Enap (Enalapril) 20mg – 60 tablets
ACE inhibitor. It is a prodrug from which the active metabolite enalaprilat is formed in the body. It is believed that the mechanism of antihypertensive action is associated with competitive inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin I to angiotensin II (which has a pronounced vasoconstrictor effect and stimulates the secretion of aldosterone in the adrenal cortex).
As a result of a decrease in the concentration of angiotensin II, a secondary increase in plasma renin activity occurs by eliminating negative feedback with the release of renin and a direct decrease in the secretion of aldosterone. In addition, enalaprilate appears to have an effect on the kinin-kallikrein system, preventing the breakdown of bradykinin.
Thanks to the vasodilator effect, reduces peripheral vascular resistance (afterload), jamming pressure in the lung capillaries (preload) and resistance in the pulmonary vessels; increases cardiac output and tolerance to stress.
In patients with chronic heart failure with long-term use of enalapril increases exercise tolerance and reduces the severity of heart failure (evaluated by NYHA criteria). Enalapril in patients with mild to moderate heart failure slows its progression, as well as slows the development of left ventricular dilation. In left ventricular dysfunction, enalapril reduces the risk of major ischemic outcomes (including the incidence of myocardial infarction and the number of hospitalizations for unstable angina).
When ingested, about 60% is absorbed from the gastrointestinal tract. Simultaneous eating does not affect the absorption. It is metabolized in the liver by hydrolysis to form enalaprilata, due to the pharmacological activity of which is realized hypotensive effect. The binding of enalaprilate to plasma proteins is 50-60%.
T1 / 2 enalaprilata is 11 h and increases in renal failure. After oral administration, 60% of the dose is excreted by the kidneys (20% in the form of enalapril, 40% in the form of enalaprilat), 33% is excreted through the intestine (6% in the form of enalapril, 27% in the form of enalaprilat). After the/in the introduction of enalaprilata 100% excreted by the kidneys unchanged.
Arterial hypertension (including renovascular), chronic heart failure (in combination therapy).
Chronic heart failure (as part of combination therapy).
Prevention of clinically severe heart failure in patients with asymptomatic left ventricular dysfunction (as part of combination therapy).
Prevention of coronary ischemia in patients with left ventricular dysfunction in order to reduce the incidence of myocardial infarction and reduce the frequency of hospitalization for unstable angina.
The ingestion of the initial dose – 2.5-5 mg 1 times/day. The average dose is 10-20 mg / day in 2 doses.
The maximum daily dose when administered is 80 mg.