Hydrohlorotyazyd, enalapril | Enap-NL 20 tablets 12.5 mg + 20 mg 20 pcs.
Special Price
$17.46
Regular Price
$25.00
In stock
SKU
BID464320
Release form
Tablets.
Tablets.
Release form
Tablets.
Packing
20 pcs.
Pharmacological action
Combined drug whose action is due to the properties of the components that make up its composition.
Enalapril - an ACE inhibitor, is a prodrug: as a result of its hydrolysis, enalaprilat is formed, which inhibits ACE.
Hydrochlorothiazide is a thiazide diuretic. It acts at the level of the distal renal tubules, increasing the excretion of sodium and chlorine ions.
At the beginning of treatment with hydrochlorothiazide, the volume of fluid in the vessels decreases as a result of increased excretion of sodium and fluid, which leads to a decrease in blood pressure and a decrease in cardiac output.
Due to hyponatremia and a decrease in fluid in the body, the renin-angiotensin-aldosterone system is activated. Reactive increase in the concentration of angiotensin II partially limits the decrease in blood pressure. With continued therapy, the hypotensive effect of hydrochlorothiazide is based on a decrease in total peripheral vascular resistance. The activation of the renin-angiotensin-aldosterone system results in metabolic effects on the electrolyte balance of the blood, uric acid, glucose and lipids, which partially neutralizes the effectiveness of antihypertensive treatment.
Contraindications
Hypersensitivity to the components of the drug.
Hypersensitivity to sulfonamides.
anuria.
Severe renal impairment (creatinine clearance (QC) <30 ml / min).
Hereditary or idiopathic angioedema.
Angioneurotic edema associated with the use of ACE inhibitors (history).
Primary hyperaldosteronism.
Addison's disease.
porphyria.
Children and adolescents under 18 years of age (efficacy and safety not established).
Precautions: Bilateral renal artery stenosis.
Stenosis of a single kidney artery.
Impaired renal function (CC 30-75 ml / min).
Severe stenosis of the aortic orifice.
Idiopathic hypertrophic subaortic stenosis.
ischemic heart disease.
Cerebrovascular disease (including cerebrovascular insufficiency).
Chronic heart failure.
Severe autoimmune systemic diseases of the connective tissue (including SLE, scleroderma).
Inhibition of bone marrow hematopoiesis.
Diabetes mellitus.
Hyperkalemia.
Condition after kidney transplantation.
Severe impairment of liver and / or kidney function.
Conditions accompanied by a decrease in bcc: As a result of diuretic therapy.
While limiting salt intake.
Diarrhea.
Vomiting.
Gout.
Elderly patients.
Special instructions
Effect on driving ability and driving:
Enap-NL does not affect driving or operating machinery, but arterial hypotension and dizziness may occur in some patients (mainly at the beginning of treatment), contributing to a decrease in the ability to drive a car and work with mechanisms. Therefore, at the beginning of treatment, it is recommended to avoid driving, working with machinery, and performing other work requiring attention until a response to treatment is established.
Composition
1 tablet contains:
Active ingredients:
Enalapril maleate 20 mg.
Hydrochlorothiazide 12.5 mg.
Excipients:
Sodium bicarbonate, lactose monohydrate, calcium hydrogen phosphate (anhydrous), corn starch, talc, magnesium stearate.
Dosage and Administration
Treatment of hypertension should not be started with a combination of drugs. Initially, adequate doses of the individual components should be determined. The dose should always be selected individually for each patient.
Take the drug regularly at the same time (preferably in the morning). The tablets are swallowed whole during or after a meal with a small amount of liquid.
The usual dose is one to two tablets per day.
If you miss the next dose of the drug, you must take it as soon as possible if there is a sufficiently large amount of time left before the next dose. If several hours are left before taking the next dose, you should wait and take only it. Do not double the dose.
If a satisfactory therapeutic effect is not achieved, it is recommended to add another drug or change the therapy.
