What Do Folate Levels Indicate?

Enalapril maleate folic acid tablets are used to treat essential hypertension with elevated plasma homocysteine levels. Enalapril maleate lowers blood pressure in patients with hypertension, and folic acid can lower plasma homocysteine levels. It is unclear whether reducing plasma homocysteine levels can prevent cardiovascular and cerebrovascular events.

Drug Name: Enalapril maleate folic acid tablets

Drug type: Occupational injury medical insurance

Enalapril maleate folic acid tablets ingredients

This product is a compound preparation whose components are different dose combinations of enalapril maleate and folic acid.

Traits of Enalapril Maleate Folic Acid

This product is yellow or light yellow tablets.

Enalapril maleate folic acid tablets indications

For the treatment of essential hypertension with elevated plasma homocysteine levels. Enalapril maleate lowers blood pressure in patients with hypertension, and folic acid can lower plasma homocysteine levels. It is unclear whether reducing plasma homocysteine levels can prevent cardiovascular and cerebrovascular events.

Enalapril maleate folic acid tablets specifications

Enalapril maleate 5mg / Folic acid 0.4mg.
Enalapril maleate 10mg / Folic acid 0.4mg.
Enalapril maleate 10mg / Folic acid 0.8mg.

Enalapril maleate folic acid tablets usage dosage

According to the control of blood pressure, different specifications of enalapril maleate folic acid tablets were selected. Usually the recommended starting dose is 5mg / 0.4mg daily, adjust the dose according to the patient's response, or follow the doctor's advice.
Patients with liver and kidney dysfunction and elderly patients should reduce the dosage or follow the doctor's advice as appropriate.

Adverse reactions of enalapril maleate folic acid tablets

Enalapril maleate is generally well tolerated by enalapril maleate. In clinical studies, the overall incidence of adverse reactions to enalapril maleate was similar to placebo, and most were mild and transient without the need to discontinue treatment.
The following adverse reactions are related to the application of enalapril maleate.
1. Dizziness and headaches are more common. 2% -3% of patients report feeling tired and weak. Other adverse reactions were reported in less than 2% of patients, including hypotension, orthostatic hypotension, syncope, nausea, diarrhea, muscle spasms, rash, and cough. Renal dysfunction, renal failure and oliguria are rare.
2. Allergic / angioedema have been reported in the face, limbs, lips, tongue, glottis, and / or throat, but are rare (see Precautions)
3. The very rare adverse reactions that occur in controlled clinical trials or after the drug is marketed are:
(1) Cardiovascular myocardial infarction or cerebrovascular accident may be secondary to low blood pressure in high-risk patients (see Precautions)
Chest pain; palpitations; arrhythmia; angina; Raynaud's phenomenon.
(2) Intestinal obstruction of digestive system; pancreatitis; liver failure; hepatitis-hepatocellular or cholestatic; jaundice; abdominal pain; vomiting; indigestion; constipation; anorexia; gastritis.
(3) Nervous / mental system depression; insanity; drowsiness; insomnia; nervousness; paresthesia; dizziness; abnormal dreams.
(4) Lung infiltration in the respiratory system; bronchospasm / asthma; dyspnea; runny nose; sore throat and hoarseness.
(5) Skin hyperhidrosis; erythema polymorpha; exfoliative dermatitis; Steven-Johnson syndrome; toxic epidermal necrosis; pemphigoid; itching; urticaria; baldness.
(6) Other impotence; flushing; change in taste; tinnitus; glossitis; blurred vision.
A syndrome with some or all of the following symptoms has been reported: fever, serositis, vasculitis, myalgia / myositis, arthralgia / arthritis, positive antinuclear antibodies, increased erythrocyte sedimentation, eosinophilia, and white blood cells Increased, can also appear rash, photosensitivity and other skin diseases.
Important changes in laboratory standard clinical parameters are rarely associated with taking enalapril maleate, but have elevated blood urea nitrogen and serum creatinine, various liver enzymes and / or serum bilirubin Increase. These are often restored after deactivation. Hyperkalemia and hyponatremia have also occurred.
Reduced hemoglobin and hematocrit have also been reported.
Since the release of enalapril maleate, a few cases have been reported with neutropenia, thrombocytopenia, bone marrow suppression, and granulocytopenia, which cannot be ruled out to be related to the use of enalapril maleate.
Folic acid has fewer adverse reactions and rare allergic reactions. Gastrointestinal symptoms such as anorexia, nausea, and bloating can occur during long-term heavy medication. When taking folic acid in large amounts, the urine can be yellow.
In the clinical trial of enalapril maleate folic acid tablets, the adverse effects of taking enalapril maleate folic acid tablets were similar to those of enalapril maleate alone, mainly cough, headache, mouth Dryness, fatigue, epigastric discomfort, nausea, palpitations, rashes, etc. Most adverse reactions are mild and transient and do not require treatment discontinuation.

