Lisinopril or ramipril which is better. Pills for hypertension with a quick effect. Action on the body

Blood pressure problems are one of the most common pathologies diagnosed in people. different ages. Chronic or abrupt change indicators require correction by appropriate medications. One such drug is Lisinopril, from the instructions for use of which we will learn at what pressure it should be used. We will also consider what contraindications should be considered before starting treatment.

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 it 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 illnesses 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;
• lesions of the peripheral nervous system that are caused by diabetes.

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

How to take the drug

Before starting treatment with Lisinopril, you should read the instructions to understand what these pills help with and 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 therapy.

Lisinopril has a prolonged action, so it is enough to take it once a day, preferably in the morning. The medicine should be taken large quantity clean water. An adequate treatment regimen is developed by a cardiologist, taking into account the age of the patient and the presence of chronic diseases.

Dosage of the drug depending on the disease:

1. Diabetic nephropathy - on initial stage treatment should take no more than 10 mg of the drug per day. 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. Maximum safe allowable dose- 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. The number should be reduced physical activity especially during hot weather.

An overdose of the drug is rare - in this case, blood pressure drops sharply, a state of shock is possible, the development of acute kidney 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.

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

Possible violations:

• pain in chest area, a sharp decline indicators blood pressure;
• deterioration of potency;
• violations in digestive system, which 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, there may be allergic reactions as 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, and use during lactation is possible only if 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.

We can definitely say about the lack of compatibility of Lisinopril and alcohol. During treatment, drinks and preparations that contain ethanol should be completely excluded. The drug enhances negative impact alcohol on the body, which can cause the development serious violations from the side of the liver.

Important! Before taking Lisinopril for high blood pressure, you must pass full examination to exclude the presence of kidney pathologies, eliminate dehydration.

Differences from other drugs

Hypertension requires long-term treatment, so sometimes drugs have to be taken for life. To keep from falling therapeutic effect, medicines needs to be changed periodically. A replacement for Lisinopril is selected by a cardiologist.

Lisinopril or Enalapril - which is better?

Lisinopril effectively lowers blood pressure, and therapeutic effect longer than enalapril, which should be taken twice a day. Both drugs are approximately equally tolerated, but enalapril does not negative impact potency and 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 ACE inhibitor group, 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 drugs 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 acceptable minimum, coma and other serious consequences.

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?

The first drug to eliminate high blood pressure by suppressing ACE, was Captopril. 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 pressure normalization at 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 blood pressure in the body.

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, pill studies 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 more prolonged action, so it controls the pressure in the afternoon more effectively than 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 may cause 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, resulting in the elimination of vasoconstriction and growth factors blood pressure. Like Enalapril and Lisinopril, 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 sudden lethal outcome, slows 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. Hypotensive action 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 from high pressure, Ramipril is so far one of the few drugs that not only effectively copes with arterial hypertension, but also simultaneously prevents heart pathologies, the development of MI. According to some experts, it can be considered the gold standard among similar drugs. Especially high efficiency the drug shows 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 above drugs 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. How prophylactic 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 medication, 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 right choice between enalapril, lisinopril and others ACE inhibitors.

Currently, there are about 20 different products on the Russian pharmaceutical market. dosage forms enalapril, therefore, requires an objective study of each of these drugs.

The aim of this study was to evaluate the effect of the angiotensin-converting enzyme (ACE) inhibitor enalapril (ENAM, Dr. Reddy's Laboratories Ltd.) in comparison with the reference drug captopril on the daily blood pressure profile in patients with mild to moderate arterial hypertension.

