EDNYT 5mg Gedeon medicine for hypertension, heart failure (3 blisters x 10 tablets)

There is a history of vascular nerve edema due to the previous angiotensin enzyme inhibitors, spontaneous or genetic nerve edema.

pregnancy.

Precautions when using

Hypotension with symptoms

Rarely hypotension symptoms in patients with hypertension without complications. In patients with enalapril hypertension, hypotension tends to occur if the patient has a decrease in the volume of circulatory, for example, due to diuretics, a diet that limits salt, feces, diarrhea or vomiting. In patients with heart failure, whether or not with renal failure, hypotension with symptoms has also been recorded.

This is more likely to occur in patients with severe heart failure, reflecting the high doses of dosage, reducing blood sodium or kidney damage.

In these patients, it is recommended to start treatment under medical monitoring and closely monitor patients when adjusting the dose of Enalapril and/or diuretics.

Similar measures are also applied in patients with ischemic heart disease or cerebrovascular disease, which in these patients with excessive hypotension can lead to myocardial infarction or stroke.

If the pressure occurs, the patient should be placed in a lying position and intravenously physiological saline solution if necessary. If the patient has a transient hemorrhagic response, there is no need to stop the drug and may continue to take 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 stenosis or mitral stenosis /disease myocardial hypertrophy

as well as vasodilators, angiotensin enzyme inhibitors must be used carefully in patients with left ventricular valve disease or left ventricular obstruction, and not in case of cardiac shock and significant hemodynamic obstruction.

Renal function impairment

In case of impaired renal function (Creatinine clearance

Renal failure has been reported in Enalapril therapy and is mainly seen in patients with severe heart failure or suffering from kidney disease, including renal artery stenosis. If being recognized early and appropriate treatment, kidney failure in treatment with Enalapril is usually recovered.

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 kidney function can occur with only small changes in serum creatinine, need to monitor medical closely when starting therapy with low dose, careful dose and monitor kidney function.

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, reduced platelet and anemia has been recorded in patients with ACE inhibitors. Rarely occurs neutrophils in patients with normal renal function and no complications.

Should use enalapril very carefully in patients with blood vessel disease, which is treating immunosuppressive, is using allopurinol or processaamid or has a combination of these complications, especially in patients with previous renal function.

Some patients have serious infections without responding to positive antibiotic therapy. If using enalapril in these patients should periodically monitor the number of white blood cells and require the patient to report immediately if there is any sign 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 can be encountered at 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 causes 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 ventilation.

Black racial patients use Angiotensin transferred inhibitors with higher angio rates than patients of other skin -colored races.

Patients with a history of angioemia are not related to angiotensin transferred enzyme inhibitors may increase the risk of angioed with enamel inhibitors.

Anaphylactic reaction in sensitive removal therapy with winged insects:

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 10mg 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. The pharmacokinetic material for 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 30 ml/min/1.73 m2 because there is no data.

Race difference

Like the enzyme inhibitors Angiotensin, Enalapril is clearly less effective to lower blood pressure on black people rather than 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.

The evidence of epidemiology has not been identified after the risk of teratogenicity after the mother uses Angiotensin transferring enzyme 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 diagnosed with pregnancy, it is advisable to stop treating with angiotensin transferring enzyme inhibitors immediately and if appropriate, then start another alternative therapy.

Using angiotensin transferring enzyme inhibitors 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 poisoning (kidney failure, hypotension, hyperkalemia). If you use Angiotensin transferring enzyme inhibitors from the second quarter of pregnancy onwards, need for kidney and skull ultrasound.

When the mother uses the Angiotensin transferring inhibitor, it is necessary to closely monitor the condition of hypotension on the child.

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 drug

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 substitutes can significantly increase blood potassium. If indicated in combination with Spironolacton, the medication should be used carefully and regularly monitor the blood potassium.

diuretics (thiazid or diuretics):

High -dose dosage treatment can cause fluid loss and the risk of hypotension at the beginning of Bing Enalapril treatment. 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.

Non -steroid anti -inflammatory drugs (NSAIDs): Non -steroid anti -inflammatory drugs can reduce the hypotension of the enzyme inhibitors in Angiotensin transfer. Concomitance nonsteroidal anti-inflammatory drugs (including COX-2 inhibitors) and angiotensin inhibitors that increase blood potassium and may cause kidney function. These effects are usually recovered.

Acute renal failure may occur but rarely special for patients with kidney 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.

lithium

Hypermathy and recovery lithium lithium has been reported when used simultaneously lithium and enzyme inhibitors Angiotensin. Simultaneous use of thiazid diuretics may increase lithium concentration and increase the risk of lithium poisoning with angiotensin transfer enzyme inhibitors. It is not recommended to use the combination of enalapril and lithium but if the combination is necessary, closely monitor blood lithium

alcohol

Alcohol can increase the hypotension effect of angiotensin transferring enzyme inhibitors.

Three -round antidepressants/anti -psychotic/anesthetic/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.

Parentive drugs

Paralges can reduce the anti -hypertension effect of angiotensin transferring enzyme inhibitors.

Ocean anti -diabetic drugs (e.g. Sulphonyl URE/ 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 renal function.

Gold

Nitritoid reactions (symptoms including facial furniture, nausea, vomiting and hypotension) have been reported but rarely in patients with injection yellow treatment (sodium urothomalate) and angiotensin transferring enzyme inhibitors including enalapril.

Acetvlsalicylic acid , Blood soluble drugs and beta blockers

Enalapril is safe when used simultaneously with acetysalicylic acid (at the dose of heart treatment), medications that soluble thrombosis and beta blockers.

antacids

can reduce the bioavailability of the enzyme inhibitors.