What is the difference between lisinopril and enalapril. Enalapril and Lisinopril: contraindications, side effects. Comparison of negative symptoms

Enalapril is an antihypertensive (lowering blood pressure) drug of the inhibitor group.

Angiotensin - protein substance, spasmodic walls of blood vessels, releasing aldosterone from the adrenal glands, which retains salt and fluid in the body. Enalapril converts angiotensin, reduces its effect on the vascular bed and pressure increase.

Blood pressure is related to the work of the heart: the upper (systolic) - the contraction of the heart is maximum, the lower (diastolic) - the heart is as relaxed as possible. Normal performance: 120/80 mmHg Art. BUT Arterial hypertension (AH) is a persistent increase in pressure, has three degrees of development:

• optimal pressure - 120/80;
• normal - 120-130 / 80-85;
• increased - 130-139 / 85-89;
• hypertension of the 1st degree - 140-159 / 90-99;
• hypertension of the 2nd degree - 160-179 / 100-109;
• hypertension of the 3rd degree - above 180 / above 110.

The active components of this drug reduce both upper (systolic) and lower (diastolic) pressure. This makes it possible to use the drug as a prophylactic agent and normalize the condition of patients with grade 2-3 hypertension.

The drug reduces pressure gently, without affecting the blood circulation of the brain and its work, reduces the load on the muscles of the heart and improves vascular patency, has a slight diuretic (diuretic) effect.

The effect of taking the drug occurs within an hour, the medicinereduces pressure and acts during the day, so Enalapril is not suitable for emergency assistance. It is not used in hypertensive crises. It should be taken regularly in the doses prescribed by the doctor and after 7-14 days should stabilize the patient's pressure. For positive impact on the heart muscle long time take this medicine (duration - from several weeks to six months).

Dosage form

The international name is enalapril, tablets for pressure, are produced under other trade names, depending on the manufacturer, enam (India), enap (Slovenia).Group - ACE inhibitors (angiotensin-converting enzyme). Tablets are biconvex, round, white with a risk in the middle of 5, 10, 20 mg in blisters of 10 pcs. and carton. Leave - by prescription. Shelf life - 2 years, store at a temperature of 15-25 about C in a dry, dark place.

Active ingredient - enalapril maleate - 5 mg; excipients: lactose monohydrate, sodium starch glycolate, cellulose, polyvinylpyrrolidone, silicon dioxide (aerosil), talc, magnesium stearate, sodium bicarbonate.

pharmachologic effect

The drug Enalapril from pressure, due to the vasodilating effect, will reduce peripheral vascular resistance, reduce the load on the myocardium, and gradually normalize blood pressure. Taking the medicine produces the following effects on the body:

• relaxation of the walls of arteries, veins (to a lesser extent);
• reduces upper and lower pressure;
• reduces the load on the heart muscle;
• improves blood flow in the heart and renal arteries;
• prevents the development of heart failure;
• gives a slight diuretic effect, which reduces water retention in the body;
• with prolonged use, it inhibits the process of hypertrophy (muscle thickening and loss of elasticity) of the left ventricle of the heart, which occurs with hypertension;
• reduces the risk of blood clots by reducing the process of platelet aggregation.

Indications for use

With high blood pressure caused by scleroderma, CHF, coronary ischemia, left ventricular dysfunction, Enalapril is used.

The medicine is taken regardless of time food intake, it can be combined with diuretics, metabolic and otherpressure pills. Tell your doctor about all medications and chronic illnesses you are taking.

Assign Enalapril:

• with arterial hypertension, for the treatment of renal hypertension;
• in chronic heart failure (in combination with other drugs) to prevent abnormal growth and loss of elasticity of the left ventricular muscle.

To reduce high blood pressureprescribe the primary dosage - 5 mg Enalapril per day. If there is no proper effect, the dose may be increased to 10 mg per day (in 2 divided doses). Maximum daily dose- 40 mg. With heart failure - 5-20 mg per day.

In the elderly, the process of metabolism and excretion from the body is slowed down, so the doses are reduced (the initial dose is 1.25 mg / day).

The doctor prescribes a scheme for how to take Enalapril correctly for a specific patient, taking into account clinical picture disease, general condition and presence concomitant diseases. It also increases or decreases the dose. During the period of taking E nalapril abide by instructions for use and when need to stop taking.

In the process of treatment you need:

• control pressure throughout the day;
• check blood and urine parameters (do laboratory tests);
• monitor the condition of the kidneys and heart;
• do not exceed the dose of admission, choose the minimum dose that gives the desired effect;
• do not drink alcohol.

In case of an overdose, you should immediately seek medical help.

Contraindications

• allergy, individual sensitivity to the drug;
• age up to 12 years, over 65 years;
• angioedema;
• bilateral stenosis of the arteries of the kidneys, renal failure;
• liver disease
• pregnancy and breastfeeding;
• hypertrophic cardiomyopathy
• stenosis of the mitral or arterial valve;
• diseases of the gastrointestinal tract;
• violations of metabolic processes, hyperkalemia;
• diabetes;
• vascular diseases.

If you experience an allergic reaction to taking the drug, which can be very dangerous, immediately call an ambulance:

• severe pain in the abdomen;
• swelling of the tongue, larynx, face;
• cough and difficulty breathing;
• slow heart rate (exceeded levels of potassium in the body);
• with kidneys (difficulty urinating;
• sudden muscle weakness;
• chills, weak pulse;
• pre-fainting state.

Side effects

Enalapril has no serious side effects. The drug is usually well tolerated by patients. Side effects are observed:

have not a large number patients (2-3%)

• dizziness and headache;
• fatigue, asthenia;
• dry cough;

in rare cases(less than 2% of cases)

• hypotension
• orthostatic reactions
• feeling of tachycardia (heartbeat more than 90 beats / min.);
• fainting
• muscle spasms, diarrhea, nausea
• allergies (angioneurotic edema, skin rashes);

even less frequently:

• impaired kidney function (renal failure);
• hyperkalemia;
• oliguria;
• hyponatremia;
• dry mouth;

in rare cases

• insomnia or drowsiness;
• depression;
• bronchospasm;
• impaired vision, taste, smell;
• interstitial pneumonitis;
• glossitis;
• cholestatic hepatitis;
• indigestion.

At the beginning, after taking enalapril, dizziness may occur due to a sharp decrease in pressure. You need to stay at home, lie down if necessary. It is better to take the medicine during the day, do not drink before bedtime, as it gives a diuretic effect. In the complex therapy of CHF, a trial dose of Enalapril Geksal is prescribed - 2.5 mg. After 3-4 days, increase to 5 mg until you get therapeutic effect.

Enalapril FPO and Akri can be taken at any time 2.5-5 mg per day, but not more than 20 mg, 40 mg is the maximum allowable dose. You can take the drug for a long time and even for life, if there are no adverse reactions.

The active substance of the drug is absorbed by 60% within an hour, maximum effect comes in 7 hours. Possibly in case of overdose sharp drop pressure and the onset of collapse, the risk of a heart attack, ischemic disorders, convulsions. If such symptoms of a side effect of the drug appear, it is necessary to wash the stomach, lay the patient down, raise his legs and call an ambulance.

Sometimes when long-term use drug, depression occurs, the temperature rises or a rash appears on the body, these side effects usually resolve after discontinuation.

Analogues and substitutes

There are many analogues of Enalapril produced by pharmaceutical companies:

• Lisinopril is weaker than Enalapril to obtain a similar effect, it is required to be taken in large doses. Negatively affects male potency. It is excreted from the body only by the kidneys, unlike Enalapril, which is excreted by both the kidneys and the liver.
• Enap (KRKA company, Slovenia). Available in the form of tablets and solutions (for injection). It works more efficiently, the quality is high, side effects are extremely rare. However, the price is somewhat higher: 280-4000 rubles. - packaging, 500 rubles. - 10 ampoules than Enalapril - 20-25 UAH.

1. Enalapril Geksal (Germany). This German analogue is not at all more effective than the Russian Enalapril, and its cost is higher (78-100 rubles per pack).
2. Captopril and Enalapril are drugs of the same group, their therapeutic effect is the same (lowering pressure and improving myocardial function). Differences: Enalapril is able to support normal pressure, to obtain the same result, Captopril should be taken 2-3 times a day. On the other hand, Captopril is absorbed into the bloodstream and is more effective in case of a hypertensive crisis for emergency care and in CHF, and is used for cardiac pathologies.
3. Enalapril FPO drug domestic production. Has the same effect adverse reactions, differ in price and dose: Enalapril FPO - 80 mg, Enalapril - 40 mg.
4. Lorista is a drug that has a minimum side effects: no dry cough, no effect on male potency, can be used for elderly patients (over 60) and patients with renal insufficiency.
5. Lozap - a similar drug, has no special differences, take 1 time per day at the same time.
6. Berlipril (Berlin-Chemie, Germany). The active substance enalapril amlodipine is a complex compound, the price is 140-180 rubles.

