What Is Enalapril Maleate?

Enalapril maleate tablets. Indications: It is used for each stage of essential hypertension, renal hypertension, and congestive heart failure.

Enalapril maleate

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Enalapril maleate tablets. Indications: For each period of primary

Chinese alias:

Method Name: Enalapril Maleate-Determination of Enalapril Maleate-

The product is

Oral, starting dose is 5mg 10mg daily, divided into 1-2 times, patients with severely impaired renal function (

1. Individual patients, especially in applications

Enalapril maleate

Malaisuan Yinapuli

Enalapril Maleate

Page number: 2005 edition two -37

[Revised]

[Properties] "This product is white or almost white crystalline powder; odorless, slightly

[Efficacy Indications] Primary hypertension of each stage; Renovascular hypertension; Heart failure at all levels. For patients with symptomatic heart failure, this product is also suitable for improving survival rate, delaying the progression of symptomatic heart failure, and reducing heart disease Hospitalization caused by medical failure; prevention of symptomatic heart failure, for patients with asymptomatic left ventricular dysfunction, prevention of coronary ischemic events in patients with left ventricular dysfunction, the product is suitable for reducing the incidence of myocardial infarction and reducing unstable angina pectoris The resulting hospitalization. [Chemical composition] The main ingredient of this product is enalapril maleate, and its chemical name is N-[(S) -1- (ethoxycarbonyl) -3-phenylpropyl] -L-alanyl- L-proline, (Z) -butenedioate. Its molecular formula: C24H32N2O9 molecular weight: 492.52

[Pharmacological action] This product is an angiotensin converting enzyme inhibitor. After oral administration, it is hydrolyzed into Enalaprilat, which strongly inhibits angiotensin-converting enzyme, reduces the content of angiotensin II, causes systemic vasodilation, and causes hypotension. It has obvious antihypertensive effects on rat models of renal hypertension of type , renal hypertension of type and spontaneous hypertension.

[Drug interactions] 1. Used together with diuretics to enhance the antihypertensive effect, but it must be avoided to cause severe hypotension.

2 This product can reduce potassium loss when used with potassium diuretics, but can increase blood potassium when used with potassium diuretics.

3 This product can cause lithium poisoning when used with lithium preparations, but the toxicity will disappear after discontinuation.

[Adverse reactions] There may be dizziness, headache, drowsiness, dry mouth, fatigue, epigastric discomfort, nausea, palpitations, chest tightness, cough, flushing, rash, and proteinuria. Reduce if necessary. If leukopenia occurs, the drug should be discontinued.

[Contraindications] Avoid allergic to this product or patients with bilateral renal artery stenosis. Use with caution in severely impaired renal function.

Dosage

The absorption of this medicine is not affected by food, so it can be taken before, during or after meals. Primary hypertension is based on the severity of hypertension, with a starting dose of 10-20 mg once daily. For mild hypertension, the recommended starting dose is 10 mg daily. For other degrees of hypertension, the starting dose is 20 mg daily. The usual maintenance amount is 20 mg / day, which can be adjusted to the maximum dose of 40 mg per day according to the needs of the patient. Renovascular hypertension may be particularly sensitive to angiotensin-converting enzyme inhibitors due to blood pressure and renal function in these patients. Treatment should be started at a small dose, such as 5 mg / day or less, and then the dose should be adjusted according to the needs of the patient. Adjusted. For most patients, taking 20 mg once daily will receive the desired effect. It is recommended that this drug be used with caution in patients with hypertension who have recently been treated with diuretics. Symptomatic hypotension may occur after taking this product in combination with diuretics to treat high blood pressure. This is more likely for patients who have recently been treated with diuretics. These patients may have insufficient blood volume or loss of salt, so caution is recommended. use. Diuretic therapy should be discontinued 2-3 days before starting the drug. If this is not possible, the drug should be started in small doses (5 mg / day or less) to determine its initial effect on blood pressure and then adjust the dose according to the needs of the patient. Dosage of renal insufficiency In general, enalapril should be taken at intervals and / or reduced.

Mild damage (creatinine clearance 30-80 mL / min): starting dose 5-10 mg / day;

Moderate damage (creatinine clearance 10-30 mL / min): starting dose 2.5-5 mg / day;

Severe damage (creatinine clearance <10 mL / min, usually such patients need dialysis): 2.5 mg during dialysis.

Enalapril is dialyzable, and the dose during the non-dialysis period should be adjusted according to the blood pressure response. Heart failure / asymptomatic left ventricular dysfunction Patients with symptomatic heart failure or asymptomatic left ventricular dysfunction, the starting dose of this product is 2.5 mg and should be taken under close medical supervision to determine its effect on blood pressure Initial effect.

This medicine is usually used in combination with diuretics (if appropriate, digitalis) to treat symptomatic heart failure. After the use of this drug for the treatment of heart failure, if no symptomatic hypotension has occurred or has been effectively treated, the dose should be gradually increased to the commonly used 20 mg maintenance dose according to the patient's tolerance, once or Take 2 times. This dose adjustment can be completed in 2-4 weeks. If there are still some signs and symptoms of heart failure, the dose escalation process can be accelerated. For patients with symptomatic heart failure, this dosage regimen can effectively reduce the incidence of death. Due to reports of hypotension and subsequent renal failure (more rarely), blood pressure and renal function should be closely monitored before and after starting this product. For patients treated with diuretics, the dose of diuretics should be reduced as much as possible before starting treatment with the product. The appearance of hypotension after the use of this product does not mean that hypotension will occur in the long-term treatment of this product, nor does it prevent continued use of this drug. Serum potassium should also be monitored.