EDNYT 10mg Gedeon treatment for hypertension, heart failure (3 blisters x 10 tablets)
Dosage form Box of 3 blisters x 10 tablets
Specifications Enalapril
Ingredient
| Composition information | Content |
| Enalapril | 10mg |
Uses
Indications
EDNYT 10mg drug is indicated in the following cases:
While Enalapril's blood pressure lowering mechanism is thought to be mainly inhibiting the renin-ankiotensin-aldosteron system, the system plays a key role in regulating blood pressure, in fact Enalapril has anti-hypertension even in hypertension patients with rheumatism.
Using Enalapril for patients with hypertension reduces lying blood pressure and stands without increasing the heart rate significantly. Symptoms of posture hypotension are less likely. In some patients, it takes a few weeks to treat to achieve optimal blood pressure decrease. Stop Enalapril Maleat suddenly does not cause soaring blood pressure.
ACE activity inhibitors occur from 2 to 4 hours after taking the single -dose of Enalapril. Anti -hypertension effects appear after 1 hour, blood pressure reaches a maximum reduction after drinking 4-6 hours. The time period is related to the dose. However, in the recommended dose, anti -hypertension and hemodynamic effects are maintained for at least 24 hours.
In hemodynamic studies with enalapril in patients with idiopathic hypertension, reducing blood pressure is often accompanied by a decrease in peripheral artery resistance and an increase in cardiac intake without changing heart rate or small change. After taking Enalapril, blood circulation through the kidneys increases; The speed of glomerular filtration is constant. There is no evidence of sodium and water retention. However, in patients with glomerular filtration rate before low treatment, this speed will usually increase.
In a short -term clinical study in diabetes patients with diabetes and no diabetes with kidney disease, after using Enalapril, the amount of albuminuria and secretion of IgG and the total amount of proteinuria decreased. When used with the thiazid diuretics, the hypotension effect of Ednyt is the bronze. Ednyt can reduce or prevent hypokalemia caused by drugs.
In patients with heart failure treated with digitalis and diuretics, oral or injection enalapril often reduces peripheral and blood pressure resistance. Supply of heart increases, while heart rate decreases (normal heart rate increases in patients with heart failure). Pulmonary capillary pressure also decreases.
The drug has the effect of improving the severity of heart failure when measured by NYHA standard (New York Heart Association) and exertion test; These effects are maintained during long -term treatment. In patients with mild to moderate heart failure, Enalapril slowed down the progression of dilatation and/or heart hypertrophy and heart failure (shown by the decrease in the end of the diastolic and left ventricular systolic, and improving blood ratio).
still limiting experience in children over 6 years old with hypertension. In a clinical study of 10 patients with hypertension, children from 6 to 16 years old weighing> 20 kg and glomerular filtration speed> 30 ml/min/1.73 m2, patients 50 kg dose 1.25; 5 or 40mg per day. Using enalapril once a day reduces blood pressure in the way depends on the dose. The anti -hypertension effect depends on the dose of Enalapril is considered in groups (depending on age, gender, race).
However, with the lowest dose of the study, the dose of 0.625mg and the dose of 1.25mg corresponding to the average dose of 0.02mg/kg once a day, not effective against strong hypertension. The maximum dose of research is 0.58mg/kg (to 40mg) once a day. Data on unwanted effects for children's patients is not different from adult patients.
pharmacokinetic
absorption
Enalaril Maleat is quickly absorbed, the peak concentration in the serum is reached within 1 hour after drinking. Based on the urinary analysis, Enalapril's absorption level after taking Enalapril Maleat is about 60%. The absorption of Ednyt is not affected by food in the gastrointestinal tract. After absorbing, Enalapril oral is hydrolyzed quickly and strongly into Enalaprilate, a strong enamel inhibitor. Enalaprilat's peaked plasma concentration reached 4 hours after taking Enalapril in the form of tablets. Effective selling time for enalaprilat accumulation after many times of drinking enalapril is 11 hours. In people with normal renal function, the stable concentration of enalaprilat in serum is achieved after 4 days of treatment.
distribution
Within the treatment concentration, Enalaprilate is attached to serum protein not exceeding 60%. Enalapril passed the placenta fence.
transformation
Except for transformation into Enalaprilat, there is no evidence that there is any other significant metabolism of Enalapril.