Pharmacies also offer other analogues similar to Enalapril in composition: Renitek, Miopril Kalpiren, Vasopren, Envas. These drugs repeat the domestic Enalapril. If the drug causes any side effects, then it is impossible to replace it with analogues without consultation and advice from the attending physician.

To control the condition of patients suffering from arterial hypertension in chronic form developed several groups of drugs. One of them is angiotensin-converting enzyme inhibitors. The task of such drugs is to prevent its formation and thus prevent vasoconstriction. The most common prescriptions are Lisinopril and Enalapril. What are the properties of these tablets and how do they work differently from other drugs that regulate blood pressure?

Captopril was the first drug to treat high blood pressure by suppressing ACE. It differed from other drugs that normalize blood pressure by a longer duration of action. In the 80s of the last century, its analogue appeared - Enalapril.

In addition to normalizing pressure in arterial hypertension, the drug is prescribed for chronic heart failure and essential hypertension. It is also prescribed to prevent the occurrence of heart failure in patients with latent left ventricular dysfunction and the prevention of myocardial infarction, to maintain normal state patients with unstable angina.

The active substance of Enalopril is the component of the same name. The substance is a prodrug: after penetration into the body, it is transformed into an active metabolite - enalaprilat. It is believed that its ability to have an antihypertensive effect lies in the mechanism of suppression of ACE activity, which in turn slows down the formation of angiotensin II, which contributes to a strong vasoconstriction and simultaneously stimulates the formation of aldosterone.

Thanks to this and a number of processes triggered by enalaprilat, vasodilation occurs, a decrease in the total peripheral vascular resistance, the functioning of the heart muscle improves and its endurance to stress increases.

The drug is produced in tablets with different contents of enalapril - 5, 10, 15 and 20 mg. Treatment begins with a single dose of 2.5-5 mg of drugs. The average dose is considered to be 10-20 mg / s, divided into two doses.

The drug was developed in the mid 80s. XX century, but began to be produced later. The action of the drug is provided by lisinopril, a substance that also has the ability to suppress the activity of angiotensin-converting enzyme, which affects the processes that regulate in the body blood pressure.

Like enalapril, lisinopril reduces the rate of formation of angiotensin II, which has the ability to constrict blood vessels, reduces peripheral vascular resistance and resistance in the vessels of the lungs, and improves the heart's resistance to stress.

The drug is prescribed to normalize blood pressure in patients with hypertension (and can be used as the main tool or additional along with other drugs), with CHF. It helps quite effectively with MI, if it was applied on the first day after a heart attack, and diabetic nephropathy.

The drug is also produced in tablets with different contents of lisinopril: 2.5, 5, 10 and 20 mg in one pill.

The daily dosage at the beginning of therapy is 2.5 mg, which is taken at a time, with a maintenance course - 5-20 mg (depending on the indications).

The problem of choice: similarities and differences of drugs

As can be seen from the characteristics, both drugs that are part of the same group of drugs have almost identical properties and therefore act in a similar way. Therefore, the question of choosing Lisinopril or Elanopril for therapy, and determining which will help best in each case, is not easy even for a specialist.

To make the task easier and to clarify the difference between drugs, a couple of decades ago, studies of tablets were conducted with the participation of several groups of volunteers. The data obtained showed that the effectiveness of both drugs is almost the same: Lisinopril and Enalapril lowered blood pressure well, and the difference between them was very insignificant. So, for example, it was noticed that Lisinopril has a longer effect, so it controls pressure more effectively in the afternoon, unlike its competitor.

There were differences in the way and speed of pills excretion from the body: Enalapril - through the kidneys and intestines, the second drug - by the kidneys.

In addition, some experts argue that Lisinopril has a faster effect, unlike Enalapril. It can be drunk to eliminate the consequences of MI if no more than a day has passed after the attack.

Enalapril can provoke a side effect in the form of a dry cough. This mainly happens with a long course of administration, and if it occurs, the dosage of the medication should be reviewed or replaced with another medication.

The drug is based on the component of the same name. The substance is a prodrug: after oral administration, it is transformed into a metabolite of ramipril with a strong effect. Suppresses ACE, as a result of which factors of vasoconstriction and an increase in blood pressure are eliminated. Like Enalapril and Lisinopril, the active substance reduces OPSS, reduces pressure in blood vessels lungs.

It has a beneficial effect on the state of the cardiovascular system: in patients with chronic heart failure, it reduces the likelihood of a sudden death, slows down the progression of heart failure and reduces the number of conditions that require hospitalization.

Ramipril significantly reduces the incidence of myocardial infarction, stroke, and the incidence of death in patients after coronary artery disease, stroke, or with peripheral vascular disease.

The drug is produced in the form of tablets. The hypotensive effect of ramipril appears after 1-2 hours, intensifies for up to 6 hours and lasts at least a day.

The dosage is determined after examination of the patient. The initial amount recommended by the manufacturers is 1.25-2.5 mg once or twice a day. If the body normally tolerates the action of ramipril, then an increase in the dose of the drug is possible. The amount of the drug in the maintenance course is also determined individually.

Comparison of Ramipril with other drugs

Unlike other drugs for high blood pressure, Ramipril is still one of the few drugs that not only effectively copes with arterial hypertension, but also simultaneously prevents heart pathologies and the development of MI. According to some experts, it can be considered the gold standard among similar drugs. The drug shows especially high efficiency in the treatment of patients with high risk MI, stroke and mortality, particularly in type 2 diabetics. The drug significantly reduced the rate of atherosclerosis in them.

Ramipril is considered more effective than the drugs described above or Captopril, as it perfectly protects the brain, the circulatory system of the fundus, kidneys and peripheral vessels from the consequences of high pressure. So far, this is the only remedy that, along with the hypotensive effect, also prevents disorders in the cardiovascular system.

Ramipril vs Lisinopril: What's the Difference?

When comparing two drugs, the advantage clearly belongs to the first drug. Lisinopril does not dissolve in fats, therefore it does not penetrate deeply and does not have such a strong effect as Ramipril.

A drug for use in monotherapy or fixed complex treatment regimens used in patients with arterial hypertension. It is also prescribed for chronic heart failure to prevent recurrence of stroke in patients who have already had it. As a prophylactic, it is used to reduce the risk of complications of the heart and blood vessels in patients with coronary artery disease.

The active substance of Perindopril is the component of the same name. The substance belongs to the group of drugs-ACE inhibitors. Its mechanism of action is similar to Enalapril, Lisinopril and Ramipril: it prevents vasoconstriction, reduces peripheral vascular resistance, increases cardiac output and resistance to stress.

The hypotensive effect of perindopril develops within an hour after taking the medicine, reaches a peak within 6-8 hours and lasts a day.

The drug is available in tablets containing perindopril 2, 4, 8 mg.

The recommended dosage of drugs at the beginning of therapy is 1-2 mg once a day. With a maintenance course, 2-4 mg is prescribed. With arterial hypertension, a daily intake of 4 mg (possibly increasing to 8 mg) at a time is indicated.

In patients with kidney pathologies, the dosage of perindopril is adjusted taking into account the condition of the organ.

As with any type of therapy, the medicine for arterial hypertension should be selected taking into account all the nuances of the patient's health, the functioning of the organs. Only in this case is it possible to make the right choice between Enalapril, Lisinopril and other ACE inhibitors.

Blood pressure problems are one of the most common pathologies diagnosed in people of all ages. Chronic or abrupt change indicators require correction by appropriate medications. Lisinopril - instructions for use, at what pressure should the drug be used? What contraindications should be considered before starting treatment?

At what pressure should I take Enalapril?

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Lisinopril - instructions for use

At what pressure should Lisinopril be taken? The drug belongs to the group of ACE inhibitors. After taking the drug, vasodilation occurs, so this remedy is indicated for hypertension. With regular intake, the work of the heart muscle and blood circulation improves, excess sodium salts are removed from the body. The drug effectively reduces diastolic and systolic indicators, while not affecting the heart rate.

The drug is produced in the form of tablets with different dosage. The color of the tablets depends on the amount of the active substance. Saturated orange - 2.5 mg, pale orange - 5 mg, pink - 10 mg, white - 20 mg. The price of Lisinopril is 70–200 rubles. depending on the dosage and number of tablets in the package.

Important! Lisinopril increases life expectancy in the presence of serious diseases of the heart and blood vessels, suspends ventricular dysfunction after a heart attack.

Part medicinal product includes lisinopril dihydrate, depending on the manufacturer, the tablets may include various additional substances that do not have a therapeutic effect.

Indications for use:

• hypertension and hypertension of various etiologies;
• myocardial infarction in the acute stage;
• insufficiency of the heart muscle of a chronic nature;
• defeat of the peripheral nervous system that are caused by diabetes.

The drug has many analogues that have similar therapeutic effects, practically do not differ in cost - Lizitar, Vitopril, Dapril, Lipril.

