Enalapril Stella 10mg treatment for hypertension, congestive 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

enalapril stella 10 mg indicated treatment in the following cases:

Hypertension: Enalapril is used to treat mild to severe hypertension. The drug is used for monomers or in combination with other anti-hypertension drugs. The left ventricular function to reduce the incidence of coronary ischemia, including myocardial infarction. ACE inhibitors, merely.

ATC code: C09AA02.

Enalapril Maleat is the precursor of enalaprilat and has little pharmacological activity until it is hydrolyzed in vivo into enalaprilate.

Medicines that reduce blood pressure in people with normal blood pressure, hypertension and have a good effect on hemodynamics in patients with congested heart failure, mainly due to inhibition of the Renin - Angiotensin - Aldosteron system.

Enalapril prevents the transformation of angiotensin I into angiotensin II (strong vascular contractions) thanks to the inhibition of angiotensin switching enzymes (ACE).

On hypertension people, Enalapril reduces blood pressure by reducing the total peripheral resistance accompanied by a slight increase or no increased heart rate, systolic volume or cardiac supply. The drug causes artery dilatation and maybe even veins. Enalapril usually 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 hypoglycemia or hypoglycemia.

In people with congestion heart failure, enalapril often coordinates with cardiac glycosides and diuretics, reducing the total peripheral resistance, pulmonary artery pressure, heart size, average artery pressure and right atrial pressure. Heart index, cardiac supply, systolic volume and increased intense tolerance.

Renal blood flow may increase, but glomerular filtration is usually unchanged when treated with enalapril. However, in some patients, both blood flow and glomerular filtration increases. Hemorrhage nitrogen concentration (bun) and serum creatinine sometimes increases when treated with enalapril for a long time, but is more common in people with kidney damage before, users simultaneously with diuretics and patients with congestive heart failure.

pharmacokinetics

After oral use, about 60% of the enalapril dose is absorbed at the digestive tract and the peak of plasma is achieved within 0.5 - 1.5 hours.

Enalapril is hydrolyzed in the liver into enalaprilat; The peak concentration of enalaprilate in plasma is achieved after 3 to 4 hours oral 1 dose of Enalapril. Enalaprilat's plasma protein binding is 50 - 60%.

Enalapril is excreted in urine and in stool, in the form of enalaprilate and constant form, mostly through the urinary tract.

Enalaprilat's elimination consists of many stages but the sale time is too effective due to accumulation after taking many doses of Enalapril is about 11 hours in patients with normal kidney function.

Before taking Enalapril Stella 10mg treatment for hypertension, congestive heart failure (3 blisters x 10 tablets)

How to use

enalapril stella 10 mg is used by oral.

Dosage

Adults

Hypertension treatment:

The starting dose of 5 mg of Enalapril Maleat/day. Because there may be hypotension in some patients when they start treatment with ACE inhibitors, the first dose should be used at bedtime.

In patients with kidney failure or taking diuretics: The starting dose of 2.5 mg/day. Dion diuretics should be discontinued 2-3 days before the beginning of Enalapril treatment and continue if necessary.

Maintenance dose usually uses 10 - 20 mg x1 times/day, but can increase to 40 mg/day in case of severe hypertension. The dose can be divided into 2 times if the single dose is not enough to control.

Heart failure treatment:

Patients with heart failure or asymptomatic left ventricular dysfunction: Oral starting dose is 2.5 mg/day.

Normal maintenance dose is 20 mg/day, taken once or divided into 2 times, but may increase to 40 mg/day divided into 2 times.

Asymptomic left ventricular dysfunction:

Patients use 2.5 mg x 2 times/day and increase gradually until the tolerance to the daily maintenance dose of 20 mg (divided into several times).

Adjust the dose in patients with heart failure and renal failure or hypoglycemia

In patients with hypoglycemia (serum sodium 1.6 mg/dL, the dose should start 2.5 mg/day under tight medical monitoring. The dose may be increased to 2.5 mg x 2 times/ day, then 5 mg x 2 times/ day and higher if necessary, usually this dose adjustment may be conducted for 4 days or longer if not excessive blood pressure occurs or serious renal function impairment. The maximum dose is 40 mg/day.

