Enalozid

Эналозид Drug photo

The description is actual on 27.10.2015

  • Latin name: Enalozid
  • ATH code: C09BA0
  • Active ingredient: Enalapril (Enalapril) + Hydrochlorthiazidum (Hydrochlortiazid)
  • Producer: JSC Farmak (Ukraine)

Structure

The tablet Enalozid 12.5 contains 10 mg of active agent of a maleate of enalapril and 12.5 mg of Hydrochlorthiazidum.

Additional components: starch (potato), monohydrate of lactose, Ca stearate and povidone.

The tablet Enalozid 25 contains 10 mg of active agent of a maleate of enalapril and 25 mg of Hydrochlorthiazidum. Additional substances are similar to a dosage 12.5.

Enalozid Mono does not contain a diuretic component Hydrochlorthiazidum and is issued in dosages of 5 and 10 mg. Additional components: medical low-molecular polyvinylpirrolidone, monohydrate of lactose, Ca stearate.

Enalozid Forte contains high concentration of active ingredient of a maleate of enalapril – 20 mg; a dosage of a diuretic component of Hydrochlorthiazidum – 12.5 mg. Additional components: Mg stearate, prezhelatinizirovanny form of starch 1500, corn starch, Na hydrocarbonate, Fe oxide (yellow), monohydrate of lactose.

Release form

The hypotensive medicine is issued in the tableted look. In each cardboard pack there are 2 blisters (on 10 tablets) and the instruction from the producer with recommendations.

Pharmacological action

The combined hypotensive medicine with diuretic effect. Two operating components are capable not only to exponentiate effects of each other, but also to reduce expressiveness of negative reactions.

Enalapril is pro-medicine which in a human body is exposed to a metabolism with formation pharmacological of active component – Enalaprilat. Active ingredient is capable to improve a blood stream in renal system, to reduce an afterload and preload of a cardiac muscle a myocardium, makes the expressed hypotensive impact. In addition Enalapril reduces losses of potassium against therapy by Hydrochlorthiazidum. The mechanism of influence is based on processes of inhibition of a specific angiotensin-converting enzyme that leads to reduction of production of angiotensin-2 of which the vasopressor effect is characteristic.

Use of Enalapril allows to reduce the general peripheric vascular resistance, to expand a gleam of vessels, without causing at the same time reflex tachycardia. Under influence of Enalapril disintegration of bradikinin is prevented, secretion of Aldosteronum decreases.

Hydrochlorthiazidum – the second component of drug, is diuretic from group of tiazid. Active agent has natriuretic and diuretic effects, reduces the volume of the circulating blood, makes anti-hypertensive impact due to decrease in level of ions of Na in a vascular wall that leads to decrease in sensitivity of vessels to action of vasopressor agents.

Pharmacodynamics and pharmacokinetics

The operating medicine components well are absorbed from a gleam of a digestive tract. As a result of a metabolism of Enalapril inactive metabolites and active component – Enalaprilat are formed pharmacological. After reception of per os the maximum concentration of enalaprilat in plasma is registered in 3-4 hours. The therapeutic effect is registered in 2 hours and reaches the maximum indicator 4 hours later. The reached hypotensive effect is capable to remain within 24 hours that allows to accept a medicine of 1 times a day. Time of semi-removal of Hydrochlorthiazidum – 10 hours, Enalaprilat – 11 hours. Time of removal of active components at patients with pathology of renal system increases.

Indications, Enalozid's use

The combined medicine is applied in therapeutic and cardiological practice to treatment of patients who have an arterial hypertension:

  • essential;
  • symptomatic.

Enalozid can be applied as a part of complex therapy of heart failure (a chronic current).

Contraindications

Hypotensive drug Enalozid is not used for treatment of patients who suffer from individual hypersensitivity to Hydrochlorthiazidum, Enalapril and other diuretic drugs from group of tiazid.

The medicine is not appointed at pathology of absorption of a galactose glucose, at a galactosemia, insufficiency of lactose. Medicine is not applied at the following states:

  • anury;
  • insufficiency of hepatic system, pathology of kidneys;
  • diabetes mellitus;
  • gout;
  • hyper aldosteronism (primary form);
  • after transplantation of a kidney;
  • porphyria.

The combination of Hydrochlorthiazidum and Enalapril is not applied in therapy of pregnant women and the feeding women. Use in pediatric practice is not allowed (age restriction – 14 years).

Patients to whom the hemodialysis using specialized high-flowing membranes, and also an afereza of LPNP with dextran sulfate is carried out are not recommended to appoint producer a medicine. Restriction is introduced also for patients with a stenosis of arteries of renal system. After carrying out desensitization to aspen and to apitoxin Enalozid's use is forbidden.

Relative contraindications:

  • chronic form of alcoholism;
  • atherosclerotic defeats of vessels;
  • aortal stenosis;
  • disturbances of blood circulation of a brain;
  • subaortal muscular stenosis (idiopathic form);
  • the states provoking dehydration (reception of diuretic means, carrying out a hemodialysis, vomiting, a diarrheal syndrome).

Before inspection of epithelial bodies the medicine is cancelled. It is recommended to be careful when working which demand high concentration of attention.

Side effects

Patients note good tolerance of the combined antihypertensive. Seldom negative reactions are registered.

Digestive tract:

  • hyperbilirubinemia;
  • discomfort in epigastriums, abdominal pains;
  • increase of level of enzymes of hepatic system;
  • disturbances of a chair;
  • nausea;
  • cholestasia;
  • hepatitis;
  • digestion disturbances;
  • pancreatitis;
  • vomiting.