Enalapril maleate folic acid tablets contraindications

Patients who are allergic to any component of this product, or patients who have previously been treated with an angiotensin-converting enzyme inhibitor for angioedema, and patients with hereditary or spontaneous angioedema, should not use this product.
Use with caution in severely impaired renal function.

Notes on Enalapril Maleate

Enalapril maleate 1. Symptomatic hypotension rarely occurs in patients with uncomplicated hypertension. Hypertensive patients taking enalapril maleate are more likely to develop hypotension due to insufficient blood volume due to diuretic therapy, dietary salt restriction, dialysis, diarrhea or vomiting (see Drug Interactions and Adverse Effects) reaction). In patients with heart failure, the occurrence of symptomatic hypotension has been observed, and patients with more severe heart failure are most likely to develop it. Such patients should begin treatment under medical monitoring and should be closely followed up whenever the dose of enalapril maleate or / and diuretics is adjusted. The same treatment applies to patients with ischemic heart disease or cerebrovascular disease, because excessive blood pressure drops in these patients can lead to myocardial infarction or cerebrovascular accidents.
If hypotension occurs, the patient should lie on his back and, if necessary, be infused with saline. Transient hypotension is not a contraindication to continued medication. After blood volume expansion, the blood pressure can be administered once it is increased.
Some patients with normal or low blood pressure may experience a further decrease in systemic blood pressure after taking it. If symptoms of hypotension occur, it is necessary to reduce the dose and / or stop using diuretics and / or this product.
2. Aortic stenosis / hypertrophic heart disease Angiotensin-converting enzyme inhibitors should be used with caution in patients with left ventricular outflow tract infarction.
3. Renal insufficiency The hypotension that occurs after treatment with angiotensin-converting enzyme inhibitors can make some patients' kidney function further damaged. This condition has been reported to cause acute renal failure, but it is usually reversible.
Patients with renal insufficiency may need to reduce the volume and / or frequency of medications (see Dosage and Administration). Some patients with bilateral renal artery stenosis or unirenal and renal artery stenosis have experienced an increase in blood urea nitrogen and serum creatinine, which can usually be reversed by stopping treatment; especially for patients with renal insufficiency.
Some patients who have no previous significant kidney disease usually have mild or transient elevated blood urea nitrogen and serum creatinine when using enalapril maleate together with diuretics, which may require dose reduction and / or discontinuation Diuretics and / or enalapril maleate.
4. Allergic / angioneuronic edema It has been reported that patients with angiotensin-converting enzymes that inhibit tadpoles occasionally report angioedema of the face, limbs, lips, tongue, glottis, and / or throat. It can occur at any time during the treatment period. At this time, this product should be discontinued immediately and appropriate monitoring should be given to ensure that the symptoms completely subsided before the patient is discharged. When swelling is confined to the face and lips, it usually disappears without treatment. Antihistamines are useful for relieving symptoms.
Angioedema with laryngeal edema may lead to death. When edema occurs in the tongue, glottis, and / or throat, airway obstruction may be caused and appropriate treatment should be given immediately, including such as a hypodermic 1: 1000 epinephrine solution (0.3 ml-0.5 ml) and / or immediate maintenance Measures of airway patency.
People with a history of angioedema not associated with angiotensin replacement enzyme inhibitor treatment are at high risk for angioedema when using angiotensin-converting enzyme inhibitors (see Contraindications).
5. Allergic-like reactions when desensitizing with the venom of the Hymenoptera When desensitizing patients treated with angiotensin-converting enzyme inhibitors with the venom of the Hymenoptera, life-threatening allergic-like reactions may occur, This situation is rare. This reaction can be avoided by temporarily discontinuing the angiotensin-converting enzyme inhibitor before each desensitization.
6. Hemodialysis patients who have been treated with high-permeability membranes (such as AN69) for dialysis and who have been treated with angiotensin-converting enzyme inhibitors have reported allergic reactions. For these patients, another type of dialysis membrane or another type of antihypertensive drug should be considered.
7. Cough It has been reported that angiotensin-converting enzyme inhibitors can cause cough, which is characterized by sputum-free, persistent, and may disappear after withdrawal. In the differential diagnosis of cough, the possibility of cough caused by angiotensin-converting enzyme inhibitors should be considered.
8. Surgery / Anesthesia For patients undergoing major surgery or anesthesia with anesthetic drugs that may cause hypotension, enalapril blocks the production of angiotensin II due to compensatory renin release. If hypotension occurs and it is considered to be due to the above mechanism, blood volume should be expanded to correct it.
Serum Potassium-See Drug Interactions During taking folic acid, please consult a physician when taking this product with other multivitamin drugs or health foods containing folic acid.
Enalapril maleate folic acid tablets 1. The effect of folic acid on reducing homocysteine is significantly affected by the C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene. Patients with a homozygous mutant (TT genotype) had better results after taking enalapril folic acid maleate.
2. This product can be used in combination with other antihypertensive drugs, especially diuretics. The antihypertensive effect is obviously enhanced, but it should not be used in combination with potassium diuretics.
3. Individual patients, especially those with diuretics or reduced blood volume, may cause excessive blood pressure drops. Therefore, the first dose should start with a low dose or as directed by a doctor.
4. Do regular white blood cell counts and renal function tests.
5. It is forbidden to use this product when its properties are changed.
6. Keep this product out of the reach of children.