Elimination
Enalaprilat is excreted mainly through the kidneys. The main component in urine is Enalaprilate, accounting for about 40% of the dose, and Enalapril has not metabolized (about 20%). Effective sales time of Enalaprilat after many times taking Enalapril Maleat is 11 hours. After reaching a plasma concentration for at least 24 hours, the sale time in plasma varies from 5.6 to 14.8 hours.
Characteristics of some patient groups
kidney failure
Enalapril and Enalaprilate exposure increases above patients with renal function. When used at 5mg once a day, patients with mild to medium to medium (creatinine clearance are 40 - 60 ml/min) with AUC value in the stable state of enalaprilat approximately 2 times higher than normal kidney function patients. In patients with severe renal impairment (creatinine clearance
Children and teenagers
The research is conducted by multi -dose kinetics conducted on 40 children with hypertension including men and women from 2 months old to
breastfeeding women
After using a single dose of 20mg for 5 postpartum women, Enalapril's average peak concentration in breast milk is 1.7 Ug/l (ranging from 0.54 to 5.9 Ug/l) achieved after 4-6 hours after drinking. The average peak concentration of Enalaprilate is 1.7 µg/l (ranging from 1.2 to 2.3 µg/l); Time to reach the peak transformed in the 24 -hour period. Based on the peak concentration in the milk, the maximum absorption amount is estimated in the baby to eat only about 0.16% of the mother's dosage that has been adjusted according to weight. A woman taking the Enalapril dose of 10mg/day for 11 months has an Enalapril peak concentration in milk is 2 µg/l after 4 hours of drug use and the peak concentration of Enalaprilate is 0.75 µg/l after 9 hours of medication. The total content of Enalapril and Enalaprilat measured in milk for 24 hours, respectively 141.44 µg/l and 0.63 µg/l. Enalaprilate cannot be detected in milk (
Before taking EDNYT 10mg Gedeon treatment for hypertension, heart failure (3 blisters x 10 tablets)
How to use
because the food does not affect the absorption of Ednyt, can be used before, during or after meals.
Dosage
Maximum daily dose is 40mg. The drinking time of Enalapril Maleat does not depend on meals, but should drink with a sufficient amount of water. The daily dose is usually taken once in the morning but can also be divided into two mornings and evening.
Note: After taking the first dose, there may be hypotension in patients (patients with salt loss and/or water, for example after fertilizer, vomiting, diarrhea, diuretic treatment in patients with heart failure, hypertension with severe kidney or hypertension). In patients with malignant hypertension or severe heart failure, they must start treatment and adjust the dose in the hospital.
Dosage should be determined depending on the individual patient and the response of blood pressure.
Hypertension
The starting dose is from 5mg to a maximum of 20mg depending on the level of hypertension and patient condition (see below). Use Ednyt once/day.
In the case of mild hypertension, the recommended starting dose is 5 - 10mg/day. Patients with renin-ankiotensin-aldosteron systems (for example: kidney hypertension, salt and/or water, heart loss, serious hypertension) may have strong hypotension after the first dose. The starting dose should start 5mg or lower for these patients and need a doctor's supervision when the patient starts taking the drug.
Pre -dosage treatment with high doses can cause dehydration and the risk of hypotension when starting treatment with Enalapril. It is recommended to start the starting dose of 5mg or lower for these patients. If possible, diuretic therapy should be stopped from 2-3 days before starting treatment with Ednyt. Need to monitor kidney function and serum potassium.
Normal maintenance dose is 20mg once a day. The maximum maintenance dose is 40mg once a day.
heart failure
In controlled disordered left ventricular disorders, Ednyt is used with diuretics and digitals or beta blockers if suitable. Ednyt's starting dose in patients with heart failure is 2.5mg, and medication must be taken under the close supervision of the doctor to determine the beginning effect on blood pressure. If the antihypertensive effect is not seen, or effectively controlled the hypotension after the first dose of Ednyt in the heart failure patient, it is necessary to increase the dose slowly to the normal maintenance dose of 20mg, use a single dose or divide into 2 times depending on the patient's tolerance. It is recommended that the dosage should be in a period of 2-4 weeks. The maximum dose is 40mg/day divided into 2 times.
