Enap - inhibitor
The composition and the form of Enap
The drug is released in the form of tablets in a dosage of 2, 5 mg, 5 mg, 10 mg and 20 mg. Active component of the drug - Enalapril maleate.
Additional ingredients: lactose monohydrate, giproloza, magnesium stearate, talc, sodium bicarbonate, corn starch.
The blister packs of 10 tablets. 20 tablets in a carton (two blisters).
Enap analogs are the following drugs: Berlipril, Enalozid, Enam, ednit, enalapril, Enafarm and others.
According to the instructions Enap is an ACE inhibitor antihypertensive agent, and "prodrug" whereby formed enalaprilat. The mechanism of action is caused by inhibition of Enap ACE activity occurring under the influence of enalaprilat. This leads to a reduction in systolic and diastolic blood pressure, and reduce the load on the myocardium.
Review Enap increasingly expands the artery, not a vein. Significant reflex increase in heart rate is not observed.
The therapeutic range of blood pressure reduction has no effect on cerebral blood flow and reduce the pressure on the background of the blood flow in the vessels of the brain is maintained at a sufficient level. In addition, the use of Enap causes increased blood supply to the kidney and coronary blood flow.
Long-term use causes a decrease in myocyte Enap artery walls and reduced resistive type left ventricular hypertrophy infarction, slows the development of left ventricular dilatation, and prevents the development of heart failure. It improves the blood circulation of ischemic myocardium.
Enalapril inhibits platelet aggregation and produces not strong diuretic effect.
Acting drug or equivalent Enap starts about an hour after his admission, and four hours later peaks. Effect of the drug throughout the day.
Enap - indications for use
Enap according to the instructions indicated for hypertension.
The indication for Enap in combination with other drugs are:
- congestive heart failure;
- left ventricular dysfunction without symptoms persist.
The instructions to Enap contain the following contraindications:
- hypersensitivity to enalapril and additional components of the drug;
- angioedema in history;
- during pregnancy and breastfeeding;
- Children under six years.
In the opinion of Enap should be used with caution when:
- renal artery stenosis;
- idiopathic hypertrophic subaortic stenosis;
- primary hyperaldosteronism;
- aortic stenosis;
- coronary heart disease;
- renal insufficiency;
- systemic connective tissue diseases.
Dosing and dosing regimen Enap
According to the instructions
Enap is intended for oral administration. It is preferable to take the drug at the same time to achieve maximum therapeutic effect.
When hypertension recommended dosage of a drug or analog Enap is 5 mg once a day with gradual increase in dosage, but not more often than once every two weeks. As a rule, maintenance dose is 10-20 mg per day. The maximum daily dose - 40 mg. Advantageously too high a dosage divided into two steps.
For patients receiving diuretics, the initial dose of enalapril is 2, 5 mg per day.
When hyponatremia or content of serum creatinine over 140 mmol / l initial dose of the drug should not exceed 2, 5 mg per day.
When kidney disease dosage is determined depending on the indication and Enap on renal function. When QA 30 ml per minute initial dose should not exceed 5 mg per day; at least 30 ml QC per minute - not more than 2, 5 mg per day with gradual increase in dosage to optimum.
In old age, the drug or analogue Enap may cause prolongation of the time his actions and a more pronounced anti-hypertensive effect, therefore, the initial dosage should not exceed 1, 25 mg, with a gradual increase to its optimum.
In chronic heart failure the initial dosage Enap on instructions of 2, 5 mg once a day, with a gradual increase to its optimum, but no more frequently than once every two weeks. On average, the optimal dose - 10-20 mg per day.
For the treatment of asymptomatic left ventricular dysfunction Enap recommended dosage is 2, 5 mg twice a day, with a gradual increase it to 10 mg twice a day.
The most common treatment Enap long, usually throughout life, if not any unwanted side effects that require its cancellation.
Overdose Enap Review causes severe drop in blood pressure, up to the development of myocardial infarction, collapse, thromboembolic disorders or acute stroke. Most overdose accompanied by convulsions and stupor.
Treatment is necessary to conduct the following:
- put the patient on the bed with a low headboard;
- in the case of mild overdose recommended gastric lavage and conduct symptomatic treatment;
- in more severe cases it is necessary to hold a series of measures to stabilize the pressure (introduction / in saline and plasma substitutes, hemodialysis).
Side effects Enap
In the opinion of Enap it calls the following side effects, which tend to have mild and do not require discontinuation of the drug:
- Cardiovascular: chest pain, orthostatic collapse, lowering blood pressure, arrhythmia, heart pains, palpitations, Raynaud's syndrome, pulmonary thromboembolism branches.
- Special Senses: tinnitus, impaired vision and hearing, impaired vestibular apparatus.
- Peripheral and Central Nervous System: headache, confusion, dizziness, drowsiness or insomnia, fatigue and weakness, depression, paresthesia.
- Respiratory system: bronchospasm, hoarseness and sore throat, cough, sore throat, runny nose, shortness of breath.
- Digestive system: vomiting, abdominal pain, constipation or diarrhea, nausea, pancreatitis, elevated liver enzymes, intestinal obstruction, liver function abnormalities.
- Metabolism: hyponatremia, hyperkalemia.
- Urinary system: hypercreatininemia, proteinuria, renal failure.
- The system hematopoiesis: agranulocytosis, thrombocytopenia, eosinophilia, neutropenia.
- Allergies: angioedema, photosensitivity, urticaria, rash and pruritus, exfoliative dermatitis.
- Dermatological reactions: alopecia, pemphigus.
- Other side effects include hot flashes, increased erythrocyte sedimentation rate, decreased libido and potency.
Enap preparation stored at room temperature for no longer than 36 months.