How to take the drug

Before starting treatment with Lisinopril, you should study the instructions in order to understand what these pills help from, how to take them correctly. The drug is excreted from the body through the kidneys, so the presence of serious diseases of this organ should be reported to the doctor before starting treatment.

Important! The therapeutic effect of the drug occurs in an hour, a lasting effect - after a monthly course. The drug acts slowly, so it is not used as first aid for a hypertensive crisis.

Lisinopril has a prolonged action, so it is enough to take it once a day, preferably in the morning. Take the medicine in large quantities pure water. An adequate treatment regimen is developed by a cardiologist, taking into account the age of the patient, the presence of chronic diseases.

Dosage of the drug depending on the disease:

1. Diabetic nephropathy - at the initial stage of treatment, no more than 10 mg of the drug per day should be taken. It is possible to increase the dose to 20 mg, but this can be done in last resort because there is a high risk of serious complications.
2. Hypertension, essential hypertension - therapy begins with a dose of 10 mg. To support pressure indicators on normal level you need to take 20 mg of the drug per day. The maximum safe allowable dose is 40 mg.
3. Chronic heart failure - treatment begins with a dose of 2.5 mg, every 3-5 days it is increased. Maximum daily dosage- 10 mg.

During treatment with Lisinopril, it is necessary to constantly monitor blood pressure, check kidney function, regularly replenish the loss of fluids and salts. You should reduce the amount of physical activity, especially in hot weather.

An overdose of the drug is rare - in this case, it sharply decreases arterial pressure, perhaps a state of shock, the development of acute renal failure. First aid is to wash the stomach, the introduction of saline.

Important! The drug impairs concentration and attention, so it is necessary to refrain from driving, high-altitude and underground work.

Contraindications and side effects

Lisinopril effectively helps with high pressure, but the drug has many side effects. If you follow the dosage, adhere to the correct treatment regimen, then Negative consequences after taking the medicine are not observed, or disappear within a few days.

Possible violations:

• chest pain, a sharp decline blood pressure indicators;
• deterioration of potency;
• disorders in the digestive system that provoke the appearance of nausea and vomiting;
• increase in ESR, decrease in hemoglobin level;
• increase in the content of urea nitrogen and keratin;
• joint pain;
• muscle weakness, migraine, dizziness attacks.

At the initial stage of treatment, allergic reactions may occur in the form of skin rashes, sometimes there is Quincke's edema. Often, taking the drug is accompanied by an unproductive cough.

The main contraindications are individual intolerance to the components of the drug and lactose, hypersensitivity to drugs from the group of ACE inhibitors, angioedema, idiopathic edema. Lisinopril is contraindicated in pregnancy at any time, use during lactation is possible only if the breastfeeding. There is no reliable data on the safety of using the drug in pediatrics, so it is not prescribed to persons under 18 years of age.

Caution and under constant control doctor should take Lisinopril for the elderly, diabetics, with a history of chronic kidney disease, problems with cerebral circulation.

Lisinopril and alcohol - compatibility. During treatment, drinks and drugs that contain ethanol should be completely excluded. The drug enhances negative impact alcohol on the body, which can cause serious liver disorders.

Important! Before taking Lisinopril for pressure, it is necessary to undergo a complete examination to exclude the presence of kidney pathologies, eliminate dehydration.

How is Lisinopril different from other blood pressure medications?

Hypertension requires long-term treatment, sometimes drugs have to be taken for life. In order not to decrease the therapeutic effect, drugs must be changed periodically. A replacement for Lisinopril is selected by a cardiologist.

Lisinopril or Enalapril - which is better?

Lisinopril lowers blood pressure more effectively, the therapeutic effect is longer than that of Enalapril, which should be taken twice a day. Both drugs are approximately equally tolerated, but enalapril does not negative impact potency, but is excreted from the body with the help of the liver and kidneys.

Diroton or Lisinopril - which is better?

The drugs have much in common - they are released in the form of tablets with a dosage of 5-20 mg, it is enough to take them once a day, a lasting effect is achieved in 2-4 weeks. But to maintain optimal performance the dose of Diroton should be 2 times more than Lisinopril.

There are some differences among the contraindications. Diroton should not be taken by persons who have a hereditary predisposition to Quincke's edema. Lisinopril should not be taken with lactose intolerance. Otherwise, the action of the drugs is identical.

Lisinopril or Lozap - which is better? Both drugs belong to the group of ACE inhibitors. But Lozap is an expensive drug, it is prescribed only if the patient has persistent intolerance to all other budgetary medicines from this category.

Any medications for high blood pressure can be taken only after consulting a cardiologist - all potent drugs have many contraindications and side effects. Self-medication of hypertension can lead to a decrease in indicators below the permissible minimum, coma, and other serious consequences.

With changes in pressure indicators, drug therapy is necessary. Various synthetic and natural preparations. Enalapril - instructions for use, at what pressure does this drug help? What contraindications should be considered?

Enalapril is an effective and time-tested drug that belongs to ACE inhibitors, which is used to correct systolic and diastolic pressure. At what pressure is it used? The drug is used to treat high blood pressure, it is used alone or in combination with other drugs for hypertension and hypertension.

The drug is produced in the form of tablets, with a dose of the active substance 5, 10, 20 mg. The composition contains the active substance enalapril, auxiliary components that do not have any therapeutic effect.

The mechanism of action of the drug is based on the ability of enalapril to slow down the production of angiotensin, reduce the amount of aldosterone. Due to this, the walls of blood vessels relax, blood flow in the cardiac and renal arteries normalizes, and prevents the development of heart failure and thrombosis.

Does enalapril increase or decrease blood pressure? The drug effectively reduces systolic and diastolic pressure, while not causing a jump in heart rate readings.

What does the drug help? With regular intake, the ability to withstand stress increases, the manifestation of pathological changes in the left ventricle decreases, the load on the heart muscle is weakened, and it prevents the development of nephropathy in diabetics.

Drug analogues:

• Enam;
• Invoril;
• Miopril;
• Renitex;
• Enamp.

Enafarm N - combination drug, which contains not only enalapril, but diuretic components - this increases the hypotensive property of the drug.

Enalapril - budget drug, its price is 30-100 rubles. The cost is affected by the country of origin - Russian medicines are the cheapest, and Serbian ones have the highest price.

Important! Enalapril - powerful drug, which has many contraindications and side effects, so you can buy it at a pharmacy only with a doctor's prescription.

Before starting treatment, you must carefully read the instructions for use - it contains all indications, contraindications, adverse reactions and signs of overdose.

Indications for use:

• any kind of hypertension and hypertension;
• chronic heart failure;
• nephropathy in insulin diabetics;
• pathological changes in the tissues of the left ventricle.

With angina pectoris and myocardial infarction, the drug is included in complex and rehabilitation therapy.

Important! Enalapril acts slowly, so it is not advisable to use it in a hypertensive crisis.

The drug is not prescribed during pregnancy, lactating women, persons under 18 years of age, elderly people. The drug is contraindicated in case of individual intolerance, porphyria. The drug should be taken with caution if there is a history of serious pathologies kidneys, diseases that impair the outflow of blood from the left ventricle.

Enalapril does not belong to modern medicines, it was invented a long time ago, therefore, various adverse reactions often occur when taken. But if the dosage is observed, the drug is well tolerated, negative consequences are rare.

Frequent adverse reactions:

• cough without sputum, sometimes there is difficulty breathing, pharyngitis;
• the drug can provoke diarrhea, intestinal obstruction;
• nausea, aversion to food, ulcer;
• pain in the heart, bradycardia;
• deterioration in the clarity of vision;
• migraine, dizziness, fatigue.

Sometimes, against the background of long-term use, they develop depressive states, a rash appears, the body temperature rises. All adverse reactions are reversible, when the drug is discontinued, they quickly disappear.

In case of an overdose, a collapse may occur against the background of a sharp decrease in pressure, a heart attack, disorders in the brain of an ischemic nature, stupor and convulsions. When similar symptoms it is urgent to do a gastric lavage, lay the person down, raise his legs, call an ambulance.

Important! Enalapril and alcohol are strictly forbidden to combine. Alcoholic drinks enhance the effect of the drug, which can cause the development irreversible consequences, a sharp decrease in pressure below the permissible norm.

The drug is absorbed by 60%, the therapeutic effect appears after 2-4 weeks of regular use. The maximum result is formed 7 hours after administration, lasts throughout the day.

Important! At the initial stage, there may be severe dizziness, the pressure sometimes drops sharply. Therefore, after taking the medicine, it is advisable to stay at home, not to engage in work that requires concentration.

The dosage of the drug depends on the disease, the age of the patient, the presence of chronic diseases.

You can take the medicine regardless of the meal once a day. It is better to drink the medicine in the morning, because it has a slight diuretic effect. With monotherapy, the initial dose is 5 mg, if the condition does not improve, then it is increased by 2 times after 7-14 days. With moderate hypertension, it is enough to take 10 mg of medication per day. The maximum daily dose should not exceed 40 mg, while the medicine should be drunk in 2 doses.

