Cerepril 5 SPM treats hypertension, heart failure (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Enalapril maleate
Ingredient Heart failure, high blood pressure

Ingredient

Composition information	Content
Enalapril maleate	5mg

Uses

indications

Cerepril 10 drugs are indicated in the following cases:

Treatment of hypertension.

Treatment of heart failure (decreased death and complications in people with symptoms and disordered disorders as symptoms).

Treatment after myocardial infarction (hemodynamics has been stable).

Treatment of kidney disease due to diabetes (increase or no hypertension).

Treatment of chronic renal failure.

Pharmacology

Cerepril is an ACE (ACE) inhibitors with oral activity. This is the first type of active ingredient selected for most groups of patients with high blood pressure and highly effective in treating congestive heart failure.

Move inhibitors have an impact on the renin -anidensin - aldosterone system that leads to hypotension, does not cause reflexes of tachycardia. In congestive heart failure, the drug reduces peripheral vascular resistance, pulmonary artery pressure, increases heart supply, thus reducing the severity of heart failure.

In humans of hypertension, Enalapril reduces blood pressure by reducing the entire peripheral resistance, accompanied by a slight increase or no increase in the heart frequency, systolic flow or heart flow. The drug causes artery dilatation and maybe even veins. Enalapril often reduces systolic and diastolic blood pressure by about 10-15% in both lying and sitting positions. Hypoglycemia and tachycardia rarely occur, but often seen in people with hypoglycatrological or hypotension.

In people with congestion, enalapril, often combined with cardiac glycosides and diuretics, reducing the entire peripheral resistance, steak pulmonary artery pressure, heart size, and average artery pressure and right atrial pressure. Heart index, cardiac amount, systolic volume and tolerance of exertion increases. Enalapril decreased after the burden. Left ventricular hypertrophy decreases after 2-3 months of using Angiotensin transferring enzyme inhibitors, because Angiotensin II is a strong heart muscle growth.

Renal blood flow may increase, but glomerular filtration is usually unchanged during Enalapril treatment. Blood urea nitrogen (bun) and serum creatinine sometimes increase when treated with enalapril for a long time, but more common in people with kidney damage before or in people with hypertension due to kidney. In addition, the kidney function can deteriorate while treating with ACE inhibitors in people with poor perfusion kidneys.

In people with diabetes, Enalapril has shown to reduce proteinuria. Enalapril also proves to increase insulin sensitivity in people with hypertension or without diabetes.

Enalapril does not reduce lipid metabolism at any extent.

Dynamic pharmacokinetics

After drinking, about 60% of Enalapril dose is absorbed from the digestive tract. The peak concentration of the serum is reached within 0.5 - 1.5 hours. Half life elimination of the drug is about 11 hours. Hemorrhagic effect lasts about 24 hours. Food does not affect the absorption of drugs. After absorption, Enalapril is hydrolyzed in the liver into Enalaprilat.

The peak concentration of the serum enalaprilate appears within 3 to 4 hours. Take an Enalapril dose of hypotension usually about 1 hour after drinking, lowering up to 4-6 hours and usually lasts for 12 - 24 hours. Blood pressure may be slowly reduced and must be treated for a number of weeks to achieve adequate effects.

Enalapril's hemodynamic effects begins to be slower and lasts longer than Captopril. In people with congestive heart failure, Enalapril's hemodynamic effect is clearly within 2-4 hours and may last 24 hours after taking a dose.

about 50 - 60% Enalapril binds to plasma proteins.

About 60% of the oral dose is excreted into the urine in the form of enalaprilate and the form of non -metabolic, the rest of the drug eliminates in feces.

Before taking Cerepril 5 SPM treats hypertension, heart failure (3 blisters x 10 tablets)

How to use

oral medication.

Dosage

adults

Definitely hypertension:

The starting dose is usually used for adults is 2.5 - 5 mg/day. Adjust the dose by response to the patient's blood pressure. The usual maintenance dose is from 10 - 20 mg, taken once a day; Common dose limit for adults: 40 mg/day.

Simultaneous treatment with diuretics:

Discontinue diuretics (if possible) for 1-3 days before starting treatment with ACE inhibitors, and it is necessary to take the drug in very low initial dose, 5 mg or less for 24 hours. Gradually increase the dose carefully according to the treatment response.

heart failure:

Should use Enalapril simultaneously with diuretics, monitoring treatment from the beginning due to experienced treatment doctor. If the patient has severe heart failure (degree 4), impaired renal function and/or an abnormal trend of electrolytes, it must be carefully monitored at the hospital right from the beginning of treatment. This principle is also applied when combined with vasodilators. The appropriate dose in the first week is 2.5 mg once/day for the first 3 days, using 2.5 mg twice a day for the next 4 days. The dose may then be gradually increased to normal maintenance dose 20 mg/day, once used or divided into 2 morning and evening use. In rare cases, a dose may be increased to 40 mg/day. Adjust the dose for 2 - 4 weeks.

