Enalapril, hydrochlorothiazide (Enap-H) 10 mg + 25 mg – [60 tablets]

A combination drug, the action of which is due to the properties of the components that make it up. It has an antihypertensive effect.

Enalapril inhibits ACE, which promotes conversion of angiotensin I into angiotensin II, decreases the concentration of aldosterone in blood, increases the release of renin by juxtaglomerular cells in the walls of arterioles of renal tubules, improves the kallikrein-kinin system, stimulates the release of prostaglandins and endothelial relaxing factor (NO), inhibits sympathetic nervous system. Taken together, these effects eliminate spasm and dilate peripheral arteries, reduce RPO, systolic and diastolic BP, post- and preload on the myocardium. It dilates arteries to a greater extent than veins, and there is no reflex increase in HR. Hypotensive effect is more pronounced at high plasma renin concentration than at normal or reduced concentration. Reduction of BP within therapeutic limits has no effect on cerebral blood flow. Improves blood supply to ischemic myocardium. Increases renal blood flow without changing glomerular filtration rate. In patients with initially decreased glomerular filtration, its rate usually increases.

Maximal enalapril effect develops after 6-8 hours and lasts up to 24 hours.

Hydrochlorothiazide is a thiazide diuretic of medium potency. It reduces sodium ion reabsorption at the cortical segment of the loop of Genle without affecting its part in the medullary layer of the kidney. It blocks carboanhydrase in the proximal part of the convoluted tubules, increases renal excretion of potassium ions, hydrocarbonates and phosphates. Practically does not affect the acid-base state. Increases the excretion of magnesium ions. Delays calcium ions in the body. Diuretic effect develops in 1-2 hours, reaches a maximum in 4 hours, lasts 10-12 hours. The action decreases with decreasing glomerular filtration rate and stops when its value is less than 30 ml/min. It reduces BP by reducing the BCC and changing the reactivity of the vascular wall.

Combination of enalapril and hydrochlorothiazide results in more pronounced BP reduction compared to monotherapy with each of the drugs separately and allows keeping hypotensive effect of Enap-N for at least 24 hours.

Arterial hypertension (in patients who are indicated for combined therapy).

– anuria;

– Severe renal dysfunction (CKD <30 ml/min);

– history of angioedema associated with previous use of ACE inhibitors;

– hereditary or idiopathic angioedema;

– bilateral renal artery stenosis, single renal artery stenosis;

– Lactose intolerance, lactase deficiency, or glucose/galactose malabsorption;

– pregnancy;

– lactation period;

– children and adolescents under 18 years of age (efficacy and safety have not been established);

– hypersensitivity to the drug components or sulfonamide derivatives.