Enalapril maleate folic acid tablets for pregnant and lactating women

Enalapril maleate 1. This medicine is not recommended during pregnancy. If you are found to be pregnant, you should stop using this product immediately unless it is necessary to save your mother's life.
The use of angiotensin-converting enzyme inhibitors during the third and third trimesters of pregnancy can cause morbidity and death in the fetus and newborn. The use of angiotensin-converting enzyme inhibitors during this period has been linked to various injuries to the fetus and newborn (including hypotension, renal failure, hyperkalemia, and / or neonatal cranial hypoplasia). There has been maternal oligohydramnios (presumed to be a manifestation of reduced fetal kidney function) and can cause limb spasms, craniofacial deformities, and lung dysplasia. If patients use this product, they should be explained to the patient about its potential harm to the fetus.
Taking the uterus in contact with this angiotensin-converting enzyme inhibitor during the first three months of pregnancy does not cause the above-mentioned adverse reactions to occur in the embryo and fetus.
In rare cases where angiotensin-converting enzyme inhibitors must be used during pregnancy, a series of ultrasounds should be performed to assess the condition inside the amniotic membrane. If you find too little amniotic fluid, you should stop using this product. Patients and doctors should be aware that when oligohydramnios occurs, the fetus has suffered irreversible damage.
Infants born to mothers who have used this product should be closely observed to find out if they have hypotension, oliguria, and hyperkalemia. Enalapril can be removed from the fetal blood circulation through the placenta and peritoneal dialysis. In theory, it can be removed by changing blood.
2. Nursing mothers Enalapril and Enalapril (hydrolysates of Enalapril) are secreted in small amounts in human milk. Nursing mothers should use caution when using this product.

Enalapril maleate folic acid tablets for children

The safety of this product in patients under 18 years of age has not been verified, and children should use it with caution.

Enalapril maleate folic acid tablets for elderly

Elderly patients should reduce the dosage or take it as prescribed by a doctor.

