Enalapril

When ATH:
C09AA02

Characteristic.

Enalapril maleate - white or almost white crystalline powder, poorly soluble in water, soluble in ethyl alcohol and methyl alcohol. Molecular weight 492,43.

Pharmacological action.
Gipotenzivnoe, vazodilatirtee, kardioprotektivnoe, natriuretic.

Application.

Hypertonic disease, symptomatic hypertension, heart failure, diabeticheskaya nephropathy, secondary hyperaldosteronism, Raynaud's disease, scleroderma, complex therapy of myocardial infarction, angina, chronic renal failure.

Contraindications.

Hypersensitivity, pregnancy, lactation, childhood.

Pregnancy and breast-feeding.

Category actions result in FDA - C (I trimester). (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

Category actions result in FDA - D (II and III trimesters).

Side effects.

CNS depression, depression, ataxia, convulsions, drowsiness or insomnia, peripheral neuropathy, visual impairment, taste, olfactory, tinnitus, conjunctivitis, lacrimation, hypotension, myocardial infarction, acute ischemic stroke (as a consequence of hypotension), heart rhythm disturbance (pryedsyerdnaya Rituals- or bradycardia, atrial fibrillation), orthostatic hypotension, angina, thromboembolism pulmonary artery branches, bronchospasm, dyspnoea, nonproductive cough, interstitial pneumonitis, bronchitis and other upper respiratory tract infection, rhinorrhea, stomatitis, xerostomia, glossitis, anorexia, dyspepsia, ground, constipation, pancreatitis, abnormal liver function (cholestatic hepatitis, hepatocellular necrosis), renal dysfunction, oligourija, urinary tract infection, gynecomastia, impotence, neutropenia, thrombocytopenia, exfoliative dermatitis, toxic epidermal necrolysis, pemphigus, shingles, alopecia, photodermatitis, allergic reactions (Stevens-Johnson syndrome, hives, angioedema, anaphylactic shock, and others.).

Cooperation.

Effects of enalapril increase diuretics, antihypertensives, alcohol, weaken - estrogens, NSAIDs, sympathomimetic. Potassium-sparing diuretics and kalisodergaszczye drugs increase the risk of hyperkalemia.

Overdose.

Symptoms: Excessive hypotension, myocardial infarction, acute stroke and thromboembolic complications in the background of a sharp decrease in blood pressure.

Treatment: / in isotonic sodium chloride solution and symptomatic therapy.

Dosing and Administration.

Inside. The initial dose - 5 mg 1 once a day, and in patients with kidney disease or taking diuretics - 2,5 mg 1 once a day. If well tolerated and necessary, the dose can be increased to 10-40 mg per day, once or in two divided doses..

Precautions.

The initial dose is administered in a hospital with constant monitoring of blood pressure for at least 3 no. In the course of therapy should be periodically monitored concentration of transaminases and alkaline phosphatase in the bloodstream (with an increase in their maintenance treatment cancel). Be wary appointed to renal dysfunction (titration should be carried out under the supervision of the concentration of enalapril in the blood, since the glomerular filtration rate is inversely proportional to its level in plasma).

Cooperation