Ezapril 20 mg 20 tablets

Tradename

Ezapril

Composition

Each tablet contains:

Enalapril maleate 20 mg

Auxiliary components:

Sodium bicarbonate, anhydrous lactose, starch, magnesium stearate.

Properties

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 conversio angiotensin I to angiotensin Il (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 Il, a secondary increase in plasma renin activity occurs due to the elimination of negative feedback during the release of renin and a direct decrease in aldosterone secretion. In addition, enalaprilat appears to have an effect on the kininkallikrein system, preventing the breakdown of bradykinin.

Due to the vasodilating action, it reduces the OPSS (afterload), the pressure of wedging in the pulmonary capillaries (preload) and resistance in the pulmonary vessels; increases cardiac output and exercise tolerance.

Indications

Arterial hypertension (including renovascular), chronic heart failure (as part of combination therapy).

Essential hypertension.

Chronic heart failure (as part of combination therapy).

Contraindications

A history of angioedema, bilateral renal artery stenosis or renal artery stenosis of a solitary kidney, hyperkalemia, porphyria, simultaneous use with aliskiren in patients with diabetes mellitus or impaired renal function (CC ml / min), pregnancy, lactation (breastfeeding) , children and adolescents under 18 years of age, hypersensitivity to enalapril and other ACE inhibitors.

Precautions:

It is used with extreme caution in patients with autoimmune diseases, diabetes mellitus, liver dysfunction, severe aortic stenosis, subaortic muscle stenosis of unknown origin, hypertrophic cardiomyopathy, with loss of fluid and salts. In the case of previous treatment with saluretics, in particular in patients with chronic heart failure, the risk of orthostatic hypotension increases, therefore, before starting treatment with enalapril, it is necessar to comensate for the 10 and salts.

Side effects

From the nervous system: dizziness, headache, tiredness, fatigue; very rarely when used in high doses — sleep disorders, nervousness, depression, imbalance, paresthesia, tinnitus.

From the side of the cardiovascular system: orthostatic hypotension, fainting, palpitations, pain in the region of the heart; very rarely when used in high doses — hot flashes.

From the digestive system: nausea; rarely — dry mouth, abdominal pain, vomiting, diarrhea, constipation, liver dysfunction, increased activity of hepatic transaminases, increased concentration of bilirubin in the blood, hepatitis, pancreatitis; very rarely when use high doses — glossitis.