Ezapril

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

Essential hypertension.

Chronic heart failure (as part of combination therapy).

Prevention of the development of clinically significant heart failure in patients with asymptomatic left ventricular dysfunction (as part of combination therapy).

Prevention of coronary ischemia in patients with left ventricular dysfunction in order to reduce the incidence of myocardial infarction and reduce the incidence of hospitalizations for unstable angina.

Tradename: Ezapril

Composition: Each tablet contains:

* Enalapril maleate 10 mg

* 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.

In patients with chronic heart failure, long-term use of enalapril increases exercise tolerance and reduces the severity of heart failure (assessed by NYHA criteria). Enalapril in patients with mild to moderate heart failure slows down its progression, and also slows down the development of left ventricular dilatation. In left ventricular dysfunction, enalapril reduces the risk of major ischemic outcomes (including the incidence of myocardial infarction and the number of

hospitalizations for unstable angina pectoris).

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

Essential hypertension.

Chronic heart failure (as part of combination therapy).

Prevention of the development of clinically significant heart failure in patients with asymptomatic left ventricular dysfunction (as part of combination therapy).

Prevention of coronary ischemia in patients with left ventricular dysfunction in order to reduce the incidence of myocardial infarction and reduce the incidence of hospitalizations for unstable angina.

Method of administration and dosage: For oral administration, the initial dose is 2. mg 1 time / day. The average dose is 10-20

mg / day in 2 divided doses.

The maximum daily dose for oral administration is 80 mg.

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.

With long-term treatment with enalapril, it is necessary to periodically monitor the peripheral blood picture. Sudden discontinuation of enalapril does not cause a sharp increase in blood pressure.

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.

From the hematopoietic system: rarely neutropenia; in patients with autoimmune diseases — agranulocytosis.

From the urinary system: rarely — renal dysfunction, proteinuria.

From the respiratory system: dry cough.

On the part of the reproductive system: very rarely, when used in high doses, impotence.

Dermatological reactions: very rarely, when used in high doses, hair loss.

Allergic reactions: rarely — skin rash, Quincke’sedema.

Storage method: At a temperature not higher than 30 degrees.

Packaging: The cardboard box holds 2 blisters of 10 tablets.