The study included men aged 45 to 68 years with hypertension Stage II (according to WHO criteria), with a consistently elevated diastolic blood pressure from 95 to 114 mm Hg. Art., who needed regular intake of antihypertensive drugs. Sick, suffering chronic diseases and those in need of accompanying regular treatment, as well as those who had contraindications to long-term treatment ACE inhibitors were not included in the study. In all patients, prior antihypertensive therapy was discontinued before the start of the study, and then placebo was prescribed for 2 weeks. At the end of the placebo period, randomization was performed. Then each patient took enalapril (Enam) for 8 weeks at a daily dose of 10 to 60 mg for 2 doses (average daily dose 25.3+3.6 mg) and the reference drug captopril (Capoten, Akrikhin JSC, Russia) 50 mg 2 times a day (average daily dose 90.1+6.0 mg). Between courses active drugs placebo was given for 2 weeks. The sequence of prescribing drugs was determined by the randomization scheme. Once every 2 weeks, the patient was examined by a doctor who measured blood pressure with a mercury sphygmomanometer and counted the heart rate (HR). 24-hour ambulatory BP monitoring was performed at baseline, after 2 weeks of placebo, and after 8 weeks of treatment with each drug. We used the SpaceLabs Medical system, model 90207 (USA). The technique of carrying out is described in detail by us earlier.

The study included 21 patients. Three dropped out of the study: one patient due to spontaneous normalization of blood pressure during the placebo period; another refused to take part in the study and the third because of bronchoconstriction during the placebo period. The final stage The study included 18 patients aged 43 to 67 years (52.4±1.5) with duration arterial hypertension 1-27 years (11.7±1.9 years). The following indicators were analyzed: average daily systolic blood pressure (SBP, mm Hg); average daily diastolic blood pressure (DBP, mm Hg); heart rate (HR, beats per minute), as well as separately for day and night periods; SBP time index (IVSAD, %) and DBP time index (IVDBP, %) — the percentage of measurements exceeding 140/90 mm Hg. Art. during the day and 120/80 mm Hg. Art. at night; VARSAD and VARDAD (mm Hg) - BP variability (as standard deviation average) separately for day and night.

Statistical analysis was carried out using Excell 7.0 spreadsheets. applied standard methods variation statistics: calculation of averages, standard errors of the mean. Significance of differences was determined using Student's t test.

Table 1. Effect of enalapril, captopril and placebo on the daily BP profile

At the end of the placebo period, mean systolic and diastolic blood pressure measured with a mercury sphygmomanometer (156.3±3.5/103.6±1.5 mm Hg) did not differ significantly from baseline (161.8±4.2/106 .6 ± 1.7 mm Hg). Treatment with enalapril and captopril led to a significant decrease in diastolic blood pressure (to 91.5±2.0 (p<0,001) и 97,1±2,2 мм рт. ст. (p<0,05) соответственно). Значимое снижение систолического АД вызывал только эналаприл [до 140,1±2,5 мм рт. ст. (p<0,001); 146,6±4,6 мм рт. ст. при приеме каптоприла].

The results of 24-hour blood pressure monitoring are presented in Table. 1. As can be seen from the table, against the background of taking placebo, all the analyzed indicators did not undergo significant changes compared to the baseline. Long-term use of enalapril compared with placebo led to a significant decrease in SBP and DBP both on average per day and in the daytime. At night, there was a tendency to decrease in blood pressure, but it was not significant. During the daytime, enalapril caused a significant decrease in IBSAD and IVABP (at night - only IVABP), which indicates a significant decrease in the "pressure load" during these periods. All other indicators against the background of taking enalapril changed unreliably. Captopril significantly reduced, compared with placebo, only the IVSAD in the daytime period. Other analyzed parameters during long-term treatment with captopril compared with placebo did not change significantly.

Side effects (Table 2) were observed in 9 patients taking enalapril (dry cough - 6, sore throat - 1, diuretic effect - 1), and in one patient the drug had to be discontinued due to dry cough and in two - the dose was reduced to 5 mg); when taking captopril - in 6 patients (cough - 3, weakness - 1, headache - 1, sore throat - 1; in two patients, the dose of the drug was reduced by half due to side effects).

