Enalapril-H (enalapril) tablets 10 mg/25 mg. №20

Description

Enalapril-H Storage
active substances: enalapril, hydrochlorothiazide;

1 tablet contains enalapril maleate 10 mg, hydrochlorothiazide 25 mg;

Enalapril-H Excipients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, pregelatinized starch, potato starch, magnesium stearate, colloidal anhydrous silica, povidone.

Enalapril-H Dosage form
Tablets.

Main physical and chemical properties: white or white tablets with a creamy tinge, flat-cylindrical shape with a dash and bevel.

Pharmacotherapeutic group
Drugs acting on the renin-angiotensin system. Combined drugs of ACE inhibitors. Enalapril and diuretics. ATX code C09B A02.

Pharmacological properties
The drug contains a combination of two antihypertensive drugs. The antihypertensive effects of the two components complement each other and persist for 24 hours. The presence of enalapril reduces the potassium loss associated with hydrochlorothiazide.

Pharmacodynamics.

Enalapril is a highly specific competitive ACE antagonist, a prodrug that is converted to the active metabolite enalaprilat in the body.

Enalaprilat inhibits ACE activity, as a result of which angiotensin I is not converted to angiotensin II – a substance that has a significant vasoconstrictive effect; it also reduces the secretion of aldosterone, which reduces the concentration of angiotensin II and aldosterone in the blood. Inhibits the breakdown of bradykinin, which is a powerful vasopressor peptide. The mechanism by which enalapril lowers blood pressure is primarily associated with inhibition of the activity of the renin-angiotensin-aldosterone system, which regulates blood pressure; Enalapril may have an antihypertensive effect even in patients with low-renin hypertension.

The pressor (sympathoadrenal) and depressor (kallikrein-kinin and prostaglandin) systems of the body are suppressed, the formation of vascular endothelial factor increases. As a result of these effects the general peripheral vascular resistance, arterial pressure, pressure in a small circle of blood circulation decreases, cardiac output increases. Enalapril causes a gradual decrease in systolic and diastolic blood pressure.

Indication
Hypertension in patients treated with combination therapy.

Contraindication
Hypersensitivity to enalapril and other angiotensin-converting enzyme (ACE) inhibitors, hydrochlorothiazide and other sulfonamide derivatives or to other components of the drug; history of angioneurotic edema associated with prior treatment with ACE inhibitors; hereditary or idiopathic angioneurotic edema; severe renal impairment, creatinine clearance less than 30 ml / min or serum creatinine level exceeds 265 μmol / l (3 mg / 100 ml), renal artery stenosis, hemodialysis, clinical condition after kidney transplantation, severe liver dysfunction; anuria, primary hyperaldosteronism, treatment-resistant hypokalaemia or hyperkalaemia, refractory hyponatraemia, symptomatic hyperuricaemia (gout), pregnancy or pregnancy planning (see Use during Pregnancy or Breastfeeding).

Enalapril should not be used with aliskiren-containing products in patients with diabetes mellitus or renal impairment (GFR <60 ml / min / 1.73 m2).