Enalapril maleate folic acid tablets drug interactions

Enalapril maleate 1. Antihypertensive treatment This product can be used in combination with other antihypertensive drugs at the same time, especially diuretics. When ganglion blockers or adrenal blockers are used in combination with this product, the patient's condition should be carefully observed.
The interaction of enalapril maleate with the following drugs is not clinically significant: furosemide, digoxin, timolol, warfarin, indomethacin, and sulindac. The combination of propranolol with enalapril maleate lowers the serum concentration of enalapril, but it has no clinical significance. There is no interaction between cimetidine and enalapril maleate in animal experiments.
2. Serum potassium In clinical trials, serum potassium is generally maintained within the normal range. After 48 weeks of treating hypertensive patients with this product alone, the average serum potassium increased by about 1.2mEq / L. Concomitant application of enalapril maleate can reduce serum potassium reduction caused by thiazide diuretics.
Risk factors for the occurrence of hyperkalemia include renal insufficiency, diabetes mellitus, and concurrent use of potassium-sparing diuretics (such as amphetamine, ampicillin, or amiloride), potassium supplements, or potassium-containing substitute salt. Taking enalapril maleate at this time can cause a significant increase in serum potassium. If it is considered appropriate to use the above-mentioned agents at the same time, they should be used with caution and the serum potassium should be monitored frequently.
3. Serum lithium Like other sodium-releasing drugs, enalapril maleate may reduce lithium clearance. Therefore, as with lithium salts, care should be taken to monitor serum lithium concentrations.
4. Non-steroidal anti-inflammatory drugs For some patients with renal insufficiency, when angiotensin-converting enzyme inhibitors are used in combination with non-steroidal anti-inflammatory drugs, renal function may be further reduced. This effect is usually reversible.
Folic acid 1. High-dose folic acid can antagonize the antiepileptic effects of phenobarbital, phenytoin, and polimetone, significantly reduce the threshold of seizures, and increase the number of seizures in sensitive patients.
2. Oral high-dose folic acid can affect the absorption of trace element zinc.
3. Drug interaction may occur if used with other medicines at the same time, please consult your doctor or pharmacist for details.

Enalapril maleate folic acid tablets overdose

There is limited data on the use of enalapril maleate overdose of enalapril maleate. The most prominent feature of overdose is hypotension, which occurs 6 hours after taking the drug. At the same time, the renin-angiotensin system was blocked and a coma appeared. There have been reports of cases where serum enalapril levels were 100 times and 200 times higher than normal after taking 300 mg and 400 mg doses, respectively.
For the treatment of overdose, intravenous infusion of normal saline is recommended, and angiotensin II can also be entered if possible. If you have just run out of medication, you should induce vomiting. Enalapril can be removed from the systemic circulation by hemodialysis (see Precautions, Hemodialysis Patients).

Clinical trial of enalapril maleate folic acid tablets

In a multicenter, randomized, double-blind, parallel-controlled clinical study conducted in China, 480 patients with mild to moderate essential hypertension aged 18-75 years were treated with enalapril maleate 8 Week's efficacy evaluation. The results showed that enalapril maleate folic acid compound and enalapril maleate alone had a similar reduction in blood pressure. Enalapril folic acid tablets 10mg / 0.8mg, enalapril folic acid tablets 10mg / 0.4mg, enalapril tablets 10mg were effective in reducing plasma homocysteine by 37.1%, 33.3% and 6.9%, respectively. The compound has a better effect on reducing plasma homocysteine than enalapril.
Methylenetetrahydrofolate reductase gene C677T polymorphism has a certain modification effect on lowering blood pressure or reducing homocysteine. The effective rates of lowering blood pressure or reducing homocysteine in the two groups of patients treated with enalapril folic acid tablets were 57.6%, 64.8%, and 81.3% in patients with CC, CT, and TT genotypes. The efficiency of enalapril folic acid tablets was higher in patients with TT genotype than in patients with CC / CT genotype.

