Treatment of arterial hypertension. Treatment of clinically expressed heart failure. Prevention of clinically expressed heart failure in patients with asymptomatic left ventricular dysfunction (ejection fraction ≤ 35%).
Enap HL 20 Storage
active substance: 1 tablet contains enalapril maleate 20 mg and hydrochlorothiazide 12.5 mg;
Excipients: sodium bicarbonate, lactose monohydrate, corn starch, pregelatinized starch, talc, magnesium stearate.
Enap HL 20 Dosage form
Main physical and chemical properties: round flat tablets of white color with a beveled edge and a notch on one side.
Enap HL 20 Pharmacotherapeutic group
Combined drugs of ACE inhibitors. Enalapril and diuretics. ATX code C09B A02.
Enap® 20 HL is a combination of an angiotensin converting enzyme (ACE) inhibitor (enalapril maleate) and a diuretic (hydrochlorothiazide).
ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the pressor substance angiotensin II. After absorption, enalapril is hydrolyzed to enalaprilat, which inhibits ACE inhibitors. Inhibition of ACE leads to a decrease in plasma angiotensin II levels, leading to increased plasma renin activity (due to inhibition of negative feedback during renin release) and decreased aldosterone secretion.
ACE is identical to kininase II. Enalapril can also block the breakdown of bradykinin, which is a potent vasodepressant peptide. However, the role of this fact in the therapeutic effects of enalapril remains unknown. While the mechanism by which enalapril lowers blood pressure is primarily associated with inhibition of renin-angiotensin-aldosterone system (RAAS) activity, which plays a major role in blood pressure regulation, enalapril may have an antihypertensive effect even in hypertensive patients.
Hypertension in patients treated with combination therapy.
Hypersensitivity to any of the components of the drug or to other drugs that are derivatives of sulfonamides.
History of angioneurotic edema associated with previous treatment with ACE inhibitors and hereditary or idiopathic angioneurotic edema.
Severe liver dysfunction.
Renal artery stenosis.
Severe renal impairment (creatinine clearance ≤30 ml / min).
Hypokalemia or hyperkalemia resistant to treatment.
Symptomatic hyperuricemia (gout).
Pregnant women or women planning to become pregnant (see section “Use during pregnancy or breast-feeding”).
Concomitant use with aliskiren-containing products in patients with diabetes mellitus or renal impairment (glomerular filtration rate (GFR) <60 ml / min / 1.73 m2) (see sections “Pharmacodynamics” and “Specifics”).
Concomitant use with sacubitril / valsartan therapy due to an increased risk of angioneurotic edema. Enap® 20 NL should not be used for 36 hours after the last dose of sacubitril / valsartan, a drug containing a neprilysin inhibitor, or after switching from another drug (see sections “Interaction with other medicinal products and other forms of interaction” and “Features application”).