In patients those on diuretic therapy, it is recommended to cancel the treatment or reduce the dose of diuretics at least 3 days before the start of treatment with Enap-NL 20 to prevent the development of symptomatic hypotension. Before starting treatment, kidney function should be examined.
The duration of treatment is not limited.
Use for impaired renal function:
For patients with creatinine clearance greater than 0.5 ml / s or serum creatinine less than 265 µmol / l (3 mg / dl), the usual Enap-NL dose may be prescribed 20.
Side effects of
From the cardiovascular system:
Heartbeat, various cardiac arrhythmias, marked decrease in blood pressure, orthostatic hypotension, cardiac arrest, myocardial infarction, cerebrovascular stroke, angina pectoris, Raynaud's syndrome, necrotizing angiitis. digestive system:
Dry mouth, glossitis, stomatitis, inflammation of the salivary glands, anorexia, nausea, vomiting, diarrhea, constipation, flatulence, epigastric pain, intestinal colic, ileus, pancreatitis, liver failure, hepatitis, hepatitis, .
From the respiratory system:
Rhinitis, sinusitis, pharyngitis, hoarseness, bronchospasm, asthma, pneumonia, pulmonary infiltrates, eosinophilic pneumonia, pulmonary embolism, pulmonary infarction, unproductive dry cough, respiratory distress syndrome, including pneumonitis and pulmonary edema.
From the side of the central nervous system and peripheral nervous system:
Depression, ataxia, drowsiness, insomnia, anxiety, nervousness, peripheral neuropathy (paresthesia, dysesthesia).
From the urinary system:
Oliguria, renal failure, impaired renal function, interstitial nephritis.
From the reproductive system:
Gynecomastia, decreased potency.
On the part of the sensory organs:
Impaired vision, impaired taste, impaired smell, tinnitus, conjunctivitis, dry conjunctiva, lacrimation.
From the hemopoietic system:
Leukocytosis, eosinophilia, neutropenia, leukopenia, agranulocytosis, anemia, hypoglobinemia, pancytopenia.
From the side of metabolism:
Hypokalemia, hyperkalemia, hypomagnesemia, hypercalcemia, hyponatremia, hypochloremic alkalosis, hyperglycemia, glucosuria, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, increased activity of liver enzymes, hyperbillirubinemia.
Dermatological reactions:
Sweating, rash, herpes zoster, alopecia.
Allergic reactions:
Urticaria, pruritus, pruritus, skin rash, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme, Steven-Johnson syndrome, photosensitivity, hypersensitivity reactions (angioedema, thrombocytopenic purpura), anaphylactic.
Other:
Weakness, fever, lupus-like syndrome described in the literature (fever, myalgia and arthralgia, serositis, vasculitis, skin rash, increased ESR, leukocytosis, eosinophilia, positive test for antinuclear antibodies).
Overdose
If you take too many tablets at one time, you should call your doctor immediately.
Symptoms: increased diuresis, marked decrease in blood pressure with bradycardia or other disorders of the heart rhythm, convulsions, paresis, paralytic ileus, disorders of consciousness (including Coma), renal failure, impaired KSH, impaired electrolyte balance of blood.
Treatment: The patient is placed in a horizontal position with a low head. In mild cases, gastric lavage and ingestion are indicated. In more serious cases, aimed at the stabilization of blood pressure: in / in the introduction of saline solution, plasma substitutes. It is necessary to control blood pressure, heart rate, respiratory rate, serum concentration of urea, creatinine, electrolytes and diuresis of the patient. If necessary - in / in the introduction of angiotensin II, hemodialysis (excretion rate of enalaprilat - 62 ml / min).
Storage conditions
In a dry place at a temperature not exceeding 25 РC.
Shelf life
2 years.
Deystvuyushtee substance
Gidrohlorotiazid, Эnalapril
Terms and conditions
prescription
dosage form
tablets
Possible product names
Enap NL 20 tab 12.5mg + 20mg x 20
Enap tablets 10 mg 20 pcs.
Enap-HL 20 tab. 20mg / 12.5mg N20 Slovenia
ENAP-HL 20MG + 12.5MG. No. 20 TAB. / KRKA /
Enap-HL tablets 20 / 12.5 mg, 20 pcs.