Dosage Ednyt is recommended for patients with heart failure or asymptomatic left ventricular dysfunction:
week Dosage mg/day
week 1 Day 1 to 3: 2.5mg/day* With the single dose 4 to 7: 5mg/day divided into 2 times
Week 2 10mg/day, a single dose or divided into 2 times
Week 3 and 4 20mg/day, a single dose or divided into 2 times
Must closely monitor blood pressure and kidney function before and after starting treatment with Ednyt because there is a report on hypotension and rarer than kidney failure. For patients taking diuretics, the dose should be reduced if possible before starting treatment with Ednyt. Patients with hypotension after the first dose use Ednyt does not mean hypotension will continue to recur when long -term treatment with Ednyt and not necessarily stop the drug. Should monitor serum and kidney function.
Dosage on patients with renal function:
Overall, the distance should be extended between enalapril and/or dose reductions.
Creatinine clearance (CrCl)
Starting dose mg/day
5 - 10mg
2.5mg
2.5mg during the hemolysis days*
Elderly
Should adjust the dose suitable for the kidney function in the elderly.
Children
There is still limited clinical trials on the use of Ednyt in children with hypertension. For patients who can swallow the pills, the dose should be adjusted according to the individual based on the patient and responding on blood pressure. The recommended starting dose is 2.5mg for patients from 20 to less than 50 kg and 5mg for patients> 50 kg. Take medication once a day. The dosage should be adjusted according to the needs of the patient with a maximum dose of 20mg daily for patients from 20 to less than 50 kg and 40 mg for patients> 50 kg. It is not recommended to use EDNYT for babies and pediatric patients with glomerular filtration speed
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 using overdose? The outstanding feature of the overdose is reported as severe hypotension, and with the Renin-Anotensin system that is blocked and dizzy, starting to occur about 6 hours after the drug. Symptoms accompanied by an overdose of enzyme inhibitors may include circulatory shock, electrolyte disorders, kidney failure, lung ventilation, tachycardia, chest drum, slow heart rate, dizziness, anxiety and cough. After taking the dose of 300mg and 440mg enalapril, the serum enalaprilate concentration is 100 and 200 times higher than the usual treatment.
Treatment recommends overdose is intravenously physiological saline solution. If hypotension, patients should be placed in the site of shock treatment. If possible, treated with Angiotensin II or intravenous catecholamine. If the patient has just been drinking water, you can use the measure to remove Enalapril Maleat (for example, causing vomiting, washing the gut, using adsorbent and sodium sulphate). Enalaprilate can be removed from circulation with hemolysis. Rhythmic therapy is indicated for anti -therapeutic heart rate. Need to continuously monitor the signs of life, serum electrolytes and creatinine levels.
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 EDNYT 10mg, you may experience unwanted effects (ADR).
The following unwanted effects, usually mild and transient, have been recorded related to Enalapril Maleat or other enzyme inhibitors: The desired effect is listed in the following table according to the organs and frequency.
Agency system
common (can be encountered at the rate of up to 1/10)
Uncommon (can be encountered at 1/100)
Rare (can be encountered at 1/1000)
Very rare (can be encountered at a rate of up to 1/10000) and unknown (not estimated from existing data)
Neutral leukopenia, hemoglobin reduction, hematocrit reduction, thrombocytopenia, grain leukemia, marrow failure, hypoglycemia, lymph nodes, autoimmune diseases
headache Confusion, sleeping, insomnia, agitation, colds, dizziness
abnormal dreams, sleep disorders
Brushing the chest, myocardial infarction (the ability to lower secondary hypotension in high -risk patients)
dizziness
Fainting, hypotension (including hypotension)
Blushing, hypotension with vertical posture, stroke * (The ability to lower secondary hypotension in high risk patients)
Raynaud syndrome
ho
Difficulty breathing
runny nose, sore throat, anhydrous, bronchospasm/Hen
Lung infection, rhinitis. Allergic alveolar inflammation/ leukemia pneumonia EOSIN
nausea
diarrhea, abdominal pain, taste change
Pancreatitis, vomiting, indigestion, constipation, anorexia, stomach irritation, dry mouth, stomach ulcers
Trarming day/ulcer, silk, tongue inflammation
gastrointestinal angioedema
Sweating, itching, urticaria, hair loss diverse roses, Stevens-Johnson syndrome, flaky dermatitis, epidermal necrosis, poisoning, skin redness * * Big breasts in men weakness tired annoying, fever Hypertoatemia, hyponatremia liver enzyme, serum bilirubin increased ** Symptomic complexes may include a few or all of the following symptoms: fever, baritis, vasculitis, myocarditis/myocarditis, joint pain/arthritis, positive antibodies, increased rate of red blood cell settings, eosinophilia, eosinophilia, leukopenia. Can encounter redness, hypersensitivity to light or other skin manifestations. 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
EDNYT 10MG drug is contraindicated in the following cases:
pregnancy.
