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Enalapril
The active ingredient Enalapril is a medication for hypertension from the group of ACE inhibitors. It is derived from the first ACE inhibitor Captopril and has regard to the side effects some advantages. Here you can read everything of interest to Enalapril, adverse reactions and applications.
How Enalapril works
The active ingredient Enalapril affects one of the most important systems in the human body to regulate blood pressure: the renin-angiotensin system (RAAS). In order to maintain the blood pressure Renin is an enzyme produced in the kidneys. It converts the protein angiotensinogen from the liver into the hormone precursor angiotensin I. In a second step the so-called angiotensin converting enzyme (ACE) converts the angiotensin I into the active angiotensin II This hormone then effects via different mechanisms, a blood pressure rise.
- Use the kidney less water is excreted.
- The adrenal cortex is amplified stimulated the formation of the hormone aldosterone, which also inhibits water and electrolyte secretion.
- Small arterial vessels are narrowed, reducing blood pressure continues to rise.
ACE inhibitors such as Enalapril block the ACE. This less angiotensin II is formed – the pressor effects decrease. Makes sense inhibition, but only if the blood pressure is increased pathologically to set the system back to normal levels. The workload on the heart.
Pharmacokinetics and metabolism of Enalapril
After taking Enalapril is rapidly absorbed about two-thirds through the intestines into the blood, where it reaches the highest levels after one hour. The recording is not hindered by food. In the blood is Enalapril, which is actually an inactive precursor of the active ingredient Enalaprilat, only transformed into this. The highest levels of the active form can be found after about four hours in the blood. Excretion of Enalapril and Enalaprilat is through the kidneys into the urine.
When is Enalapril used?
The active ingredient Enalapril is used to treat heart failure and to prevent and heart failure when certain pre-existing conditions are present.
In general, Enalapril must be taken long-term to relieve the heart and vessels permanently and thereby protect.
How Enalapril is used
Enalapril is taken in pill form. Usually starting with a low dose that is then slowly increased to the maintenance dose – at an initially high Enalapril dosage may lead to a sharp drop in blood pressure with dizziness to fainting. The tablet is taken once a day, at very high doses of 40 milligrams Enalapril (maximum daily dose) should be administered in the morning and evening are divided.
therapeutic sense may (for example Lercandipin) be the combination with diuretics (‘water resources’) or other anti-hypertensives such as calcium channel blockers.
What are the side effects of Enalapril?
During the treatment, it comes with more than one in ten patients treated to Enalapril side effects such as blurred vision, cough, nausea and weakness.
Another Enalapril side effects occur in every tenth to hundredth patient, abdominal pain, rash, hypersensitivity reactions, fatigue and increased potassium and creatinine blood levels.
Some of the side effects can be directly attributed to the low blood pressure. Especially in the early stages of treatment, the normal blood pressure feels subjectively often too low to.
With side effects like cough, rash or hypersensitivity reactions of the doctor should be notified. Possibly the medication should be changed.
What should I watch for while taking Enalapril?
The use in combination with other drugs to treat high blood pressure, acting on the RAAS should be done only in special cases. Examples of such agents are aliskiren and sartans as Candesartan, Losartan or Valsartan.
In the combined administration of Enalapril and potassium-sparing diuretics (such as Spironolactone, triamterene, amiloride) or potassium supplements may lead to greatly increased potassium blood levels.
The in severe hypertension often prescribed combination therapy with other high blood pressure medications should begin at different times ever, so that the blood pressure at the beginning does not drop too much.
The use of tricyclic antidepressants, neuroleptics and other anesthesia drugs can also lead to increased blood pressure. Taking the mood stabilizer lithium should be monitored by blood level checks.
The intake of NSAIDs (such as aspirin or Ibuprofen), which are often taken as a headache remedy may antagonize the effects of Enalapril.
In diabetic patients who use oral antidiabetics or insulin, the blood sugar should be monitored closely. There is a risk of low blood sugar (hypoglycemia).
The use of Enalapril in the first three months of pregnancy and during lactation is not recommended. In the second and third trimesters (trimester) of antihypertensives must never be taken.
The use in patients with impaired renal performance requires a lower Enalapril dose. The active ingredient can also be used in children if the kidneys are working adequately.
How to obtain medication with Enalapril
The active ingredient Enalapril is in each dose prescription.
Since when Enalapril is known?
The first ACE inhibitor Captopril was developed using a small protein compound that has been found in the venom of Bothrops jararaca and can effectively lower blood pressure. Captopril was developed in 1974 with the pharmaceutical company Bristol-Myers Squibb and came in 1981 in the US market. However, the drug had some unpleasant side effects such as rashes and dysgeusia. Only two years later did the pharmaceutical company Merck & amp; Co. the active substance Enalapril as a direct competitor to the market which has a better side effect profiles.