Enalapril maleate folic acid tablets pharmacology and toxicology

Pharmacological effects Enalapril maleate is a second-generation angiotensin-converting enzyme inhibitor, which is rapidly and completely hydrolyzed into Enalaprilat after oral administration. The latter is mainly to reduce blood pressure by inhibiting the renin-angiotensin-aldosterone system, which plays an important role in blood pressure regulation.
Folic acid is an essential substance for the growth and reproduction of body cells. Folic acid is formed by the action of dihydrofolate reductase and vitamin B ₁₂ to form tetrahydrofolate (THFA), which combines with a variety of one-carbon units to form tetrahydrofolate coenzymes, transmitting one-carbon units, participating in many important reactions and nucleic acids And amino acid synthesis. Folic acid can act on the methionine cycle. One carbon unit can be converted to methyl to remethylate homocysteine, and methionine can be used for cell methylation and protein synthesis. Folic acid can also Nucleic acid synthesis is promoted through the role of one-carbon unit donor. Therefore, exogenous folic acid supplementation can promote the homocysteine methylation process and reduce plasma homocysteine.
Toxicological studies Enalapril maleate General toxicity studies have been performed in mice, rats, dogs and monkeys to evaluate the safety of enalapril. Enalapril is less acutely toxic. Oral LD50 in mice and rats is approximately 2000 mg / kg. A single dose of 200 mg / kg of enalapril in dogs resulted in death after 3 or 4 days, while a single dose of 100 mg / kg did not show significant changes during two weeks of observation.
Rats were given enalapril at 10, 30, and 90 mg / kg for up to a year, and all rats in all dose groups experienced a slight average weight loss. Rats in the 30 and 90 mg / kg daily dose groups had elevated serum urea nitrogen, but no drug-related histological changes were found in the kidneys. The electrolytes in rats changed slightly, the serum potassium of rats in the 90mg / kg / day group was slightly increased, and the serum sodium and chloride of the rats in the 10mg / kg day group were slightly decreased. In the three-month study, all dose groups experienced a slight increase in mean kidney weight and a decrease in mean heart weight, but these changes did not persist in the one-year study.
No histological changes caused by the drug were found in rats, and differences in organ weights may be related to functional changes. Rats were given enalapril 90 mg / kg / day and saline was used instead of drinking water. One month later, no weight loss or serum urea nitrogen was found compared with rats given the same administration but with tap water as drinking water.
Significantly increased toxicity was seen in rats given enalapril 90 mg / kg / day plus a low-salt diet, including death, weight loss, serum urea nitrogen, creatinine, potassium, and renal tubular degeneration, and a slight decrease in serum gas.
When administered to dogs enalapril at a dose of 30 mg / kg / day or higher, the main toxicological feature is altered renal function with death. These changes include renal tubular degeneration, increased serum urea nitrogen and glucose, and decreased serum nitrogen. When given a higher toxic dose of 90 mg / kg / day, dogs showed an increase in alanine aminotransferase, aspartate aminotransferase and / or alkaline phosphatase activity. These changes are accompanied by slight steatosis of the liver and small cell necrosis of the liver. Enalapril was administered at 15 mg / kg / day for one year, and no drug-induced changes were found in dogs.
Enoxapril was orally administered to dogs at a dose of 60 mg / kg / day via gavage (25 mg / kg / twice) via saline, and the toxicity was significantly reduced compared to dogs without salt.
Monkey enalapril was administered at 30 mg / kg / day for one month without any drug-related changes.
Based on the above studies, the toxicity of enalapril seems to be mainly related to its pharmacological effects. The exact mechanisms of major toxic changes and dorsal tubule degeneration are unknown; however, it is generally believed that they are caused by prolonged and marked hypotension due to excessive therapeutic effects. Studies have shown that salt supplementation can reduce the toxicity of enalapril and its hypotensive effect, which supports that toxicity is related to hypotension rather than the direct toxic effect of enalapril on renal tubular cells. The increased antihypertensive effect of enalapril combined with hydrochlorothiazide and the increased toxicity also supports that hypotension may be the main cause of toxicity. Rats were given 90 mg / kg / day of enalapril for two years without causing kidney damage, and 15 mg / kg / day of enalapril was given to the more sensitive breed dogs for a total of one year. No drug-induced changes occurred. These studies indicate that Enalapril has a wide range of security.
The potential teratogenic effects of enalapril have also been studied in rats and rabbits, and its effects on reproduction and development have been studied in rats.
On the 6th to 17th day of conception, pregnant rats were given enalapril at 1200mg / kg / day (2000 times the maximum dose for humans) and did not show any lethal or teratogenic effects on embryos, at 1200mg / At the dose of kg / day, the average fetal body weight decreased, but if pregnant rats were given physiological saline instead of tap water during this period, the average fetal body weight did not decrease at this dose, and rats were given 120 mg / kg / day enalapril The average weight of unsupplemented fetuses was also unaffected. In the low-dose group (12 mg / kg / day), the body weight of the mother decreased, but this was not found in rats at a dose of 1200 mg / kg / day and supplemented with normal saline. Rats were given 1200 mg / kg / day enalapril and supplemented with normal saline. The increase in serum urea nitrogen was also suppressed, and the increase in serum potassium was partially suppressed, while at a low dose of 100 mg / kg / day (in pregnant rats The lowest measurable dose level) and serum urea nitrogen were increased in rats that were not supplemented with normal saline. Rats were given 200 mg / kg / day of enalapril and were not supplemented with normal saline. Serum potassium was elevated, while 100 mg / kg / The daily dose group was not elevated.
On the 6th to 18th day of conception of rabbits, enalapril was not teratogenic when given 30 mg / kg / day (50 times the maximum human dose) and supplemented with normal saline. At this dose level (50 times the maximum human dose), enalapril has toxic effects on the mother and fetus. When enalapril is administered to rabbits at 3-10 mg / kg / day and supplemented with salt, it has no toxic effects on the mother and fetus.
Enalapril was administered to rats at 10-90 mg / kg / day, and there were no reproductive side effects on male or female rats. Enalapril and its active metabolite, enalapril, did not show an antiglobulin positive response in the concentration range tested (without causing direct hemolysis) in an in vitro antiglobulin test.
Regardless of the presence or absence of active metabolites, enalapril or enalapril had no mutagenic effect in the Ames microbial mutagenesis test.
Enalapril was also negative in the following general toxicity studies. The studies included: Rec-Analysis, E. coli back mutation analysis, mammalian culture cell sister chromatid exchange, micronucleus tests in mice, and Cytogenetic Study of Mouse Bone Marrow in Vivo.
Enalapril was administered to rats at 90 mg / kg / day (150 times the maximum daily human halo) for 106 weeks without evidence of its carcinogenic effect.
Enalapril was administered to male and female mice at doses of 90 and 180 mg / kg / day (150 and 300 times the maximum daily human dose, respectively) for a total of 94 weeks, showing no evidence of carcinogenic effects.
Acute toxicity, general pharmacology, and long-term toxicity studies in rats with enalapril folic acid tablets showed that compared with enalapril maleate, no new toxic effects and toxic effects were found in this product.