If Enalapril Geksal is used as part of complex therapy for the treatment of heart failure, then the trial dose is 2.5 mg. It is increased by 2 times after 3-4 days, until the therapeutic effect becomes noticeable.

Enalapril FPO and Akri are taken at any time, 2.5–5 mg once every 24 hours. Maintenance dosage - no more than 20 mg, safe maximum dose- 40 mg.

How long can I take Enalapril? Treatment with the drug is long, in the absence of adverse reactions, it can be taken for life.

Important! Before any surgical intervention, even a dentist, the doctor should be warned about treatment with ACE inhibitors.

Many pharmaceutical companies produce various analogues Enalapril. They differ in cost, composition, but the therapeutic effect of all is almost the same. A high price does not always guarantee the absence of adverse reactions.

Lisinopril or Enalapril - which is more effective? Lisinopril has a negative effect on male potency, a large dosage is required for a therapeutic effect. Enalapril is effective for coronary disease, is excreted by the liver and kidneys. Lisinopril - only by the kidneys.

Enalapril Geksal and Enalapril, is there a difference? Enalapril Geksal is produced by a German pharmaceutical company, Enalapril is Russian. The German counterpart is somewhat more expensive, but in terms of efficiency it is no better than the domestic drug.

Enap and Enalapril - what's the difference? Enap is a drug from Slovenia, it is produced in the form of tablets and injection solutions. It costs several times more expensive, but it works more efficiently, adverse reactions appear extremely rarely.

Enalapril FPO and Enalapril - what's the difference? Both drugs are produced by domestic pharmaceutical companies, have the same effect, side effects. Slightly different in price, the maximum allowable dose of Enalapril FPO is 80 mg, unlike Enalapril.

Captopril or Enalapril - which is more effective? These drugs belong to the same group, have a similar therapeutic effect - they improve the functioning of the heart muscle, normalize high blood pressure. But there are also some differences.

captopril, even mild form hypertension should be taken 2-3 times a day, since its effect is shorter. Enalapril maintains optimal pressure indicators longer.

Captopril is effective in hypertensive crisis, Enalapril is not used as an emergency. Captopril is more effective in heart failure, improves endurance, it can be used for prevention deaths from serious heart disease.

Lorista or Enalapril - which is better? Lorista is a modern drug for the treatment of hypertension, chronic heart failure. It acts effectively, has a minimum number of adverse reactions - there is no dry cough, male potency does not worsen with long-term use. Lorista can be used in the treatment of persons over 60 years of age, patients with renal insufficiency without dosage adjustment.

Enalapril or Lozap - what's the difference? The drugs have the same effect, they need to be taken once a day, preferably at the same time. There are no special differences in contraindications and side effects.

Enalapril and its analogues are an effective drug for reducing systolic and diastolic blood pressure. In the absence of adverse reactions, they can be taken for a long time, but only a doctor can prescribe the dose and duration of treatment. Any self-treatment can lead to serious, irreversible consequences.

The drug "Capoten" is prescribed to quickly lower blood pressure, with chronic heart failure and a number of other problems. Produced in the form of biconvex tablets of white or cream color with rounded edges, notches for division on one side and an embossed inscription SQUIBB and 452. Packed in blister packs and cardboard boxes. Any analogue of "Kapoten" has in its composition the main active ingredient - captopril. This is the international name of the drug. Essentially, under different names sells the same product, released in different countries and at various pharmaceutical plants.

Analogues of this tool, like himself original drug, are effective in arterial hypertension, chronic and acute heart failure, in violation of the function of the left ventricle in the post-infarction period, in diabetic nephropathy. But more often, the medicine "Kapoten", like any of its analogues, has a narrow range of applications: hypertensive diseases caused by impaired blood circulation in vascular system. A drug is prescribed to stop severe forms hypertensive crisis. In professional terms, this is a drug for emergency therapy.

It should be noted right away that this medication belongs to the category of strong specific drugs, and its improper use, especially abuse, can lead to very serious consequences. Yes, at primary appointments, at wrong dosage hypertension may be replaced by hypotension. They take these pills, as well as any analogue of Kapoten, starting with small doses. At the same time, they are set strictly individually.

In the postinfarction period, already three days after the attack, doctors connect the drug "Kapoten" or an analogue of "Kapoten" at an initial dosage of 6.25 mg per day. The gradual increase in dose is 75-150 mg in two or three doses.

People with chronic heart failure also use Kapoten tablets as the main or prophylactic agent. Instructions for use analogues of the drug (tablets "Captopril", "Captopril Hexal", "Lisinopril", "Captomed" and others), as well as the main drug, recommends taking in cases where the mandatory use of diuretics does not bring the desired result. The initial dosage does not exceed 6.25 mg three times a day. Here, too, if necessary, the dose is increased to 75-150 mg.

As mentioned above, the drug and its analogues are based on the active substance captopril. And a number of medicines with the same name are produced. In addition to the above, in pharmacy network funds with the same name are being sold: tablets "Captopril-AKOS", "Capril", "Captopril-Akri", "Vero-Captopril", "Captopril-UBF" and others.

Good reviews from doctors and patients have another analogue of Kapoten - Angiopril tablets, produced in packs of 25 pieces. And there are dozens of other drugs that are close to the described remedy in terms of action and belong to the same pharmacological group. Among them are the Enalapril, Enap, Enam, Enafarm, etc. well-known tablets for every hypertensive patient. These drugs are more recommended as regularly taken medications that maintain normal blood pressure.

Their list is quite large. As a strong specific agent, the drug "Capoten" and its potent analogues are not recommended for such diagnoses:

angioneurotic edema;

• violations of the functions of the liver and kidneys;
• kidney transplantation and stenosis of the renal arteries;
• obstructive phenomena in the aorta, preventing the outflow of blood from the left ventricle;
• pregnancy and lactation;
• minor age;
• allergic reaction for the drug and its components.

In any case, you need to remember that the drug "Kapoten" is not a tool that you need to keep on hand and use at your own discretion and uncontrollably.

is a drug from the group of angiotensin-converting enzyme (ACE) inhibitors that reduces arterial

pressure

Captopril is used to treat arterial hypertension, chronic heart failure,

myocardial dystrophy

and diabetic nephropathy.

Currently, Captopril is available in several of the following varieties:

• Captopril;
• Captopril-Vero;
• Captopril Geksal;
• Captopril Sandoz;
• Captopril-AKOS;
• Captopril-Acri;
• Captopril-Ros;
• Captopril-Sar;
• Captopril-STI;
• Captopril-UBF;
• Captopril-Ferein;
• Captopril-FPO;
• Captopril Stada;
• Captopril-Egis.

These varieties of the drug actually differ from each other only by the presence of an additional word in the name, which reflects the abbreviation or well-known name of the manufacturer of a particular type of drug. Otherwise, the varieties of Captopril practically do not differ from each other, since they are produced in the same dosage form, contain the same active substance, etc. Moreover, often even the active substance in the varieties of Captopril is identical, since it is purchased from large manufacturers China or India.

Differences in the names of varieties of Captopril are due to the need for each pharmaceutical company to register the drug they produce under the original name, which is different from others. And since in the past, in the Soviet period, these pharmaceutical plants produced the same Captopril using exactly the same technology, they simply add to famous name one more word, which is an abbreviation of the name of the enterprise and, thus, a unique name is obtained, which, from a legal point of view, differs from all others.

Thus, there are no significant differences between the varieties of the drug, and therefore, as a rule, they are combined under one common name "Captopril". Further in the text of the article, we will also use one name - Captopril - to refer to all its varieties.

All varieties of Captopril are available in a single dosage form - this oral tablets. As an active ingredient tablets contain a substance captopril, the name of which, in fact, gave the name to the drug.

Varieties of Captopril are available in various dosages such as 6.25 mg, 12.5 mg, 25 mg, 50 mg and 100 mg per tablet. Such a wide range of dosages allows you to choose the best option for use.

As auxiliary components Varieties of Captopril may contain various substances, since each enterprise can modify their composition, trying to achieve optimal production efficiency indicators. Therefore, to clarify the composition of the auxiliary components of each specific type of drug, it is necessary to carefully study the attached leaflet with instructions.

Prescription for Captopril on Latin written out as follows:

Rp: Tab. Captoprili 25 mg № 50

D.S. Take 1/2 - 2 tablets 3 times a day.

In the first line of the prescription, after the abbreviation "Rp", the dosage form is indicated (in this case Tab. - tablets), the name of the drug (in this case, Captopril) and its dosage (25 mg). After the "No" sign, the number of tablets that the pharmacist must dispense to the bearer of the prescription is indicated. In the second line of the recipe after the abbreviation "D.S." provides information for the patient, containing instructions on how to take the drug.