Children:

Enalapril can be used to treat hypertension in children.

start the starting dose of 80 mcg/kg x 1 time/day, a maximum dose of 5 mg, adjust the dose depending on the response of the patient. In other words, children weighing from 20 kg - less than 50 kg using the starting dose of 2.5 mg x 1 time/day, increasing to a maximum dose of 20 mg/day; Children weighing 50kg or more use the starting dose of 5 mg x 1 time/day, increasing to a maximum dose of 40 mg/day.

dose of 100 - 500 mcg/kg/day used for children with severe heart failure.

What to do when overdose?

Enalaprilat is eliminated from the general circulatory system by hemolysis.

What to do when you forget the dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

Unwanted effects (ADR) when using Enalapril Stella 10mg that you may encounter:

Common

Nervous system: headache, dizziness, fatigue, insomnia, abnormalities, sympathy. Kinin in tissue or prostaglandin in the lungs.

Hematology: Hemoglobin and hematocrite, granulocytes, neutrophils.

Digestive: intestinal obstruction, pancreatitis, cholestatic hepatitis, increased oral lenuals.

Warnings

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

Contraindicated

Enalapril Stella 10 mg is contraindicated in the following cases:

Hypersensitivity to the drug or any ingredient in the formula.

Be cautious when taking the drug

Do not use ACE inhibitors in patients with the output of the left ventricular heart (such as aortic stenosis, myocardial hypertrophy ).

Do not use for patients with kidney vascular disease or suspect kidney blood vessel disease, but sometimes needed for hypertension against severe resistance in these patients, then they should take care of the drug very carefully and under the close supervision of the physician.

Renal failure:

Should check the kidney function of all patients before taking ACE inhibitors and during treatment.

Patients with kidney disease or high doses should regularly check proteinuria.

Checking the number of leukemia is essential for patients with glue -generating substances such as systemic lupus and sclerosis, or in patients using immunosuppressive drugs, especially when they are also impaired renal function.

There has been symptomatic hypotension during the beginning of ACE inhibitors in patients with heart failure and patients with sodium or dehydration.

Enalapril Stella 10 mg contains lactose. This drug should not be used for patients with rare genetic problems galactose intolerance, total lactase enzyme deficiency or glucose - galactose.

The ability to drive and operate machinery

Use the medication cautiously when driving or operating machinery because occasionally stunned and tired.

Pregnancy and lactation period

Pregnancy: When taking drugs for pregnant women in the middle of 3 months and at the end of the pregnancy, ACE inhibitors can be dangerous even causing death in the growing fetus. Should stop taking the drug as soon as you find pregnancy.

Breastfeeding period: Enalapril excreted in breast milk. With the usual dose of treatment, the risk of harmful effects for breastfeeding is very low.

Other special subjects

No report.

Drug interaction

Excessive hypotension may occur when using ACE medications with diuretics, other anti -hypertension drugs or other hypotension agents such as alcohol.

The phenomenon of hyperkalemia may occur in patients who are taking ACE inhibitors with potassium diuretics, potassium supplements (including salt -containing salt substitutes) or other drugs that cause hyperkalemia (such as ciclosporin or indomethacin), should monitor serum potassium levels.

Side effects on the kidneys of ACE inhibitors can increase when used with other drugs that affect kidney function such as nonsteroidal anti -inflammatory drugs.

Lithi: Lithi toxicity has been reported in patients using lithium simultaneously with sodium elimination drugs such as ACE inhibitors. Should monitor serum lithium concentration regularly if used enalapril with lithium.

Using Enalapril simultaneously with sympathetic bronchodilators, nonsteroidal anti -inflammatory drugs (NSAIDs) 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.

Storage

You should store at room temperature, avoid moisture and avoid light. No storage in the bathroom or in the freezer. You should remember that each drug may have different storage methods. Therefore, you should read carefully storage instructions on the packaging or ask the pharmacist. Keep pills out of reach of children and pets.

Expiry date: 36 months from the date of manufacture.

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