etc.) and estrogen-containing drugs significantly reduce its hypotensive effect. Adrenergic blockers, nitrate-containing drugs, anesthetics and ethanol enhance the action of the drug Enalapril. Diuretic drugs taken in conjunction with pills to lower blood pressure can cause the development of hyperkalemia. Special care should be taken with drugs from the group of immunosuppressants, since they, when taken together with enalapril-containing drugs, significantly increase its hematotoxicity.

Drug Reviews

Today, both positive and negative reviews can be heard about the drug. The first significant advantage of Enalapril tablets is the price (20-25 rubles per pack), which cannot be classified as high. In addition, the drug is also valued for its effectiveness. The main disadvantages are numerous adverse reactions and a high risk of complications in the presence of concomitant diseases.

Most patients Enalapril tablets helped get rid of a systematic increase in blood pressure. Those consumers for whom their intake caused disturbances in the functioning of various organs had to refuse not only this drug, but also its analogues, since in most cases they contain the same active substance or similar enalapril indapamide. That is why experts extremely do not recommend taking several drugs at the same time to lower blood pressure.

Analogues of "Enalapril": differences, advantages and disadvantages

There are many drugs on the global pharmaceutical market that are similar to Enalapril. Most often, they have a higher cost, which does not always guarantee the absence of adverse reactions or higher efficacy of drugs. Consider a list of drugs that have an active substance in their composition, similar to that contained in Enalapril tablets. As a rule, pharmaceutical laboratories in Western countries use amplodipine enalapril as the main component, the difference from enalapril maleate is only in its molecular structure. Otherwise, it has the same characteristics and properties.

The following analogues of Enalapril are found on the Russian pharmaceutical market:

1. Enap tablets and ampoules for injections from the Slovenian company KRKA. Their cost starts from 280 and reaches 4,000 rubles per pack of tablets, and 500 rubles per 10 ampoules with a solution. As you can see, unlike the Enalapril drug, the price of them is quite high, which makes drugs of this brand inaccessible to a large number of consumers. At the same time, experts note the high quality of this analogue.
2. Enalapril Hexal tablets from the German manufacturer SANDOZ. Domestic drug in its effectiveness is not inferior to this medication. At the same time, the cost of the analogue slightly exceeds the price of Enalapril and amounts to about 78-100 rubles per package.
3. Berlipril tablets manufactured by the German pharmaceutical company Berlin-Chemie. The main active ingredient of the drug is enalapril amlodipine. Due to the fact that the preparation of this compound is more complicated and expensive, the cost of tablets is about 140-180 rubles per pack.
4. RENITEK tablets from MERCK, the cost of which is in the average price range and amounts to 80-150 rubles per pack.

Also, in pharmacies you can find such analogues of Enalapril, similar in composition and effect to the drug, as Kalpiren, Miopril, Envas, Vazopren and Miopril. Experts, however, note that not always mentioned drugs can be used as a substitute for a domestic drug that is not suitable for the patient for any reason. The fact is that in their composition they almost completely repeat our Enalapril, which means that they can also cause a variety of complications. Doctors also advise paying attention to the composition of medicines produced abroad. Amplodipine enalapril, whose difference from enalapril maleate is small, can also affect the body in an unfavorable way. In any case, before using any of the aforementioned analogues as the main medicine, you should consult your doctor.