Captopril

lowers blood pressure and reduces stress on the heart. Accordingly, the drug is used in the treatment of arterial hypertension, heart disease (heart failure, condition after myocardial infarction, myocardial dystrophy), as well as diabetic nephropathy.

The effect of Captopril is to suppress the activity of the enzyme that ensures the conversion of angiotensin I to angiotensin II, so the drug belongs to the group of ACE inhibitors (angiotensin-converting enzyme). Due to the action of the drug, angiotensin II is not formed in the body - a substance that has a powerful vasoconstrictor effect and consequently increases blood pressure. When angiotensin II is not formed, the blood vessels remain dilated and, accordingly, blood pressure is normal, not elevated. Due to the effect of Captopril, when taken regularly, blood pressure is reduced and kept within acceptable and acceptable limits. The maximum decrease in pressure occurs 1 - 1.5 hours after taking Captopril. But to achieve a stable reduction in pressure, the drug must be taken for at least several weeks (4-6).

Also drug reduces stress on the heart, expanding the lumen of the vessels, as a result of which the heart muscle needs less effort to push blood into the aorta and pulmonary artery. Thus, Captopril increases the tolerance of physical and emotional stress in people suffering from heart failure or who have had a myocardial infarction. An important property of Captopril is the absence of an effect on blood pressure when used in the treatment of heart failure.

In addition, captopril enhances renal blood flow and blood supply to the heart, as a result of which the drug is used in the complex therapy of chronic heart failure and diabetic nephropathy.

Captopril is well suited for inclusion in various combinations with other antihypertensive drugs. In addition, Captopril does not retain fluid in the body, which distinguishes it from other antihypertensive drugs with a similar property. That is why, while taking Captopril, you do not need to additionally use diuretics to eliminate the caused antihypertensive drug swelling.

Captopril is indicated for use in the treatment the following diseases:

• Arterial hypertension (as monotherapy or as part of combination therapy. The drug is most effective in combination with thiazide diuretics, such as hydrochlorothiazide, etc.);
• congestive heart failure;
• cardiomyopathy;
• Impaired left ventricular function in people who have had a myocardial infarction (applies only if steady state patient);
• Diabetic nephropathy, which developed with type I diabetes mellitus (used for albuminuria more than 30 mg / day);
• Autoimmune nephropathy (rapidly progressive forms of scleroderma and systemic lupus erythematosus).

For people suffering from both hypertension and bronchial asthma, Captopril is the drug of choice.
General provisions and dosages

Captopril should be taken one hour before meals, swallowing the tablet whole, without biting, chewing or crushing in any other way, but with a sufficient amount

(at least half a glass).

The dosage of Captopril is selected individually, starting from the minimum, and gradually increasing to an effective one. After taking the first dose of 6.25 mg or 12.5 mg, blood pressure should be measured every half hour for three hours in order to determine the response and severity of the drug in a particular person. In the future, with increasing doses, pressure should also be measured regularly one hour after taking the pill.

It must be remembered that the maximum allowable daily dosage of Captopril is 300 mg. Taking the drug in an amount of more than 300 mg per day does not lead to a stronger decrease in blood pressure, but provokes a sharp increase in the severity of side effects. Therefore, taking Captopril at a dosage of more than 300 mg per day is inappropriate and ineffective.

Captopril for pressure(with arterial hypertension) begin to take 25 mg once a day or 12.5 mg 2 times a day. If after 2 weeks the blood pressure does not decrease to acceptable values, then the dosage is increased and taken 25-50 mg 2 times a day. If, when taking Captopril at this increased dosage, the pressure does not decrease to acceptable values, then hydrochlorothiazide 25 mg per day or beta-blockers should be added.

With an average or mild hypertension a sufficient dosage of Captopril is usually 25 mg 2 times a day. In severe form hypertension the dosage of Captopril is adjusted to 50-100 mg 2 times a day, doubling it every two weeks. That is, in the first two weeks, a person takes 12.5 mg 2 times a day, then over the next two weeks - 25 mg 2 times a day, etc.

With high blood pressure due to kidney disease, Captopril should be taken at 6.25 - 12.5 mg 3 times a day. If after 1 - 2 weeks the pressure does not decrease to acceptable values, then the dosage is increased and taken 25 mg 3 - 4 times a day.

With chronic heart failure Captopril should be started at 6.25 - 12.5 mg 3 times a day. After two weeks, the dosage is doubled, bringing to a maximum of 25 mg 3 times a day, and the drug is taken for a long time. In heart failure, Captopril is used in combination with diuretics or cardiac glycosides.

More about heart failure With myocardial infarction You can take Captopril on the third day after the end of the acute period. In the first 3-4 days, it is necessary to take 6.25 mg 2 times a day, then the dose is increased to 12.5 mg 2 times a day and drunk for a week. After that, with good tolerability of the drug, it is recommended to switch to taking 12.5 mg three times a day for 2 to 3 weeks. After this period of time, under the condition of normal tolerability of the drug, they switch to taking 25 mg 3 times a day with the control of the general condition. In this dosage, Captopril is taken for a long time. If the dosage of 25 mg 3 times a day is insufficient, then it is allowed to increase it to the maximum - 50 mg 3 times a day.

More about myocardial infarction With diabetic nephropathy Captopril is recommended to take 25 mg 3 times a day or 50 mg 2 times a day. With microalbuminuria (albumin in the urine) more than 30 mg per day, the drug should be taken 50 mg 2 times a day, and with proteinuria (protein in the urine) more than 500 mg per day Captopril drink 25 mg 3 times a day. The indicated dosages are gained gradually, starting from the minimum, and doubling every two weeks. The minimum dosage of Captopril for nephropathy may be different, as it is determined by the degree of impaired renal function. The minimum dosages with which you need to start taking Captopril in diabetic nephropathy, depending on the function of the kidneys, are shown in the table.

The indicated daily dosages should be divided into 2-3 doses per day. Elderly people (over 65), regardless of kidney function, should start taking the drug at 6.25 mg 2 times a day, and after two weeks, if necessary, increase the dosage to 12.5 mg 2 to 3 times a day.

If a person suffers from any kidney disease (not diabetic nephropathy), then the dosage of Captopril for him is also determined by creatinine clearance and is the same as in diabetic nephropathy.

Captopril under the tongue

Captopril is taken under the tongue exceptional cases when you need to quickly lower your blood pressure. When resorbed under the tongue, the effect of the drug develops after 15 minutes, and when taken orally - only after an hour. That is why Captopril is taken under the tongue for stopping

hypertensive crisis

Captopril is contraindicated for use during the entire

pregnancy

Since it has been proven in experimental animal studies toxic effect to the fruit. Taking the drug from the 13th to the 40th week of pregnancy can lead to fetal death or malformations.

If a woman takes Captopril, then it should be discontinued immediately, as soon as it becomes known about the onset of pregnancy.

Captopril penetrates into milk, so if you need to take it, you should stop breastfeeding the baby and transfer it to artificial mixtures.

For children under 18 years of age, Captopril is used only in case of emergency, calculating the dosage individually according to body weight, based on the ratio of 1-2 mg per 1 kg of body weight per day.

If the next pill was missed, then the next time you need to take usual dose, not double.

Before starting the use of Captopril, it is necessary to restore the volume of fluid and the concentration of electrolytes in the blood, if they turned out to be abnormal due to the intake of diuretics, severe diarrhea, vomiting, etc.

During the entire period of use of Captopril, it is necessary to monitor the functioning of the kidneys. In 20% of people, while taking the drug, proteinuria (protein in the urine) may appear, which resolves on its own within 4 to 6 weeks without any treatment. However, if the concentration of protein in the urine is above 1000 mg per day (1 g / day), then the drug must be discontinued.

Captopril should be used with caution and under the close supervision of a physician if a person has the following conditions or diseases:

• Systemic vasculitis;
• Diffuse connective tissue diseases;
• Reception of immunosuppressants (Azathioprine, Cyclophosphamide, etc.), Allopurinol, Procainamide;
• Carrying out desensitizing therapy (for example, bee venom, SIT, etc.).

In the first three months of therapy, take every two weeks general analysis blood. Subsequently, a blood test is performed periodically, until the end of Captopril intake. If the total number of leukocytes falls below 1 g/l, then the drug should be discontinued. Usually normal amount leukocytes in the blood is restored 2 weeks after discontinuation of the drug. In addition, it is necessary to determine the concentration of protein in the urine, as well as creatinine, urea, total protein and potassium in the blood during the entire period of taking Captopril every month. If the concentration of protein in the urine is above 1000 mg per day (1 g / day), then the drug must be discontinued. If the concentration of urea or creatinine in the blood progressively increases, then the dosage of the drug should be reduced or discontinued.