Precautions for use
Rarely hypotension symptoms in patients with non -complicated hypertension. In patients with hypertension using Ednyt, hypotension symptoms may be seen in patients dehydration, for example, diuretic, salt diet, diarrhea or vomiting. Symptomic hypotension has been recorded in patients with heart failure or no renal failure. This is most likely in patients with severe heart failure as well as affected by the high doses of diuretics, blood sodium hypoglycemia, or impaired renal function. In these patients, the therapy should be started with the supervision of a doctor and the patient must be closely monitored whenever adjusting the dose of Ednyt or diuretics.
This measure must also be taken with patients with ischemia in the heart or cerebrovascular disease because blood pressure drops sharply in these patients that can cause myocardial infarction or stroke. If the patient has a transient blood pressure response, there is no need to stop the drug and may continue to use the drug regularly after the blood pressure has increased by infusion. Some patients with heart failure with normal or low blood pressure may have an additional body blood pressure when using Ednyt. This impact is predicted and often is not the reason for stopping treatment. If symptomic hypotension occurs, it may be necessary to reduce the dose and/or stop diuretics and/or ednyt.
Aortic narrow or mitral valve stenosis/myocardial hypertrophy
as well as vasodilators, angiotens enzyme inhibitors must be used carefully in patients with left ventricular valve disease or congestion of left ventricular blood sugar, and not in case of heart shock and significant hemodynamic obstruction.
Renal function impairment
In case of impaired renal function (Creatinine clearance
Some patients with hypertension with kidney disease without obvious manifestation may have hyperurin and blood creatinine when using enalapril simultaneously and diuretics. Enalapril and/or diuretics may be reduced. This case may have to consider the possibility of patients with renal artery stenosis.
Renal hypertension
The risk of hypotension and renal failure increases when the patient has renal artery stenosis on both sides of the kidneys or the kidney stenosis in humans has only one kidney when treated by angiotensin enzyme inhibitors. Loss of renal function can occur with only small changes in serum creatinine. Medical monitoring should be closely monitored when starting therapy with low doses, careful doses and renal function monitoring.
kidney transplant
There is no experience related to using Ednyt in patients who have just had kidney transplant. Therefore, it is not recommended to use Ednyt in this case.
Hepatic failure
Rarely reports related to angiotensin transferring enzymes with jaundice starting with bile jaundice or hepatitis and progressing into violent necrosis that sometimes leads to death. The mechanism of this syndrome is not well understood. Patients taking angiotensin transferring enzymes inhibitors with jaundice or increasing liver enzyme must be clearly stopped and monitored by appropriate measures.
Neutral leukemia/grain leukemia
Neutral leukemia/grain leukemia, thrombocytopenia and anemia have been reported in patients using enzyme inhibitors. On patients with normal renal function and no complications, rarely encounter neutropenia. It must be very cautious when taking enalapril for patients with collagen vascular disease, using immunosuppressive therapy, treating with allopurinol or processing or suffering from any other complications, especially for patients who have been impaired by the previous kidney function. Some patients have serious infections but do not respond to positive antibiotics. If using Enalapril for these patients, the number of white blood cells must be periodically used and the patient should be instructed to report any signs of infection.
sensitivity/angioedema
Facility on the face, limbs, lips, tongue, subjects and/or throat have been encountered in patients treated with angiotensin transferring enamel inhibitors, including Ednyt. These side effects may experience any time during treatment. In these cases, Ednyt must be stopped immediately and monitor patients with appropriate measures to ensure that the patient has recovered from all the symptoms before discharged from the hospital. Even in cases when tongue swelling has been overcome without shortness of breath, still have to continue monitoring patients because treatment with antihistamine and corticosteroids may not be effective.
There have been reports on veins related to laryngeal edema or tongue edema but very rare. Patients with tongue edema, bar or larynx can be obstructed, especially those with a history of airway surgery. When there is a reaction on the tongue, the bar or larynx causing airway obstruction, it is necessary to quickly apply the appropriate treatment therapy that may include epinephrin solution (1: 1000) (0.3 ml to 0.5 ml) and/or use measures to ensure airy airway. Black racial patients use angiotensin transferred enzyme inhibitors with higher angio rate than other skin -colored races.
