Enalapril Hexal pills 20 mg N50
Condition: New product
1000 Items
Rating:
Be the first to write a review!
More info
Description
Enalapril Hexal pills - an antihypertensive drug, an ACE inhibitor. Pharmacological activity has enalapril metabolite - enalaprilat. Suppresses the formation of angiotensin II and eliminates its vasoconstrictor action. At the same time, OPSD, systolic and diastolic blood pressure decreases, post- and preload on the myocardium. Expands the arteries to a greater extent than the veins, and there is no reflex increase in the heart rate. It also reduces preload, reduces pressure in the right atrium in the pulmonary circulation, reduces left ventricular hypertrophy. Reduces the tone of the outgoing arteriole of the glomeruli of the kidneys, reducing, thereby, intraglomerular hemodynamics, prevents the development of diabetic nephropathy.
Active ingredients
Enalapril
Release form
Pills
Pharmacological effect
Enalapril is an antihypertensive drug from the group of ACE inhibitors. Enalapril is a “prodrug”: as a result of its hydrolysis, enalaprilat is formed, which inhibits ACE. The mechanism of its action is associated with a decrease in the formation of angiotensin I from angiotensin II, the reduction of which leads to a direct decrease in the release of aldosterone. At the same time, the total peripheral vascular resistance, systolic and diastolic blood pressure, post- and preload on the myocardium decrease. Expands the arteries to a greater extent than the veins, while a reflex increase in heart rate is not observed. The hypotensive effect is more pronounced with a high level of plasma renin than with its normal or reduced level. Reducing blood pressure in therapeutic limits does not affect the cerebral circulation, the blood flow in the vessels of the brain is maintained at a sufficient level and against the background of low blood pressure. Enhances coronary and renal blood flow. With prolonged use, left ventricular myocardial hypertrophy and myocytes of resistive-type artery walls are reduced, prevents progression of heart failure and slows down the development of left ventricular dilatation. Improves blood supply to ischemic myocardium. Reduces platelet aggregation. It has some diuretic effect. The time of onset of the hypotensive effect when taken orally - 1 hour, reaches a maximum after 4-6 hours and lasts up to 24 hours.In some patients, therapy for several weeks is necessary to achieve an optimal level of blood pressure. With heart failure, a noticeable clinical effect is observed with prolonged use - 6 months or more.
Pharmacokinetics
After ingestion 60% of the drug is absorbed. Eating does not affect the absorption of enalapril. Bioavailability of the drug - 40%. Cmax enalapril in blood plasma is reached after 1 h, enalaprilat after 3-4 h. Enalapril up to 50% binds to blood proteins. Enalaprilat easily passes through histohematogenous barriers, excluding BBB, a small amount passes through the placenta and into breast milk. Enalapril is rapidly metabolized in the liver to form the active metabolite enalaprilat, which is a more active ACE inhibitor than enalapril. T1 / 2 enalaprilat - about 11 h. Enalapril is derived mainly by the kidneys - 60% (20% in the form of enalapril and 40% in the form of enalaprilat), through the intestine - 33% (6% - in the form of enalapril and 27% - enalaprilat). It is removed during hemodialysis (speed - 62 ml / min) and peritoneal dialysis.
Indications
Arterial hypertension, with chronic heart failure (as part of combination therapy).
Dosage and administration
Assign inside regardless of meal times. With monotherapy of hypertension, the initial dose is 5 mg 1 time / day. In the absence of a clinical effect, after 1-2 weeks, the dose is increased by 5 mg. After taking the initial dose, patients should be under medical supervision for 2 hours and an additional 1 hour until their blood pressure stabilizes. If necessary, and fairly well tolerated dose can be increased to 40 mg / day in 2 divided doses. After 2-3 weeks, switch to a maintenance dose of 10-40 mg / day, divided into 1-2 doses. In moderate hypertension, the average daily dose is about 10 mg. The maximum daily dose of the drug is 40 mg / day. In the case of the appointment of patients receiving diuretics at the same time, diuretic treatment should be stopped 2-3 days before the appointment of Enalapril. If this is not possible, then the initial dose of the drug should be 2.5 mg / day. Patients with hyponatremia (the concentration of sodium ions in the serum is less than 130 mmol / l) or the concentration of creatinine in the serum more than 0.14 mmol / l, the initial dose is 2.5 mg 1 time / day. With renovascular hypertension, the initial dose is 2.5-5 mg / day.The maximum daily dose is 20 mg. In chronic heart failure, the initial dose is 2.5 mg once, then the dose is increased by 2.5 - 5 mg every 3-4 days in accordance with the clinical response to the maximum tolerated dose, depending on the values of blood pressure, but not more than 40 mg / day or 2 reception. In patients with low systolic blood pressure (less than 110 mm Hg), therapy should be started with a dose of 1.25 mg / day. Selection of the dose should be carried out within 2-4 weeks or in a shorter time. The average maintenance dose is 5-20 mg / day for 1-2 doses. Older people are more likely to have a more pronounced hypotensive effect and lengthening the time of action of the drug, which is associated with a decrease in the rate of enalapril elimination, therefore, the recommended initial dose to the elderly is 1.25 mg. In chronic renal failure, cumulation occurs with a decrease in filtration of less than 10 ml / min. When QA is 80-30 ml / min, the dose is usually 5-10 mg / day, with QC up to 30-10 ml / min - 2.5-5 mg / day, with QC less than 10 ml / min - 1.25-2.5 mg / day only in the days of dialysis. The duration of treatment depends on the effectiveness of the therapy. With too pronounced decrease in blood pressure, the dose of the drug is gradually reduced. The drug is used both in monotherapy and in combination with other antihypertensive drugs.