System of a hemopoiesis and cardiovascular system:

Nervous system (peripheral and central departments):

Allergic answers:

Other negative reactions:

  • proteinuria;
  • dispnoe;
  • impotence;
  • Reynaud's syndrome;
  • change of structure of a nail plate;
  • giperkreatininemiya;
  • change of level of sugar and electrolytes in blood;
  • insufficiency of renal system (acute form);
  • dry cough (frequent reaction to IAPF).

Enalozid, application instruction (Way and dosage)

The hypotensive medicine is intended for reception of per os. Treatment by the combined means begins with the minimum dosages of Hydrochlorthiazidum and enalapril. Within 2 weeks it is controlled over indicators of a blood pressure and degree of manifestation of therapeutic effect; if necessary correction of the scheme of treatment is carried out. Increase of a dosage is carried out each 2 weeks on requirement. The daily dosage is applied for 1 time.

Hypotensive therapy is begun with Enalozid's reception in a dose 10+12.5. The most admissible dosage of a thiazide diruyetik of Hydrochlorthiazidum – 25 mg, enalapril – 20 mg. At pathology of renal system obligatory dose adjustment of hypotensive drug which cornerstone the clearance of creatinine is is carried out. For prevention of development of orthostatic hypotonia it is recommended to avoid sharp movements and whenever possible to accept horizontal position after administration of drug. It is recommended to refuse reception of other diuretic means before an initiation of treatment. Control of level of sugar, electrolytes, the main indicators of the general blood test and a condition of renal system is obligatory.

Overdose

Big concentration of Hydrochlorthiazidum and enalapril cause arterial hypotonia. Orthostatic hypotension can be shown by dizziness, a hypopotassemia, headaches, disturbances in work of renal system. The specific antidote is not developed. Carrying out the procedures directed to a gastric lavage and purpose of enterosorbiruyushchy medicines is effective (Polisorb, Absorbent carbon, Baktistatin).

When diagnosing arterial hypotonia the patient is given horizontal position, legs raise. At the expressed form injection of Na chloride in the form of 0.9% of solution is effective. Injection of angiotensin-2 at serious conditions of the patient is admissible. The operating components are removed by a hemodialysis.

Interaction

The medicine is capable to reduce efficiency of pressor amines. Hypotensive action of the combined means amplifies at simultaneous therapy:

  • barbiturates;
  • diuretics;
  • other antihypertensives;
  • alcohol;
  • fenotiazinam;
  • monoaminooxidase inhibitors;
  • antidepressants (tricyclic forms).

The converse effect is observed at treatment by drugs of NPVS group, Colestyraminum; at meal with the high content of salt.

The risk of development of a pancytopenia, anemia, leukopenia and other pathology from the hemopoietic bodies increases at reception:

  • immunodepressants;
  • Allopyrinolum;
  • tsitostatik;
  • system glucocorticosteroids (the hypopotassemia in addition is registered).

Medicine is capable to increase time of semi-removal of muscle relaxants (not depolarizing forms), to increase toxicity of the drugs Li and cardiac glycosides (the effect develops due to the slowed-down removal of metabolites from an organism).

The combined medicine can influence sugar level in blood at the patients suffering from a diabetes mellitus. Influence of drug on efficiency of antidiabetic means (peroral forms) and insulin is registered. Additional carrying out correction of the mode of dosing of hypoglycemic medicines is recommended.

Terazozin's efficiency, Allopyrinolum and estrogensoderzhashchy contraceptives (peroral forms) decreases at treatment by Hydrochlorthiazidum. The risk of a hyperpotassemia increases at treatment by drugs of potassium and kaliysberegayushchy diuretic means.

Terms of sale

Enalozid is on sale in specialized pharmaceutical points. It is optional to show the medical prescription form.

Storage conditions

Tablet it is necessary to store in blisters in the dry place. Temperature of storage of packagings recommended by the producer – to 25 degrees.

Period of validity

Efficiency of tablets remains during 1 year at observance of the recommended storage conditions.

Special instructions

Against the carried-out hypotensive therapy by Enalozid arterial hypotonia can develop. Carrying out the researches capable to reveal changes of water and electrolytic balance (a giperkhloremichesky alkalosis, a lack of water, a hyponatremia, a hypopotassemia, a hypomagnesiemia) is obligatory. It is important to remember that excessive lowering of blood pressure can provoke a stroke, a myocardial infarction or cerebrovascular pathology at predisposed persons.

Analogs

Apteka24

  • Enalozid of a mono tablet 10 of mg No. 20farmak (Ukraine, Kiev)
  • Enalozid of the tab. 0.025g No. 30farmak (Ukraine, Kiev)
  • Enalozid No. 20farmak tablet 0.025g (Ukraine, Kiev)
  • Enalozid No. 20farmak tablet 0.0125g (Ukraine, Kiev)
  • Enalozid mono20

Paniapteka

  • Enalozid of the tab. 0.0125g No. 20farmak
  • Enalozid of the tab. 0.0125g No. 20farmak
Section: Cardiological Cardiovascular
in more detail

Education: Graduated from the Bashkir state medical university majoring in "Medical business". In 2011 gained the diploma and the certificate in Therapy. In 2012 received 2 certificate and the diploma in "Functional diagnosis" and "Cardiology". In 2013 completed courses on "Topical issues of otorhinolaryngology in therapy". In 2014 completed advanced training courses in "A clinical echocardiography" and courses in "Medical rehabilitation".

Experience: From 2011 to 2014 the Policlinic No. 33 Ufa worked as the therapist and the cardiologist in MBUZ. Since 2014 the Policlinic No. 33 Ufa works as the cardiologist and the doctor of functional diagnosis in MBUZ.

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