Patients with a history of angio angio -inhibitors that can increase the risk of angiotic angiotensin may increase the risk of angioed with enamel inhibitors.
Anaphylactic reaction in the sensitivity of insect poisoning
Very rare anaphylactic reaction threatens life in patients using angiotensin transferring enzyme inhibitors during sensitivity with serum winged insect venom. These reactions can be prevented by temporarily stopping the enzyme inhibitors before each sensitivity.
Anaphylactic reaction in LDL dialysis therapy
Rare anaphylactic reactions that threaten life in patients using angiotensin enzyme inhibitors in lipoprotein dialysis therapy with low molecular weight (LDL) with dextran sulfate. These reactions can be prevented by temporarily stopping the enzyme inhibitors before each dialysis.
Patients with hemolysis
There has been anaphylactic reaction report in patients with high pine membranes (for example, an69) and is treated simultaneously with enzyme inhibitors. For these patients, it is necessary to consider using different types of fertilizer membranes or taking another group of hypertension.
Lower blood glucose
On patients with diabetes treated with oral diabetes or insulin, when starting treatment with angiotensin transferring enzyme inhibitors must be advised to closely monitor blood glucose, especially in the first month of medication.
ho
There have been a cough show when using angiotensin transferring enzyme inhibitors. This cough is described as a dry and persistent cough but after stopping the drug. Coughing due to transferred enzyme inhibitors should be considered as part of the diagnosis of cough.
surgery/anesthesia
Enalapril prevents the establishment of the secondary Angiotensin II from the release of re -release in patients with surgery or anesthetics with anti -blood pressure. If the patient has hypotension, this mechanism should be considered and should adjust this hypotension by compensation.
Hemorrhage hyperka
Hemorrhage hyperpathy may occur during treatment of angiotensin transferring enzyme inhibitors including enalapril. Yếu tố nguy cơ bị tăng kali máu là: Bệnh nhân suy thận, suy giảm chức năng thận, tuổi tác (>70 tuổi), đái tháo đường, các triệu chứng tái phát, bệnh nhân mất nước, mất bù tim cấp, nhiễm toan chuyển hóa và dùng đồng thời các thuốc lợi tiểu giữ kali (ví dụ: Spironolacton, eplerenon, triamteren hoặc amilorid), thuốc bù kali hoặc các chất thay thế muối chứa kali hoặc trên các bệnh nhân dùng thuốc có thể làm tăng Blood potassium (for example: heparin).
The use of potassium, diuretic drugs that keep potassium, salt -containing potassium -containing salt in patients with impaired renal function can lead to significant increase in potassium potassium. Hyperboly hyperkalemia can cause serious arrhythmia, sometimes leading to death. If using Enalapril simultaneously and one of the above factors, it is necessary to be cautious and regularly monitor blood potassium.
lithium
generally do not recommend combining lithium and enalapril.
lactose
Each EDNYT 10 mg tablet contains 100 mg of lactose. Therefore, patients do not tolerate congenital galactose, deficiency of lapp lactase or absorbent glucose-galactose should not use this drug.
Children
still limit the experience of safety and effectiveness in children over 6 years old with hypertension, no experience with other indications. Pharmacokinetic data in children over 2 months of age is limited. In addition to ordering hypertension, it is not recommended to use Ednyt for children for other indications. It is not recommended to use EDNYT for babies and children with glomerular filtration speed below 30ml/min/1.73 m2 because there is no data.
Racal difference is like angiotensin transferring enzymes inhibitors, Enalapril is obviously less effective to lower blood pressure on black people rather than people of other skin races. This may be because the proportion of black people with hypertension has a higher renin condition than other skin races.
The ability to drive and operate machinery
There are no studies on the effect of this drug on the ability to drive. When driving or operating the machine, remember that sometimes the drug causes drowsiness and fatigue.
Pregnancy
The use of Ednyt is contraindicated during pregnancy and lactation. Epidemiological evidence has not been identified about the risk of teratogenicity after the mother uses angiotensin transferring enamel inhibitors in the first quarter of pregnancy, but the small rate increases the risk of not being excluded. Except for the continued use of angiotensin transferring enzyme inhibitors, patients planning to get pregnant, so they should switch to other hypertension drugs that have been shown to be safe during pregnancy.