The need to study different dosage forms of the same drug has been reliably proven on the materials of the following study.

In 1991, a comparative study of three dosage forms of isosorbide dinitrate was carried out in the Department of Preventive Pharmacology of the State Scientific Research Center for PM of the Ministry of Health of the Russian Federation - 10 mg nitrosorbide tablets (Tomsk Chemical Pharmaceutical Plant, Russia), 10 mg isodinite and 20 mg isodinite retard (Farmakhim, Bulgaria). The results of the study showed that isodinite retard had a weak antianginal and antiischemic effect, slightly different from the placebo effect.

Table 2. Side effects of long-term treatment with captopril and enalapril

Nitrosorbide and isodinite are recognized as quite effective. The reason for the weak action of isodinite retard was established - the poor solubility of the tablets (after placing them in water, they dissolved only after 5 days, and then with active periodic stirring).

Enalapril as a drug has been known for a long time. In Russia, about two dozen dosage forms of enalapril from various foreign companies and one dosage form of domestic production (Kursk Combine of Medicines) are currently registered. As can be seen from the above example, any dosage form of the drug needs to be carefully studied. Moreover, enalapril (enam) is widely used in practical healthcare due to its relatively low cost.

The present study demonstrated the high efficacy of the ACE inhibitor enalapril (Enam) in patients with mild to moderate arterial hypertension. This drug had a significant antihypertensive effect compared with placebo both on average per day and in the daytime. Enalapril belongs to the drugs of prolonged action and therefore it is recommended to prescribe it once a day. However, as practice has shown, for reliable control of blood pressure in patients with mild and moderate arterial hypertension, enalapril should be used 2 times a day.

The antihypertensive effect of captopril compared with placebo was not statistically significant, there was only a trend towards a decrease in blood pressure. Significantly, captopril reduced only the SBP time index.

Thus, the appointment of enalapril (Enam) at a dose of 10 to 60 mg per day for 2 doses during long-term treatment of patients with mild and moderate arterial hypertension allows more successful control of blood pressure during the day than the appointment of captopril at a dose of 50 mg 2 times a day. day. Thus, enalapril (Enam, Dr. Reddy's Laboratories LTD) at a dose of 10 to 60 mg per day for 2 doses in long-term treatment of patients with mild and moderate arterial hypertension has a significantly more pronounced antihypertensive effect than captopril, taken at 50 mg 2 times a day.

Literature

Arterial hypertension accompanies the lives of many people. There are several groups of medicines for the correction of a condition with increased pressure. One of them - angiotensin-converting enzyme inhibitors - includes the drugs Lisinopril and Enalapril. How is one remedy different from another? Which one works best with the fewest side effects? It is important to deal with such questions, as they arise in patients who have received a prescription from a doctor with one of the indicated names.

Angiotensin-converting enzyme inhibitors have a special effect on the patient's body. They lead to the process of slowing down the action of the enzyme, which is a link in the reaction leading to the vasoconstrictor effect.

The chemical formula of the active ingredient - lisinopril, the active substance of the drug of the same name

The drugs interfere with the mechanism of destruction of substances that cause vasodilation, help reduce pressure (systolic and diastolic), reduce the load on the myocardium.

These medicines differ in composition. The active substance of Lisinopril is lisinopril dihydrate. Additional components of the drug:

• magnesium stearate;
• lactose monohydrate;
• methylene chloride;
• silicon dioxide;
• povidone;
• corn starch.

In the production of enalapril, enalapril maleate is used, which acts as an active ingredient. For the therapeutic effect of taking it, it is required that metabolism occurs in the patient's body - the transition of the main substance of the drug into an active, active component. Complement the composition of the drug with other components that are used in their production:

• magnesium stearate;
• sodium bicarbonate;
• lactose monohydrate;
• cellulose;
• sugar;
• talc.