Askoned left ventricular failure function:

The initial dose is 2.5 mg used 2 times/day in the morning and evening; Adjust the continuous dose until the appropriate dose as described above, up to 20 mg/24 hours, divided into 2 times, used in the morning and evening. Hypertension and kidney function must be monitored before and after starting treatment to avoid severe hypotension and renal failure. If possible, diuretics should be reduced before starting with enalapril. Should monitor serum potassium concentration and adjust to normal levels. There have been cases of severe hypotension after the first enalapril dose and 2-3 % of people in clinical trials must stop treatment. The initial hypotension usually does not mean this effect will be maintained during the treatment.

Recommended doses for patients with heart failure/Asymptomatic left ventricular failure:

week

Dosage mg/day

Week 1

DAY 1 - 3: 2.5 mg/day (single dose).

4 - 7: 5 mg/day (divided into 2 use).

Week 2

10 mg/day (single -dose or divided into 2 use).

week 3 and 4

20 mg/day (single -dose or divided into 2 use).

Need to reduce the dose or extend the distance between the dose:

Creatinine clearance (ml/minute)

Initial doses (mg/day)

80 - 30

5 - 10

29 - 10

2.5 - 5

2.5

Using 2.5 mg of Enalapril on the day of hemorrhage for patients to reduce severe kidney function is treated with hemorrhage. The following days adjust the dose by blood pressure. Special dose adjustment should be adjusted during treatment in combination with other antihypertensive drugs.

Within 4 weeks, if the treatment results are not achieved, the dose increases must be increased, or it is necessary to consider using other anti -hypertension drugs.

Children

There is no proof of safety and effectiveness when taking children's drugs.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? The outstanding feature of Enalapril overdose is severe hypotension.

When an overdose occurs, it is advisable to stop treating with enalapril and monitor patients closely, apply symptomatic and supportive treatments such as vomiting, gastric lavage, plasma intravenous and sodium chloride to maintain blood pressure and treat electrolyte imbalance. Hemorrhage can be eliminated enalapril from circulation.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Cerepril 10, you may experience unwanted effects (ADR).

Sometimes coughs and dry skin occur, rash, itching.

Sometimes symptoms such as dizziness, weakness or vision disorders are caused by too much blood pressure, symptoms on most mild and transient.

Need to be able to encounter: angioedema, laryngeal edema, sore throat, blossom inflammation, acute renal failure.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Cerepril 10 drugs in the following cases:

allergies or hypersensitivity to the drug.

Evaluation at the beginning of treatment like ACE inhibitors in general.

narrowing of the kidney artery on both sides of the kidneys or kidney stenosis in humans.

Aortic valve stenosis, and severe congested heart muscle disease.

Hypotension previously.

Be cautious when using

Persons reduce kidney function.

For suspected kidney stenosis, blood creatinine requires before starting treatment.

The ability to drive and operate machinery

There is no document.

Pregnancy

Like other ACE inhibitors, Enalapril can cause disease and death for the fetus and infants when the pregnant mother uses the drug.

Using the drug in the middle 3 months and the last 3 months of pregnancy can cause disease leading to pregnancy and damage to babies, including: lowering blood pressure, reducing newborn skulls, recovery or non -recovery and death.

Must stop using Enalapril as soon as possible after being pregnant.

breastfeeding period

enalapril excreted into breast milk. With the usual dose of treatment, the risk of harmful effects for breastfeeding is very low.

Medicinal interaction

Use enalapril simultaneously with some other vasodilators (eg nitrate) or anesthetic drugs that can cause severe hypotension. Therefore, in that case, the patient should be closely monitored and adjusted by increasing the volume of circulation (infusion).

Using enalapril simultaneously with diuretics can occasionally cause excessive hypotension after starting treatment with enalapril. In that case, diuretics should be stopped or increased before using salt before starting treatment with enalapril.

Use enalapril simultaneously with lenin release drugs: Enalapril's hypotension effect increases by drugs that release lenin with anti -hypertension effect (for example, diuretics).

Use enalapril simultaneously with drugs that increase potassium and enalapril with potassium -keeping drugs, potassium -containing supplements, which can cause serum hyperpass, especially in kidney failure), closely monitor patients and regularly monitor potassium potassium levels.

Using enalapril simultaneously with lithium may increase blood omena concentration leading to lithium poisoning.

Use Enalapril simultaneously with sympathetic bronchodilators, nonsteroidal anti -inflammatory drugs (NSAID) can reduce the hypotension effect of Enalapril.

Use enalapril simultaneously with oral contraceptives that increase the risk of vascular lesions and difficult to control blood pressure.

Use enalapril simultaneously with beta - adrenergic blockers, methyldopa, nitrates, calcium blockers, hydralazin, prazosin, and digoxin does not show clinical significance.

Storage

In a dry place, avoid light, room temperature (

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.