Pharmacokinetics of Enalapril Folic Acid Maleate

Enalapril maleate is rapidly absorbed after oral administration, reaching peak serum concentration within 1 hour, and the absorption is about 60%.
After oral absorption, enalapril is rapidly and completely hydrolyzed into the potent angiotensin-converting enzyme inhibitor enalapril, and the time to reach the peak serum concentration of enalapril is about 4 hours. Enalapril is mainly excreted from the kidneys. The main component of urine is about 40% of enalapril and the prototype enalapril. Except for conversion to enalapril, there is no evidence that enalapril has other significant metabolites. The serum concentration curve of enalapril showed that the terminal phase was prolonged, which seems to be related to its binding to angiotensin-converting enzyme. In subjects with normal renal function, the serum steady-state concentration of enalapril was taken 4 days after oral enalapril. After multiple oral doses of enalapril, the cumulative effective half-life of enalacillin is 11 hours. The extent of enalapril absorption and hydrolysis is the same within the therapeutic dose range.
Studies in dogs have shown that enalapril has little or no ability to cross the blood-brain barrier; enalapril cannot enter brain tissue. Rats did not accumulate in any tissue after repeated oral enalapril administration. After administration of 14C-labelled enalapril maleate, radioactivity was detected in the milk of lactating rats. 14C-labeled enalapril maleate was given to pregnant hamsters and radioactive material was found to pass through the placenta.
Folic acid folic acid is mainly absorbed in the proximal end of the jejunum in a reduced form after oral administration. It appears in the blood in 5-20 minutes and peaks after one hour. Folic acid enters the liver through the portal vein, and is stored in the liver and distributed in other tissues and organs in the form of N5-methyltetrahydrofolate. The storage amount in the liver is about 1/3 to 1/2 of the total body. About 90% of the therapeutic amount of folic acid is excreted from the urine, and 20% to 30% appear in the urine 2 hours after the high-dose injection.
Enalapril maleate folic acid tablets In a phase I clinical trial, enalapril maleate 5 mg / 0.4 mg, 10 mg / 0.8 mg, 20 mg / 1.6 mg The pharmacokinetics of enalapril and its active metabolite showed a good linear relationship. Enalapril Tmax is 0.83 to 1.1 hours, t _1/2 is 0.92 to 2.24 hours; enalapril Tmax is 3.8 to 4.4 hours, and T _1/2 is 7.47 to 9.98 hours. There were no gender differences in pharmacokinetics. Enalapril is excreted mainly by the kidneys in the body. Diet may reduce the absorption of enalapril.

Storage of Enalapril Maleate Folic Acid Tablets

Protected from light and sealed below 30 degrees Celsius.

Enalapril maleate folic acid tablets pack

(1) aluminum-aluminum packaging, 7 sheets per board, 1 board per box; (2) aluminum-aluminum packaging, 10 sheets per board, 1 board per box; (3) aluminum-aluminum packaging, 14 sheets per board, 1 board per box; (4) ) Aluminum-aluminum packaging, 14 sheets per board, 2 boards per box.

Expiration Date of Enalapril Maleate Folic Acid Tablets

24 months.

Enalapril folic acid maleate

YBH07012010

^[1]