KRKA d.d. Novo mesto AO, Slovenia
Tablets.
Packing
20 pcs.
Pharmacological action
Combined drug whose action is due to the properties of the components that make up its composition.
Enalapril - an ACE inhibitor, is a prodrug: as a result of its hydrolysis, enalaprilat is formed, which inhibits ACE.
Hydrochlorothiazide is a thiazide diuretic. It acts at the level of the distal renal tubules, increasing the excretion of sodium and chlorine ions.
At the beginning of treatment with hydrochlorothiazide, the volume of fluid in the vessels decreases as a result of increased excretion of sodium and fluid, which leads to a decrease in blood pressure and a decrease in cardiac output.
Due to hyponatremia and a decrease in fluid in the body, the renin-angiotensin-aldosterone system is activated. Reactive increase in the concentration of angiotensin II partially limits the decrease in blood pressure. With continued therapy, the hypotensive effect of hydrochlorothiazide is based on a decrease in total peripheral vascular resistance. The activation of the renin-angiotensin-aldosterone system results in metabolic effects on the electrolyte balance of the blood, uric acid, glucose and lipids, which partially neutralizes the effectiveness of antihypertensive treatment.
Contraindications
Hypersensitivity to the components of the drug.
Hypersensitivity to sulfonamides.
anuria.
Severe renal impairment (creatinine clearance (QC) <30 ml / min).
Hereditary or idiopathic angioedema.
Angioneurotic edema associated with the use of ACE inhibitors (history).
Primary hyperaldosteronism.
Addison's disease.
porphyria.
Children and adolescents under 18 years of age (efficacy and safety not established).
Precautions: Bilateral renal artery stenosis.
Stenosis of a single kidney artery.
Impaired renal function (CC 30-75 ml / min).
Severe stenosis of the aortic orifice.
Idiopathic hypertrophic subaortic stenosis.
ischemic heart disease.
Cerebrovascular disease (including cerebrovascular insufficiency).
Chronic heart failure.
Severe autoimmune systemic diseases of the connective tissue (including SLE, scleroderma).
Inhibition of bone marrow hematopoiesis.
Diabetes mellitus.
Hyperkalemia.
Condition after kidney transplantation.
Severe impairment of liver and / or kidney function.
Conditions accompanied by a decrease in bcc: As a result of diuretic therapy.
While limiting salt intake.
Diarrhea.
Vomiting.
Gout.
Elderly patients.
Special instructions
Effect on driving ability and driving:
Enap-NL does not affect driving or operating machinery, but arterial hypotension and dizziness may occur in some patients (mainly at the beginning of treatment), contributing to a decrease in the ability to drive a car and work with mechanisms. Therefore, at the beginning of treatment, it is recommended to avoid driving, working with machinery, and performing other work requiring attention until a response to treatment is established.
Composition
1 tablet contains:
Active ingredients:
Enalapril maleate 20 mg.
Hydrochlorothiazide 12.5 mg.
Excipients:
Sodium bicarbonate, lactose monohydrate, calcium hydrogen phosphate (anhydrous), corn starch, talc, magnesium stearate.
Dosage and Administration
Treatment of hypertension should not be started with a combination of drugs. Initially, adequate doses of the individual components should be determined. The dose should always be selected individually for each patient.
Take the drug regularly at the same time (preferably in the morning). The tablets are swallowed whole during or after a meal with a small amount of liquid.
The usual dose is one to two tablets per day.
If you miss the next dose of the drug, you must take it as soon as possible if there is a sufficiently large amount of time left before the next dose. If several hours are left before taking the next dose, you should wait and take only it. Do not double the dose.
If a satisfactory therapeutic effect is not achieved, it is recommended to add another drug or change the therapy.
In patients those on diuretic therapy, it is recommended to cancel the treatment or reduce the dose of diuretics at least 3 days before the start of treatment with Enap-NL 20 to prevent the development of symptomatic hypotension. Before starting treatment, kidney function should be examined.