To reduce the risk of a sharp decrease in pressure when starting to use Captopril, it is necessary to cancel diuretics or reduce their dosage by 2 to 3 times 4 to 7 days before the first tablet intake. If, after taking Captopril, blood pressure drops sharply, that is, hypotension develops, then you should lie on your back on a horizontal surface and raise your legs up so that they are higher than your head. In this position, you need to lie down for 30 - 60 minutes. If the hypotension is severe, then to quickly eliminate it, you can enter the usual sterile intravenously. saline.

Since the first doses of Captopril quite often provoke hypotension, it is recommended to select the dosage of the drug and start its use in a hospital under the constant supervision of medical personnel.

Against the background of the use of Captopril, any surgical interventions, including dental (for example, tooth extraction), should be done with caution. The use of general anesthesia while taking Captopril can provoke a sharp decrease in pressure, so the anesthesiologist should be warned that the person is taking this drug.

With the development of jaundice, you should immediately stop taking Captopril.

While taking the drug, there may be false positive analysis on acetone in the urine, which must be borne in mind by both the doctor and the patient himself.

It should be remembered that if the following symptoms appear while taking Captopril, you should immediately consult a doctor:

• Any infectious diseases, including colds, flu, etc.;
• Increased fluid loss (eg, vomiting, diarrhea, profuse sweating etc.).

The use of Captopril sometimes causes hyperkalemia ( elevated level potassium in the blood). The risk of hyperkalemia is especially high in people with chronic renal failure or diabetes and those on a salt-free diet. Therefore, against the background of the use of Captopril, it is necessary to stop taking potassium-sparing diuretics (Veroshpiron, Spironolactone, etc.), potassium preparations (Asparkam, Panangin, etc.) and heparin.

Against the background of the use of Captopril, a person may develop a rash on the body, usually occurring in the first 4 weeks of treatment and disappearing with a decrease in dosage or additional reception antihistamines (for example, Parlazin, Suprastin, Fenistil, Claritin, Erius, Telfast, etc.). Also, against the background of taking Captopril, persistent unproductive cough(without sputum discharge), taste disturbance and weight loss, however, all these side effects disappear after 2 to 3 months after discontinuation of the drug.

Because captopril can cause

dizziness

An overdose of Captopril is possible and is manifested by the following

symptoms

• A sharp decrease in blood pressure (hypotension);
• Stupor;
• Bradycardia (decrease in heart rate less than 50 beats per minute);
• Violation of cerebral circulation;
• myocardial infarction;
• Thromboembolism;
• Angioedema;
• kidney failure;
• Violations of water and electrolyte balance.

To eliminate an overdose, it is necessary to completely stop taking the drug, perform a gastric lavage, lay the person on a flat horizontal surface and begin replenishing the volume of circulating blood and electrolytes. To do this, physiological saline, plasma substitutes, etc. are administered intravenously. In addition, symptomatic therapy is performed aimed at maintaining normal functioning vital important organs and systems. For symptomatic therapy, adrenaline is used (increases blood pressure), antihistamines, Hydrocortisone, artificial driver rhythm (pacemaker), and if necessary, carry out hemodialysis.

Captopril should not be taken with drugs that increase the concentration of potassium in the blood, such as potassium-sparing diuretics (Spironolactone, Triamteren, Veroshpiron, etc.), potassium compounds (Asparkam, Panangin, etc.), heparin, potassium-containing table salt substitutes.

Captopril enhances the effect of hypoglycemic drugs (Metformin, Glibenclamide, Gliclazide, Miglitol, Sulfonylurea, etc.), therefore, when they are combined, blood glucose levels should be constantly monitored. In addition, Captopril enhances the effect of drugs for anesthesia, painkillers and alcohol.

Diuretic and vasodilators, antidepressants, antipsychotics, Minoxidil and Baclofen markedly increase hypotensive action Captopril, as a result of which, with their combined use, blood pressure can sharply decrease. Beta-blockers, ganglioblockers, pergolide and interleukin-3 moderately enhance the hypotensive effect of Captopril without causing a sharp decrease in pressure.

When using Captopril in combination with nitrates (Nitroglycerin, Sodium nitroprusside, etc.), it is necessary to reduce the dosage of the latter.

Reduce the severity of the action of Captopril drugs NSAID groups(Indomethacin, Aspirin, Ibuprofen, Nimesulide, Nise, Movalis, Ketanov, etc.), aluminum hydroxide, magnesium hydroxide, carbonate hydroxide, orlistat and clonidine.

Captopril increases the concentration of lithium and digoxin in the blood. Accordingly, taking lithium preparations with Captopril can provoke the development of symptoms of lithium intoxication.

The simultaneous use of Captopril with immunosuppressants (Azathioprine, Cyclophosphamide, etc.), Allopurinol or Procainamide increases the risk of developing neutropenia (a decrease in the level of leukocytes in the blood below normal) and Stevens-Johnson syndrome.

The use of Captopril against the background of ongoing desensitizing therapy, as well as in combination with Estramustine and gliptins (Linagliptin, Sitagliptin, etc.) increases the risk of anaphylactic reactions.

The use of Captopril with gold preparations (Aurothiomolate, etc.) causes reddening of the skin of the face, nausea, vomiting and a decrease in blood pressure.

Captopril tablets can cause the following side effects from various organs and systems:

1. Nervous system and sense organs:

• Increased fatigue;
• Dizziness;
• Headache;
• Depression of the central nervous system;
• Drowsiness;
• confusion;
• Depression;
• Ataxia (impaired coordination of movements);
• convulsions;
• Paresthesia (feeling of numbness, tingling, "goosebumps" in the limbs);
• Impaired vision or smell;
• Violation of taste;
• Fainting.

2. Cardiovascular system and blood:

• Orthostatic hypotension (a sharp drop in pressure when moving from a sitting or lying position to a standing position);
• angina;
• myocardial infarction;
• Arrhythmia;
• palpitations;
• Acute violation of cerebral circulation;
• peripheral edema;
• Lymphadenopathy;
• Anemia;
• Chest pain;
• Raynaud's syndrome;
• Tides;
• pale skin;
• Cardiogenic shock;
• Pulmonary embolism;
• Neutropenia (decrease in the number of neutrophils in the blood);
• Agranulocytosis (complete disappearance of basophils, eosinophils and neutrophils from the blood);
• Thrombocytopenia (decrease in the number of platelets below normal);
• Eosinophilia (an increase in the number of eosinophils above normal).

3. Respiratory system:

• Bronchospasm;
• Dyspnea;
• Pneumonitis interstitial;
• Bronchitis;
• Rhinitis;
• Unproductive cough (without expectoration).

4. Gastrointestinal tract:

• Anorexia;
• Violation of taste;
• Stomatitis;
• Ulcers on the mucous membrane of the mouth and stomach;
• Xerostomia (dry mouth due to insufficient salivation);
• Glossitis (inflammation of the tongue);
• gum hyperplasia;
• Difficulty swallowing;
• Nausea;
• Vomit;
• The phenomena of dyspepsia (flatulence, bloating, abdominal pain, feeling of heaviness in the stomach after eating, etc.);
• Constipation;
• Diarrhea;
• pancreatitis;
• cholestasis;
• cholestatic hepatitis;
• Hepatocellular cirrhosis.

5. Urinary and reproductive systems:

• Violation of the kidneys up to acute renal failure;
• Polyuria (an increase in the amount of urine excreted above normal);
• Oliguria (a decrease in the amount of urine excreted below normal);
• Proteinuria (protein in the urine);
• Increased frequency and quantity of urination;
• Impotence.

6. Skin and soft tissues:

• Redness of the skin of the face;
• Rash on the body;
• itchy skin;
• exfoliative dermatitis;
• Toxic epidermal necrolysis;
• Pemphigus;
• erythroderma;
• Shingles;
• Alopecia (baldness);
• Photodermatitis.

7. Allergic reactions:

• Stevens-Johnson syndrome;
• Hives;
• Quincke's edema;
• Anaphylactic shock.

8. Other:

• Increase in body temperature;
• Chills;
• Sepsis (blood poisoning);
• Arthralgia (pain in the joints);
• Myalgia (pain in the muscles);
• Hyperkalemia (an increase in the level of potassium in the blood above normal);
• Hyponatremia (decrease in the level of sodium in the blood below normal);
• Hypoglycemia (low blood glucose) in people taking insulin or other hypoglycemic drugs at the same time;
• Gynecomastia;
• serum sickness;
• Increased activity of liver enzymes (AsAT, AlAT, alkaline phosphatase, etc.);
• Increase in the concentration of urea, creatinine and bilirubin in the blood, as well as ESR;
• Decreased hemoglobin and hematocrit levels;
• Acidosis;
• False-positive reaction of the test for the presence of a nuclear antigen.

if a person has the following diseases or conditions:

• Hypotension (low blood pressure);
• Severe disorders of the kidneys;
• Liver failure;
• Azotemia;
• Progressive stenosis (narrowing) of the renal arteries;
• Condition after a kidney transplant;
• Stenosis (narrowing) of the mouth of the aorta;
• Stenosis mitral valve or other conditions that prevent the outflow of blood from the heart;
• Primary hyperaldosteronism;
• Hyperkalemia (increased levels of potassium in the blood);
• Cardiogenic shock;
• Pregnancy;
• The period of breastfeeding;
• Age under 18;
• Individual hypersensitivity or allergic reactions to any components of the medicinal product;
• Hereditary angioedema.

