Enalaprili Neo 10mg #20 Tab
Angiotensin-converting enzyme (ACE) inhibitor.
Ingredients:
Active substance: enalapril maleate 10 mg.
Other ingredients: lactose, starch, magnesium stearate, talc.
Mode of action:
PD: the renin-angiotensin system is affected by enalapril, the angiotensin converting enzyme inhibitor. Enalapril maleate promedikamentia, whose body is formed by hydrolysis of H active metabolite - enalaprilat. Enalaprilat, inhibits angiotensin I- formation of angiotensin II- it, which leads to the increase in renin activity and aldosterone generate a reduction in adrenal gland. A It has resulted in peripheral vascular resistance, systolic and diastolic blood pressure, pre- and afterload myocardium. Improving blood circulation in coronary vessels and kidneys.
Prolonged use of enalapril reduces myocardial hypertrophy and resistant types of arteries, improves myocardial blood supply, reduces platelet aggregation.
Hypotensive effect occurs within 1 hour after, and the maximum effect is achieved after 4-6 hours. Enalapril treatment discontinuation is not followed by a sharp rise in blood pressure.
Depending on the dose and duration of exposure. At recommended doses of antihypertensive effect persists for 24 hours and hemodynamic parameters.
Pharmacokinetics: Following oral administration of the drug is absorbed up to 60%. Food intake does not affect absorption quality. Enalapril is approximately 50% bound to plasma proteins. The drug is rapidly metabolized in the liver to the active metabolite, enalaprilat formation, the maximum concentration is reached in 3-4 hours. Enalapril histohematur easily pass through barriers, in addition to the blood-brain barrier, a small number of passes through the placenta and into the mother's rdzeshi. After making a stable blood concentration is reached 3-4.
The half-life is approximately 11 hours. Predominantly excreted in the urine (60% - 20% and 40% of enalapril enalaprilat form), through the intestines - 33% (6% and 27% of enalapril enalaprilat form).
The elimination period of 30-35 hours.
Indications:
• essential hypertension;
Renovascular hypertension •;
• heart failure;
• diabetic nephropathy;
• myocardial ischemia in patients with left ventricular dysfunction and coronary;
Contraindications:
• Hypersensitivity to other ACE inhibitors and enalaprilisa;
• A history of angioedema associated with ACE inhibitors;
• porphyria;
• Pregnancy;
• Breast-feeding;
• Children and adults under 18 years of age;
• liver disease;
• renal artery stenosis in one or two;
• primary aldosteronism.
Dosage:
Enalapril,, Neo "is used as monotherapy and in combination with other drugs.
Administered orally, irrespective of food intake.
Hypertension: The initial dose is 10-20mg's (1-2 tablets) according to the severity of hypertension and prescribed 1-times a day. Mild hypertension taken 10 mg (1 tablet), in other cases - 20 mg (2 tablets) per day. The dose should be individualized. The maximum daily dose is 40 mg.
Renovascular hypertension: therapy begins 2,5-5 mg (1/4 - 1/2 tablet), then gradually increase the dose if necessary. Normally, the effective dose is 20 mg per day. If,, enalapril Neo "before becoming a patient was treated with diuretics, or need to stop taking them 2-3 days before the start of treatment or dose of 5 mg (to prevent hypotension).
Heart failure, left ventricular dysfunction without symptoms: initial dose of 2.5 mg (1/4 tablet). P dose may be increased gradually to a maintenance daily dose - 20 mg (1 tablet 2 times a day).
Diabetic nephropathy: Normal blood pressure is prescribed 2,5-5 mg (1/4 - 1/2 tablet) per day, high blood pressure at the dose selection is as hypertension cases.
Patients who have kidneys (C L 30 ml / min) and undergoing dialysis: initial dose of 2.5 mg (1/4 tablet) per day. Dialysis patients should receive the drug after dialysis. The maintenance dose is 5 mg (1/2 tablet) per day. The maximum daily dose should not exceed 10 mg (1 tablet).
