Ezapril-Co - 20 mg / 12.5 mg 20 Tablets

Arterial hypertension; chronic heart failure.

Tradename: Esapril-Co

Ezapril-Co

Composition: Each tablet contains:

Enalapril maleate 20 mg

Hydrochlorothiazide 12.5 mg

Properties: Combined antihypertensive drug.

Enalapril inhibits ACE, which promotes the conversion of angiotensin I into angiotensin Il, reduces the concentration of aldosterone in the blood, increases the release of renin, improves the functioning of the kallikrein-kinin system, stimulates the release of prostaglandins and endothelial relaxing factor, and inhibits the sympathetic nervous system. Taken together, these effects eliminate spasm and dilate peripheral arteries, reduce total peripheral vascular resistance, systolic and diastolic blood pressure, post- and preload on the myocardium. Expands the arteries to a greater extent than the veins, while there is no reflex increase in heart rate. The hypotensive effect is more pronounced with a high concentration of renin in the blood plasma than with a normal or reduced one. A decrease in blood pressure within the therapeutic range does not affect cerebral circulation. Improves blood supply to the ischemic myocardium. Increases renal blood flow, while the glomerular filtration r does not change.

The maximum effect of enalapril develops after 6-8 hours and lasts up to 24 hours.

Hydrochlorothiazide is a medium-strength thiazide diuretic. Reduces the reabsorption of sodium ions at the level of the cortical segment of the loop of Henle, without affecting its section, which passes in the medulla of the kidney. Blocks carbonic anhydrase in the proximal section of the convoluted tubules, enhances the excretion of potassium ions, bicarbonates and phosphates by the kidneys.

Virtually no effect on the acid-base state.

Increases the excretion of magnesium ions. Retains calcium ions in the body. The diuretic effect develops after 1-2 hours, reaches a maximum after 4 hours, lasts 10-12 hours. The effect decreases with a decrease in the glomerular filtration rate and stops when it is less than 30 ml / min. Reduces blood pressure by reducing the BCC, changes in the reactivity of the vascular wall.

The use of a combination of enalapril and hydrochlorothiazide leads to a more pronounced decrease in blood pressure in DV with each of

the drugs separately.

Indications: Arterial hypertension; chronic heart failure.

Method of administration and dosage: The drug is taken orally, regardless of food intake, 1-2 tab. 1 time / day In patients with a decrease in glomerular filtration to 30 ml / min, individual dose selection is required, in terms of enalapril — 5-10 mg / day.

Contraindications: Anuria; severe renal dysfunction (CC <30 ml / min); a history of angioedema associated with the use of ACE inhibitors; hereditary or idiopathic angioedema; bilateral stenosis of the renal arteries, stenosis of the artery of a single kidney; pregnancy, lactation (breastfeeding); children up to age 18; hypersensitivity to the components of the combination (including to other sulfonamide derivatives).

Precautions: Arterial hypotension with all clinical consequences can be observed after the first

administration of this combination in patients with severe heart failure and hyponatremia, severe renal failure, arterial hypertension or left ventricular dysfunction and, in particular, in patients in a state of hilovolemia as a result of diuretic therapy, salt-free diet, diarrhea, vomiting, or hemodialysis.

In case of arterial hypotension, it is necessary to lay the patient on his back with a low headboard and, if necessary, adjust the volume of the BCC by infusion of 0.9% sodium chloride solution. Arterial hypotension that occurs after taking the first dose is not a contraindication for further treatment.

Care is required in patients with coronary artery disease, severe cerebrovascular disease, aortic stenosis or idiopathic hypertrophic obstructive subaortic stenosis, which prevents the outflow of blood from the left ventricle, severe atherosclerosis, in elderly patients as a result of the risk of developing arterial hypotension and impaired blood supply to the heart, brain and renal blood supply.

Side effects: Most often: dizziness, fatigue.

1-2%: muscle cramps, nausea, asthenia, orthostatic hypotension, headache, cough, impotence.

From the side of the cardiovascular system: fainting, decreased blood pressure, palpitations, tachycardia, chest pain.

Allergic reactions: angioedema (face, tongue, lips, vocal cords, larynx, extremities, intestines), malignant exudative erythema (StevensJohnson syndrome).

From the nervous system: dizziness, insomnia or drowsiness, paresthesia, increased excitability.

From the respiratory system: shortness of breath.

From the digestive system: dry mouth, dyspepsia (including nausea, vomiting, flatulence), diarrhea or constipation, abdominal pain, pancreatitis.

From the genitourinary system: impaired rena function, renal failure, decreased libido.

On the part of the skin: skin rash, itching, sweating.

Storage method: At a temperature not higher than 30 degrees.

Packaging: The cardboard box holds 2 blisters of 10 tablets.