When a pregnancy diagnosis is diagnosed, it is advisable to stop treating with angiotensin transferring enzyme inhibitors immediately and if appropriate, then start another replacement therapy. Using angiotensin transferring enzymes in the second quarter and the third quarter of pregnancy causes fetal toxicity (reducing kidney function, less amniotic fluid, slow chemistry of the skull) and infant toxicity (kidney failure, hypotension, hyperkalemia). If the enzyme inhibitors are used for angiotensin transferred from the second quarter of pregnancy onwards, the kidney and skull ultrasound requires. When the mother uses Angiotensin transferring enzyme inhibitors, it is necessary to closely monitor the condition of hypotension on the baby.
Breastfeeding period
limited dynamic pharmacokinetics data shows that low concentration of drugs in breast milk. Although these concentrations may not be clinically correlated, contraindicated to use Ednyt for breastfeeding women in case of premature birth or in the first few weeks after birth because there may be risk on the kidneys and cardiovascular disease and because there is no clinical experience. The decision to stop breastfeeding or stopping EDNYT should consider the benefits of breastfeeding and the benefits of the mother's treatment.
Drug interaction
Diuretics keep potassium or potassium compensation:
Angiotensin transferring enzyme inhibitors reduce potassium loss due to diuretics. Potassium diuretics such as spironolacton, triamteren or amilorid, potassium compensation drugs or salt -containing salt replacements can significantly increase blood potassium. If indicated in combination with Spironolacton, you should take medicine carefully and regularly monitor blood potassium.
diuretics (thiazid or diuretics):
High -dose dosage treatment can cause loss of fluid loss and the risk of hypotension when starting with enalapril. Hypotension effects can be reduced when diuretics stop, increase fluid, use salt or use enalapril therapy at low doses.
Other anti -hypertension drugs:
Concentrated use of these drugs can increase the hypotension effect of Enalapril Maleat, especially with diuretics. Simultaneous use with nitroglycerin and other nitrates, or vasodilators can reduce blood pressure.
Steroid anti -inflammatory drugs (NSAIDs):
Non -steroid anti -inflammatory drugs can reduce the hypotension of the enzyme inhibitors Angiotensin. Concomitance nonsteroidal anti-inflammatory drugs (including COX-2 inhibitors) and angiotensin inhibitors that increase blood potassium and may cause kidney function. These effects are often recovered. Acute renal failure can occur but rarely especially for patients with kidney function damage (for example, elderly people, patients with fluid loss, including people who are being treated with diuretics). Patients need to be fully rehydrated and monitored the kidney function after starting combined treatment and periodic monitoring.
Lithi:
Hypermathy and poisoning lithium recovers from simultaneously lithium and enzyme inhibitors. Concomitant use of thiazid diuretics may increase lithium concentration and increase the risk of lithium poisoning with angiotensin transferring enzyme inhibitors. It is not recommended to use the combination of enalapril and lithium but if the combination is necessary, closely monitor the amount of blood lithium.
alcohol:
Alcohol can increase the hypotension effect of angiotensin transferring enzyme inhibitors.
Three -round antidepressants/anti -psychosis/anesthesia/addictive drugs:
Blood pressure drops sharply (so it is necessary to notify the anesthetic doctor for treatment with Enalapril Maleat). Hypotension can be encountered when used simultaneously with addictive drugs/antidepressants.
Sympathetic drugs:
Paralges can reduce the anti -hypertension effect of angiotensin transferring enzyme inhibitors.
Ocean anti -diabetes (e.g.: Sulphonylure/Biguanid) Insulin:
Epidemiological research shows that the use of angiotensin transferring enzymes and anti -diabetic drugs (insulin, oral blood glucose orally) may increase blood glucose reducing the risk of hypoglycemia. This phenomenon can occur in the first weeks combining treatment and in patients with reduced renal function.
Gold:
Nitritoid reactions (symptoms including blush, nausea, vomiting and hypotension) have been reported but rarely in patients with injection yellow treatment (sodium aurothiomalate) and angiotensin transfer inhibitors including enalapril.
Acetylsalicylic acid - Blood soluble drugs and beta blockers:
Enalapril is safe when used with acidysalicylic acid, medications that soluble thrombosis and beta blockers.
antacids:
can reduce the bioavailability of the enzyme inhibitors.
Storage
In a dry place, temperatures below 30 ° C in the original packaging, avoid moisture.
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