Side effects:,, enalapril Neo "well tolerated. Side effects occur rarely, temporary in nature and did not require discontinuation of treatment.
Enalapril,, Neo "may reveal following side effects:
CNS: headache, dizziness, weakness, fatigue, rarely - insomnia, increased nervous excitability, depression, balance disorder, tinnitus.
Cardiovascular system: the beginning of therapy may develop hypotension, orthostatic hypotension, in rare instances - chest pain, angina, heart rhythm disturbances. May occur in patients at risk of acute myocardial infarction or stroke.
Respiratory system: dry cough, sore throat, bronchospasm, rhinorrhea, dyspnea, sinusitis, rhinitis.
Digestive system: nausea, diarrhea, dyspepsia, constipation, abdominal pain, taste disturbances (metallic taste), in rare cases - glossitis.
Allergic reactions: skin rash, hives, itching, swelling of different localization.
Laboratory tests: possibly hyperkalemia, hyponatremia, hematocrit decrease.
Reproductive system: rare high doses may cause impotence.
Special instructions:
During treatment, blood pressure and kidney function.
Symptomatic hypotension may occur in patients with severe heart failure and renal failure, hyponatremia caused by taking diuretics. Such patients need special attention when changing the dose. Decreased blood pressure and needed to be burned patients saline infused slowly.
Symptomatic hypotension caused by hypovolemia often develops diuretic, diarrhea or vomiting in the background.
Normal or low blood pressure, heart failure the dose should be reduced.
Some patients develop hypotension background reversible acute renal failure, increased blood urea and creatinine detector.
Enalapril,, Neo ", as well as other ACE inhibitors can occur rarely face, lips, tongue, swelling of the limbs. This therapy should be discontinued and antihistamines to appoint. Respiratory suppression of adrenaline intravenously injected.
Enalapril,, Neo "titles kept during treatment hiposensibilizatsia cause anaphylactic reactions, which is why it is advisable before hiposensibilizatsia temporarily removed,, enalapril Neo".
Enalapril,, Neo "titles kept potassium levels is necessary to control.
Pregnancy and lactation:
The drug should not be used during pregnancy and lactation.
Interaction with other medicines or other types of interaction:
Another group receiving enhanced hypotensive effect of antihypertensive drugs.
At the beginning of therapy with diuretics making developing severe hypotension.
Analgesic, antipyretic drugs may reduce concomitant antihypertensive effect of enalapril.
Potassium-sparing diuretics and potassium are receiving drugs necessary to be careful and constant control plasma potassium concentration, as enalapril reduces withdrawal potassium.
Lithium salt intake with the separation of lithium (lithium concentration of plasma is needed).
With allopurinol, novokainamid, corticosteroids and tsitostatureb receiving increasing blood parameters change risk (leukopenia, neutropenia).
Cimetidine prolongs,, enalapril Neo "action.
Insulin or oral hypoglycemic drugs, making it is necessary to adjust the dose of the latter, as enalapril,, Neo "of tissues by sugar utilization.
Anesthetic drugs together to enhance the hypotensive effect.
Food intake does not affect absorption of the drug.
It is forbidden to drink alcohol during treatment.
Overdose:
Symptoms: Drug development within approximately 6 hours after the collapse of hypotension, myocardial infarction, cerebral blood circulation disorders, the development of thromboembolic complications.
Gastric lavage if the new drug is taken, intravenous infusion of isotonic saline. Enalapril can be eliminated from the body dialysis.
A Influence of vehicle and mechanisms management:,, enalapril Neo "is necessary to be careful while driving motor transport and mechanisms requiring concentration of attention and psychomotor speed of reaction, since it is possible to develop such reactions, which result in distractibility.
10 tablets in a blister. 2 blisters in the box.
Storage: Store in a dry, protected from light and out of the reach of children, 15-25 ° C temperature conditions.
Expiry or visual defects of the preparation can not be!
Pharmacy Issue: pharmaceutical product group II - a doctor's prescription.
Shelf life: 2 years.
