Enam tablets 20mg, # 20

various forms of arterial hypertension (including renovascular);

chronic heart failure (as part of combination therapy).

Inside, regardless of the time of the meal.

For monotherapy of arterial hypertension: an initial dose of 5 mg once a day. If there is no effect after 1-2 weeks, the dose is increased by 5 mg. After the initial dose, patients should be under medical supervision for 2 hours and an additional 1 hour until blood pressure stabilizes. If necessary and sufficiently well tolerated, the dose can be increased to 40 mg / day in 1-2 doses. After 2-3 weeks, they switch to a maintenance dose of 10-40 mg / day, divided into 1-2 doses. In moderate hypertension, the average daily dose is about 10 mg. The maximum daily dose is 40 mg.

In case of prescribing EnamЃ to patients receiving diuretics, diuretic treatment should be discontinued 2-3 days before prescribing the drug. If this is not possible, then the initial dose should be 2.5 mg / day.

Patients with hyponatremia (serum sodium concentration less than 130 mmol / l) or serum creatinine concentration more than 0.14 mmol / l: initial dose - 2.5 mg once a day.

Renovascular hypertension: the initial dose is 2.5Ц5 mg / day. The maximum daily dose is 20 mg.

In chronic heart failure: the initial dose is 2.5 mg once, then the dose is increased every 3-4 days in accordance with the clinical response by 2.5-5 mg to the maximum tolerated dose (depending on blood pressure), but not higher 40 mg / day, once or in 2 divided doses. In patients with low systolic blood pressure (less than 110 mm Hg), therapy should be started with a dose of 1.25 mg. The selection of the dose should be carried out within 2-4 weeks or less. The average maintenance dose is 5Ц20 mg / day for 1Ц2 doses.

In chronic renal failure, accumulation occurs with a decrease in filtration of less than 10 ml / min. With Cl creatinine 80-30 ml / min, the dose is usually 5-10 mg / day, Cl creatinine 30-10 ml / min - 2.5-5 mg / day, less than 10 ml / min - 1.25-2.5 mg / day only on dialysis days.

The duration of treatment depends on the effectiveness of therapy. With a too pronounced decrease in blood pressure, the dose of the drug is gradually reduced.

in a strip 10 pcs.; in a pack of cardboard 2 strips (for 2.5 mg tablets) or 2, 5, 6, or 10 (for 5, 10 and 20 mg tablets) strips.

hypersensitivity to enalapril and other ACE inhibitors;

a history of angioedema associated with treatment with ACE inhibitors;

aortic and mitral stenosis;

pregnancy;

lactation;

childhood.