Form of release of drugs

Lisinopril is available in tablet form. Depending on the characteristics of the course of arterial hypertension in a particular patient, the doctor may prescribe a medicine with a different quantitative content of the active ingredient. Manufacturers produce Lisinopril tablets with a dosage of:

• 5 mg;
• 10 mg;
• 20 mg.

Depending on the duration of the upcoming treatment, the patient is recommended to purchase the required amount of medication. A pack may contain from 1 to 5 plates, each of which contains 10 tablets.

The drug Enalapril is also a tablet. The concentration in each of them of the active substance is similar - 5, 10, 20 mg. The box contains 2 blisters of 10 tablets. The active component of enalapril maleate is also used as part of an injection solution, which is prescribed to patients during hospitalization with a diagnosis of "hypertensive crisis".

Indications for prescribing drugs

The main indication for the appointment of the two drugs under consideration is arterial hypertension. Each of the drugs has different indications for prescribing. Enalapril is used in the treatment of patients with a confirmed diagnosis:

• dysfunction of the left ventricle of the heart;
• heart failure in a chronic course.

Other reasons for the use of Lisinopril:

• chronic cardiovascular insufficiency;
• acute myocardial infarction (in the absence of arterial hypotension);
• diabetes mellitus accompanied by diabetic nephropathy.

In each case, the medicine is prescribed by a specialist. It is extremely dangerous to start treatment with any of them on your own. Even after medical recommendations, the patient should carefully read the instructions for using the drug.

Dosage and regimen of treatment with drugs of the ACE group

General approaches to taking the described drugs:

• tablets are taken regardless of food intake;
• they are taken at certain times of the day;
• the drug is washed down with a small amount of water.

Enalapril: application features

Depending on the diagnosis, Enalapril tablets are prescribed according to different schemes, different daily dosages are used.

1. Arterial hypertension. Monotherapy begins with the establishment of a daily dose of 5 mg. If the patient's pressure remains high, the dosage of the drug is adjusted to 10 mg. The beginning of treatment, an increase in the amount of the drug (the first hours after taking the drug until the blood pressure stabilizes) should be monitored by a doctor. The maximum daily dose of the drug is 40 mg, which is divided into 2 doses. Then the doctor evaluates the effect of the drug and prescribes maintenance therapy to the patient with an individual dosage of 10 to 40 mg, which must be taken once or divided into 2 daily doses. With hypertension of the renovascular type, the dosage of the drug requires individual selection, treatment begins with 5 mg of the drug, increasing, if necessary, the daily intake to 20 mg.
2. Cardiovascular insufficiency. The beginning of the use of Enalapril begins with a small dose - 2.5 mg. The doctor evaluates the patient's condition within a few weeks, adjusts the dosage of the drug, and increases its daily intake to 20 mg. The medicine should be taken in two doses. The use of the drug is preceded by a complete examination of the patient.
3. Dysfunction of the left ventricle of the heart. The condition causes a past myocardial infarction. Treatment is prescribed on an individual basis.

Lisinopril: features of use

How can Lisinopril be used differently? Use a single dose of the drug. Doctors recommend taking pills in the morning. During therapy, there are no identical treatment regimens, each patient receives different recommendations for taking the drug.

1. With arterial hypertension, the drug is not supplemented with other drugs. It is suggested to start treatment with 5 mg per day. If the pressure indicators remain the same or decrease slightly after a long period of time, the doctor may decide to increase the dosage of Lisinopril, which increases to 20-40 mg. According to statistics, it is enough for the patient to consume no more than 20 ml of the drug per day. The desired therapeutic result in most cases is achieved 2 weeks after its onset, in some patients - after a month of treatment. Renovascular hypertension requires a reduced dosage of medication. Daily intake at the beginning will be 2.5-5 mg, then the dosage is regulated.
2. With CHF, tablets are taken in an amount of 2.5 mg per day, then a maintenance dose of the drug is set - up to 5-20 mg.
3. Acute myocardial infarction. Lisinopril is supposed to be used in combination with other drugs. Tablets are used in a special way: 1 day - 5 mg, a day later - 5 mg. This is followed by a 48-hour break, treatment is resumed with the use of 10 mg of the drug, this daily dosage is maintained for at least 6 weeks. If a heart attack is accompanied by low blood pressure, these dosages are halved.
4. For patients with diabetic nephropathy, lisinopril (10 mg) is prescribed for a single dose per day. In some cases, the dose is increased to 20 mg.