The duration of treatment is not limited.
Use for impaired renal function:
For patients with creatinine clearance greater than 0.5 ml / s or serum creatinine less than 265 µmol / l (3 mg / dl), the usual Enap-NL dose may be prescribed 20.
Side effects of
From the cardiovascular system:
Heartbeat, various cardiac arrhythmias, marked decrease in blood pressure, orthostatic hypotension, cardiac arrest, myocardial infarction, cerebrovascular stroke, angina pectoris, Raynaud's syndrome, necrotizing angiitis. digestive system:
Dry mouth, glossitis, stomatitis, inflammation of the salivary glands, anorexia, nausea, vomiting, diarrhea, constipation, flatulence, epigastric pain, intestinal colic, ileus, pancreatitis, liver failure, hepatitis, hepatitis, .
From the respiratory system:
Rhinitis, sinusitis, pharyngitis, hoarseness, bronchospasm, asthma, pneumonia, pulmonary infiltrates, eosinophilic pneumonia, pulmonary embolism, pulmonary infarction, unproductive dry cough, respiratory distress syndrome, including pneumonitis and pulmonary edema.
From the side of the central nervous system and peripheral nervous system:
Depression, ataxia, drowsiness, insomnia, anxiety, nervousness, peripheral neuropathy (paresthesia, dysesthesia).
From the urinary system:
Oliguria, renal failure, impaired renal function, interstitial nephritis.
From the reproductive system:
Gynecomastia, decreased potency.
On the part of the sensory organs:
Impaired vision, impaired taste, impaired smell, tinnitus, conjunctivitis, dry conjunctiva, lacrimation.
From the hemopoietic system:
Leukocytosis, eosinophilia, neutropenia, leukopenia, agranulocytosis, anemia, hypoglobinemia, pancytopenia.
From the side of metabolism:
Hypokalemia, hyperkalemia, hypomagnesemia, hypercalcemia, hyponatremia, hypochloremic alkalosis, hyperglycemia, glucosuria, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, increased activity of liver enzymes, hyperbillirubinemia.
Dermatological reactions:
Sweating, rash, herpes zoster, alopecia.
Allergic reactions:
Urticaria, pruritus, pruritus, skin rash, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme, Steven-Johnson syndrome, photosensitivity, hypersensitivity reactions (angioedema, thrombocytopenic purpura), anaphylactic.
Other:
Weakness, fever, lupus-like syndrome described in the literature (fever, myalgia and arthralgia, serositis, vasculitis, skin rash, increased ESR, leukocytosis, eosinophilia, positive test for antinuclear antibodies).
Overdose
If you take too many tablets at one time, you should call your doctor immediately.
Symptoms: increased diuresis, marked decrease in blood pressure with bradycardia or other disorders of the heart rhythm, convulsions, paresis, paralytic ileus, disorders of consciousness (including Coma), renal failure, impaired KSH, impaired electrolyte balance of blood.
Treatment: The patient is placed in a horizontal position with a low head. In mild cases, gastric lavage and ingestion are indicated. In more serious cases, aimed at the stabilization of blood pressure: in / in the introduction of saline solution, plasma substitutes. It is necessary to control blood pressure, heart rate, respiratory rate, serum concentration of urea, creatinine, electrolytes and diuresis of the patient. If necessary - in / in the introduction of angiotensin II, hemodialysis (excretion rate of enalaprilat - 62 ml / min).
Storage conditions
In a dry place at a temperature not exceeding 25 РC.
Shelf life
2 years.
Deystvuyushtee substance
Gidrohlorotiazid, Эnalapril
Terms and conditions
prescription
dosage form
tablets
Possible product names
Enap NL 20 tab 12.5mg + 20mg x 20
Enap tablets 10 mg 20 pcs.
Enap-HL 20 tab. 20mg / 12.5mg N20 Slovenia
ENAP-HL 20MG + 12.5MG. No. 20 TAB. / KRKA /
Enap-HL tablets 20 / 12.5 mg, 20 pcs.
KRKA d.d. Novo mesto AO, Slovenia
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