The above contraindications are absolute, that is, if they are present, a person should not take Captopril under any circumstances. In addition, there are relative contraindications for use, which are also called restrictions. If a person has restrictions on the use of Captopril, you can drink, but with caution, under the supervision of a physician and after a thorough assessment of the risk/benefit ratio.

To relative contraindications for the use of Captopril refer following states or diseases:

• Leukopenia (low total white blood cell count);
• Thrombocytopenia (low total platelet count in the blood);
• Inhibition of hematopoiesis in the bone marrow;
• cerebral ischemia;
• Diabetes;
• Sodium-restricted diet;
• Being on hemodialysis;
• Old age (over 65 years old);
• Conditions in which the volume of circulating blood is reduced (for example, after vomiting, diarrhea, profuse sweating, etc.);
• Hypertrophic cardiomyopathy;
• Kidney disorders;
• Bilateral stenosis of the renal arteries;
• transplanted kidney;
• Autoimmune diseases of the systemic connective tissue (scleroderma, systemic lupus erythematosus, etc.).

Currently, Captopril has two types of analogues on the domestic pharmaceutical market - these are synonyms and, in fact, analogues. Synonyms include drugs that contain the same active substance as Captopril. Analogues include drugs that contain an active substance different from Captopril, but belong to the group of ACE inhibitors and, accordingly, have a similar spectrum of therapeutic activity.

Synonyms of Captopril are the following drugs:

• Angiopril-25 tablets;
• Blockordil tablets;
• Kapoten tablets.

Captopril's analogues from the group of ACE inhibitors are the following drugs:

• Accupro tablets;
• Amprilan tablets;
• Arentopres tablets;
• Bagopril tablets;
• Berlipril 5, Berlipril 10, Berlipril 20 tablets;
• Vasolong capsules;
• Hypernic tablets;
• Gopten capsules;
• Dapril tablets;
• Dilaprel capsules;
• Diropress tablets;
• Diroton tablets;
• Zokardis 7.5 and Zokardis 30 tablets;
• Zoniksem tablets;
• Inhibase tablets;
• Irumed tablets;
• Quadropril tablets;
• Quinafar tablets;
• Coverex tablets;
• Korpril tablets;
• Lizacard tablets;
• Lysigamma tablets;
• Lisinopril tablets;
• Lisinoton tablets;
• Lisiprex tablets;
• Lisonorm tablets;
• Lizoril tablets;
• Listril tablets;
• Liten tablets;
• metiapril tablets;
• Monopril tablets;
• Moex 7.5 and Moex 15 tablets;
• Parnavel tablets and capsules;
• perindopril tablets;
• Perineva and Perineva Ku-tab tablets;
• Perinpress tablets;
• Pyramil tablets;
• Piristar tablets;
• Prenessa tablets;
• Prestarium and Prestarium A tablets;
• Ramigamma tablets;
• ramicardia capsules;
• Ramipril tablets;
• Ramepress tablets;
• Renipril tablets;
• Renitek tablets;
• Rileys-Sanovel tablets;
• Sinopril tablets;
• Stoppress tablets;
• Tritace tablets;
• Phosicard tablets;
• Fosinap tablets;
• Fosinopril tablets;
• Fosinotec tablets;
• Hartil tablets;
• Quinapril tablets;
• Ednit tablets;
• enalapril tablets;
• Enam tablets;
• Enap and Enap R tablets;
• Enarenal tablets;
• Enafarm tablets;
• Envas tablets.

Most of the reviews about Captopril (more than 85%) are positive, due to the high efficiency of the drug in reducing elevated

blood pressure

The reviews indicate that the drug acts quickly and reduces pressure well, thereby normalizing well-being. Also, the reviews indicate that Captopril is an excellent drug for emergency reduction a sharp increase in pressure. However, for long-term use in hypertension, Captopril is not the drug of choice, because it has a significant number of side effects that are not found in more modern drugs.

There are very few negative reviews about Captopril and they are usually due to the development of severely tolerated side effects that forced them to stop taking the drug.

Captopril and Enalapril are analogue drugs, that is, they belong to the same group of drugs and have a similar spectrum of action. This means that both Captopril and Enalapril lower blood pressure and improve the condition.

in chronic heart failure. However, there are some differences between the drugs.

Firstly, with mild to moderate hypertension, Enalapril is enough to take once a day, and Captopril has to be taken 2 to 3 times a day due to the shorter duration of action. In addition, Enalapril better maintains blood pressure at a normal level with prolonged use.

Therefore, we can conclude that Enalapril is the preferred drug for long-term use in order to maintain blood pressure within acceptable values. And Captopril is more suitable for episodic reduction of sharply increased pressure.

However, Captopril, in comparison with Enalapril, has a better effect on the state of the heart in chronic heart failure, improving the quality of life, increasing the tolerance of physical and other stresses, and also preventing deaths from sudden cardiac disorders. Therefore, in chronic heart failure or other heart diseases, Captopril will be the preferred drug.

Learn more about Enalapril

Learn more about Kapoten

• Captopril 25 mg, 20 tablets - 9 - 13 rubles;
• Captopril 25 mg, 20 tablets manufactured by Sandoz - 85 - 106 rubles;
• Captopril 25 mg, 40 tablets - 12 - 29 rubles;
• Captopril 25 mg, 40 tablets produced by Sandoz - 140 - 167 rubles;
• Captopril 50 mg, 20 tablets - 25 - 50 rubles;
• Captopril 50 mg, 40 tablets - 40 - 61 rubles.

Kapoten or Captopril - which is better? There are many medicines with different names, but in fact they are analogues. However, their prices differ significantly. Examples are Capoten and Captopril. Both drugs have a similar composition, similar properties, side effects and contraindications, but they have different prices. Hence the bewilderment of people why a doctor sometimes prescribes a more expensive remedy.

Captopril and Kapoten are considered identical drugs, but there are still some differences between them. To determine this, you need to pay attention to the composition of drugs. If the main active ingredient in both drugs is the same substance, then the excipients are different. For example, Kapoten contains lactose, corn starch, microcrystalline cellulose and stearic acid. Captopril contains lactose, potato starch, microcrystalline cellulose, povidone, talc and magnesium stearate. That is, Captopril is a purer product, the cost of its production is less, so the product is cheaper. But this does not affect the effectiveness of the drug.

Capoten is an analogue of Captopril. Both drugs can be taken in hypertensive crisis and heart failure on various stages. Both drugs have cardioprotective, hypotensive and vasodilating effects. Means belong to the category of ACE inhibitors. They act on the body as follows:

• slow down the synthesis of angiotensin;
• prevent sodium retention in the body;
• dilate blood vessels;
• increase the minute volume of the heart;
• improve the resistance of the heart muscle to various loads;
• reduce peripheral resistance.

If you regularly use one of these remedies, then the overall health of a person improves. Various physical exercise cause less discomfort. Increases life expectancy. Both are considered very useful. They perform the following functions:

1. Reduce the likelihood of developing diseases of the heart and blood vessels;
2. Stabilize blood pressure.

They are allowed to be taken by the elderly. It has also been established that medications do not affect male potency.

Both drugs have a fast action, as they are instantly absorbed from digestive tract. The patient will feel improvement within half an hour after taking the drug. To enhance the effect of the drug, it is recommended to place the tablet under the tongue, then the blood pressure will quickly decrease.

Both drugs are prescribed for such diseases:

1. Hypertension or hypertension. In this case, you can use the medicine yourself. Physicians may include it in complex therapy. The human body will be easier to tolerate Kapoten during long-term treatment.
2. Nephropathy of the diabetic type.
3. Failure of the heart to different stages. In this case, it is required long-term treatment so usually doctors prescribe both drugs in turn. This will help prevent addiction in the body.
4. Various types of cardiomyopathy.
5. Problems in the functioning of the left ventricle of the heart due to a previously experienced heart attack. Both drugs help restore normal work hearts. Means are prescribed after the patient's condition stabilizes.

Medicines must be taken one hour before meals. The tablet must not be chewed or crushed. The dosage is set by the doctor. If you independently increase the volume of the established dose, this will not improve the effect of the treatment.

Determining what is the difference between Capoten and Captopril, it is necessary to study their side effects and contraindications. It is believed that Capoten is safer, but it has the same side effects as Captopril.

As for contraindications, in this case the differences between these agents are insignificant. Do not use drugs in the following cases:

• individual intolerance to the main active substances that are part of the medicines;
• hypotension;
• problems in the work of the kidneys and liver;
• period of pregnancy and lactation;
• weakened immunity, various immunological diseases;
• under the age of 16.