How drugs work on the patient's body

Despite the fact that Lisinopril and Enalapril belong to the same group of drugs, there is a difference in their therapeutic effect on the human body.

Regular use of Enalapril leads to the following results:

• spasms of arterial walls are reduced or eliminated;
• there is a normalization of blood pressure - both systolic and diastolic;
• blood circulation improves;
• the ability of blood to form blood clots decreases;
• improves the general condition associated with heart failure;
• hypertrophy of the left heart ventricle is corrected;
• there is a diuretic effect.

If the patient is prescribed Lisinopril, the treatment with the drug achieves the following:

• pressure reaches values ​​close to normal;
• reduced hypertrophy of the myocardium, vascular walls;
• the stability of the heart muscles increases with increased physical activity, which is important in the diagnosis of "heart failure";
• excess sodium salts are excreted from the body.

In what cases is medication contraindicated?

The choice of treatment for the treatment of one of the described drugs may be prevented by the diseases or pathological conditions diagnosed in the patient. The doctor will prohibit the use of Lisinopril in the following cases:

• angioedema (hereditary);
• hypersensitivity to the components of the drug;
• aortic stenosis;
• disorders of cerebral circulation;
• pathologies of the coronary vessels;
• ischemic heart disease;
• diseases associated with dysfunction of hematopoiesis;
• pathological conditions of connective tissues;
• violations of kidney function of a pronounced nature;
• hypoglycemic state;
• low pressure readings.

Treatment with Lisinopril is prohibited for children under the age of majority, for the elderly. The use of such tablets during pregnancy is excluded.

If a woman continues to take the medicine, there is a high risk of developing pathologies in the child: skull hypoplasia, hyperkalemia, abnormal development and functioning of the kidneys. Intrauterine development of the fetus can end in his death.

Enalapril treatment is not prescribed if the patient is diagnosed with:

• bilateral stenosis of the arteries of the kidneys;
• porphyrin disease;
• mitral valve pathology;
• liver dysfunction;
• hyperkalemia;
• severe heart failure;
• hypertrophic cardiomyopathy;
• intolerance to the components of the drug.

Enalapril is not used in the treatment of children under 12 years of age. The medicine is dangerous for pregnant women. It is forbidden to treat the drug for young mothers who prefer breastfeeding the baby.

The danger of side effects

When treating with Enalapril and Lisinopril, some patients note the occurrence of side effects that appear when taking each of the items:

• a sharp, significant decrease in blood pressure;
• the appearance of a headache, accompanied by severe dizziness, tinnitus;
• pain in the heart area;
• prolonged cough, which is characterized as dry and hoarse, barking;
• change in taste sensations;
• pathological changes in the composition of the blood;
• changes in the work of the gastrointestinal tract;
• allergic reactions;
• sleep disorders.

What is the difference in the side effects that occur? Enalapril negatively affects liver function, Lisinopril can disrupt kidney function. Such a difference obliges the doctor to carefully examine the state of health, to foresee all the risks for the patient before issuing a prescription for the purchase of medicine.

In order for the medicine to have only a good effect, you need to pay attention to compliance with the rules:

• regular monitoring of blood pressure indicators;
• periodic clinical blood tests, comparison of their results (before treatment and during it);
• regular visits to the doctor to diagnose the work of the heart, liver, kidneys, assess the general condition, identify side effects;
• the use of only recommended doses of drugs, treatment according to an agreed scheme;
• exclusion of the use of any alcohol during treatment.