Both medicines are considered potent, so their uncontrolled use is prohibited. It is necessary to consider the compatibility of both drugs with other drugs. When combined with a drug such as Nifedipine, the hypotensive effect will be enhanced. The patient must be under real supervision. It is better to replace the remedy with other drugs.

If an overdose is allowed, then the patient's blood pressure will drop sharply. Coma and shock are possible.

Side effects that are associated with the functioning of the nervous system are as follows:

• dizziness appears;
• the head starts to hurt constantly;
• the person feels tired and drowsy;
• in rare cases, vision deteriorates.

As for the heart and blood vessels, then Captopril, whose analogues are very diverse, can cause an increase in heart rate, but this happens extremely rarely. With Kapoten, not only does the pulse rate increase, but also due to the drug, hypotension and swelling appear.
A negative effect can also be exerted on digestive system. Captopril can cause loss of appetite, loss of the ability to distinguish between tastes, abdominal pain, and stool changes. With Kapoten, the side effects are as follows:

• diarrhea;
• stomach ache;
• changes in taste sensations;
• numbness of the tongue
• drying of the mucous membranes of the mouth;
• stomatitis;
• hepatitis (in rare cases).

Both drugs affect respiratory system: Captopril is able to cause a dry cough in a patient, the difference is that Kapoten can also provoke a cough, but when it is taken, spasms and swelling of the lungs can develop. Rarely, both drugs cause bleeding, leading to anemia. Sometimes patients have an allergic reaction in the form of swelling, rash, redness.

If you compare Captopril with Capoten, you can find minor differences. Despite the same active substance, the auxiliary compounds in the preparations are different. This does not affect the effect of drugs - both of them are considered effective. But the side effects may differ slightly due to the auxiliary components in the composition of the drugs. One of the medicines contains talc, and this can adversely affect the body. It should be borne in mind that despite the same effect of drugs on a person, prices differ significantly. This is also due to the composition: one of them contains fewer excipients, and the medicine is cheaper due to lower production costs.

Captopril and Kapoten have many analogues, so you can always choose a more suitable option. The main thing is to consult a doctor before doing this. In no case should you self-medicate.

Which is better - Enalapril or Captopril, a question that worries many people. Both medicines are considered analogues of each other. Both drugs belong to the same group of drugs and have similar properties. Not of great importance meanwhile, take captopril or enalapril. Both medications reduce pressure, help improve the condition of the heart muscle in chronic insufficiency.

However, Anaprilin, like Enalapril, differs slightly from Captopril. For example, if a patient has a moderate or mild handicap of hypertension, then it is enough to use Enalapril only 1 time per day, and Captopril will have to be taken up to 3 times a day, since the period of action active components preparation is shorter. In addition, the first drug will be better at maintaining blood pressure at the required level with long-term use. So enalapril - the best option if it is necessary to maintain pressure for a long period of time. As for Captopril, it will be appropriate to take it when it is only necessary to episodically reduce high blood pressure.

When choosing between drugs such as Captopril and Kapoten, it is difficult to say which one is considered the best. These medicines are considered synonymous, since the same component is the main one in their composition. Every drug is good. This means that both tools have the same therapeutic effect on the human body, similar rules of use, contraindications and side effects. But there are some minor differences as well.

Lisinopril and enalapril are often prescribed for high blood pressure and heart failure. Both drugs are included in the pharmacological group of angiotensin converting enzyme inhibitors. Thanks to their action, the formation of such an enzyme slows down, which contributes to vasoconstriction, as a result of which the pressure returns to normal.

It is an ACE inhibitor with antihypertensive properties. The main active ingredient is lisinopril. Release form - tablets. The drug has the following properties:

• reduces the total vascular peripheral resistance;
• lowers blood pressure;
• reduces the load on the heart and pressure in the pulmonary capillaries;
• increases the minute volume of blood ejected by the heart;
• increases the resistance of the heart muscle to stress, especially in patients with heart failure.

The drug most often expands not the veins, but the arteries. Its long-term use reduces myocardial hypertrophy, improves the nutrition of the heart muscle, and increases the life expectancy of patients who have suffered myocardial infarction. The patient's condition improves in the first days of using the remedy, and the effect is fixed after 1-2 months.

Indications for use:

• various forms of arterial hypertension;
• diabetic nephropathy;
• in combination with other drugs in the treatment of chronic heart failure and acute infarction myocardium.

Contraindications:

• hypersensitivity to ACE inhibitors;
• pregnancy and lactation;
• angioedema in history;
• hereditary angioedema;
• age up to 18 years.

Take the medication once a day, adhering to the recommended dosage. The safety of the drug has been proven by various studies. But in case of an overdose, the following side effects may develop:

• severe hypotension, palpitations, myocardial infarction, development of heart failure, pain in the chest, tachycardia, orthostatic hypotension;
• jaundice, hepatitis, pancreatitis, taste disturbance, anorexia, dry mouth;
• asthenic syndrome, convulsive contractions of striated muscles, increased fatigue, confusion, drowsiness, paresthesia, impaired concentration, emotional lability;
• anemia, thrombocytopenia, neutropenia, leukopenia;
• shortness of breath, bronchospasm, dry cough;
• decrease in potency, protein in the urine, impaired renal function, anuria, oliguria, acute renal failure;
• arthralgia, myalgia;
• urticaria, skin rash, Quincke's edema;
• increased concentration of bilirubin, creatine, urea in the blood, increased ESR, eosinophilia, increased activity of hepatic transaminases.

The compatibility of the drug with alcohol is zero. Analogues include: Lisinopril-Teva, Diroton. Manufacturers of the drug - Teva, Shtada, Sopharma, Lupine, Krka, Avant, Ratiopharm, Astrafarm, Grindeks, etc.

Characteristics of Enalapril

it antihypertensive relating to ACE inhibitors. The main active ingredient is enalapril. The drug is made in the form of tablets. Under its action, most often the arteries expand and, to a lesser extent, the veins. The drug improves coronary and renal blood flow. Due to the long-term use of the drug, the hypertrophy of the left ventricle of the myocardium is reduced and the development of heart failure is prevented.

Under the influence of the drug, the myocardium begins to be more actively supplied with blood. Decreased platelet aggregation. Enalapril slows down the development of left ventricular dysfunction in those people who have had a myocardial infarction. The drug has some diuretic effect.

To normalize blood pressure, many patients take the drug for several weeks. The course of treatment of patients with diseases of cardio-vascular system may take at least six months.

The drug is indicated in the following cases:

• primary form of arterial hypertension;
• left ventricular dysfunction and chronic heart failure;
• secondary arterial hypertension occurring against the background of kidney disease.

Contraindications:

• angioedema caused by taking Enalapril;
• individual intolerance to the components of the remedy;
• pregnancy and lactation;
• porphyria.

The drug can cause a sharp decrease in pressure, so it is taken with caution when narrowing the artery of a single kidney, bilateral stenosis of the renal arteries, decompensated forms of coronary artery disease, cerebrovascular diseases and other diseases that prevent the outflow of blood from the left ventricle.

Side effects include:

• dry unproductive cough;
• pharyngitis;
• labored breathing;
• abdominal pain;
• diarrhea;
• nausea;
• cholestasis;
• stomach ulcer;
• anorexia;
• intestinal obstruction;
• skin rash;
• hyperkalemia;
• depression
• blurred vision, drowsiness, headache, dizziness;
• bradycardia, arterial hypotension;
• palpitations, chest pain;
• myositis, myalgia, vasculitis, fever.

Analogues include: Enap, Korandil, Renitek, Miopril, Enam, Berlipril, Invoril, Vazolapril. Producers - "Pharmstandard-Leksredstva JSC", Russia, "Gedeon Richter", Hungary.

Comparison of drugs

similarity

Lisinopril and Enalapril have almost the same effect on the body, effectively lowering blood pressure and helping to reduce the risk cerebral stroke. They are produced in one dosage form, and the effect of their use lasts a day. Medications can be used as the only means, and in combination with other antihypertensive drugs.

What is the difference

The composition of medicines includes various active and auxiliary components. Enalapril has a high ability to penetrate into breast milk and through the placental barrier, and Lisinopril is low. They have different indications for use, contraindications and side effects. Drugs are produced by different companies.

What is stronger

Choosing which drug is stronger - Lisinopril or Enalapril, doctors compare them pharmachologic effect, indications for use, adverse reactions, and also evaluate the individual characteristics of the patient's body. Some patients are more affected by the first drug, others by the second.

From pressure

In the treatment of patients with hypertension, a qualitative result can be achieved - the pressure quickly returns to normal. This indicator persists for a long time in patients taking Lisinopril, so the drug is more effective.

Can enalapril be replaced with lisinopril

In some cases, with intolerance to Enalapril, it can be replaced with Lisinopril. Take it in the same dosage as the first drug. For example, 10 mg of Lisinopril is equivalent to 10 ml of Enalapril.