What drug is the most effective?

The question of how Lisinopril or Enalapril works, which is better and more effective, is of concern not only to drug users. Comparison of the medicinal properties of the tablets was carried out by doctors. The group of patients treated for arterial hypertension, whose pressure indicators were in the value of 140/90 mm Hg. Art. prescribed one of the drugs. In each case, the dosage of drugs, the scheme of its administration, necessary for the treatment of a particular patient, were used.

Today, many people complain of high blood pressure. There are many reasons for this: an unhealthy lifestyle, a hereditary factor, complications due to other diseases, and dysfunction of the circulatory system.

how to deal with it?

An increase in pressure in the medical language is called arterial hypertension. Often, to bring it back to normal, drugs of the ACE inhibitor group are used. They reduce the content of substances in the blood that make the walls of blood vessels relaxed, due to which they lose their tone, the blood begins to move at high speed. A decrease in the concentration of these substances returns the tone to the vessels.

There are a lot of such drugs on the domestic pharmaceutical market. This article will consider the properties of the drug "Lizinopril", instructions for use, analogues of the remedy. Since there are many drugs, it is difficult to choose the most effective from the entire list. Naturally, a doctor should do this, because these funds are sold only by prescription. Lisinopril is no exception. Analogues and replacement of this drug should be as similar as possible to it in its basic characteristics.

Medicine "Lizinopril": instruction

Naturally, in order to choose a replacement for a drug, you need to know all the provisions of the manual for its use. Of course, the instructions for analogues of the drug will not indicate to the Lisinopril remedy. This medicine is produced in Ukraine, Croatia, Germany, and patients respond positively to its quality.

For now, let's dwell on the characteristics of the drug "Lisinopril". Analogues and replacement will be discussed below. Moreover, the most popular and as close as possible in terms of impact on the functioning of the circulatory system of the body.

The medicine "Lizinopril" (its analogues too) has the property of expanding precisely the arteries, it has little effect on the veins. Improvement in the patient's condition is observed six hours after administration.

Treatment of arterial hypertension with this drug can be prolonged. In acute, often recurring attacks, this medicine is taken without fail. In the initial stages of the manifestation of the disease, often a two-month therapy is enough to stabilize and bring the pressure back to normal.

When the drug is canceled, there is no sharp change in blood pressure, that is, the body does not get used to the components contained in its composition.

The main advantage of the drug is that Lisinopril (analogues may not have this property) is suitable for treating people with diabetes, its action does not provoke hypoglycemia (lowering blood sugar levels to a critically dangerous level). Therefore, this medicine is in high demand.

What is included in the composition of the drug "Lisinopril"? Analogues and drug replacements must also contain identical components or part of them.

The drug includes the active substance lisinopril and auxiliary elements: corn starch, iron stearate, mannitol, calcium hydrogen phosphate.

The medicine "Lizinopril" is produced in the form of tablets (analogues and a replacement will be selected according to this parameter). One tablet of the drug may contain 5 mg of lisinopril, 10 mg, 20 mg, 30 mg, 40 mg, 50 mg. Naturally, the price of the medicine depends on the concentration of the active substance in the pills.

The method of taking the drug is very simple. One tablet is prescribed (the concentration is indicated by the doctor) to be taken once a day, preferably in the morning. It is taken orally, washed down with a glass of water.

The active substance lisinopril does not change in the body and is excreted in its pure form by the kidneys. It is quickly absorbed in the gastrointestinal tract, so it gives a relatively quick relief effect. The effectiveness of the medicine does not depend on whether it is taken before or after meals.

A drug is recommended for the treatment, as mentioned above, of arterial hypertension, heart failure, acute myocardial infarction. The analogue of Lisinopril tablets also effectively treats this entire list of diseases, but it needs to be specified in the instructions.

The drug is contraindicated in case of hypersensitivity to lisinopril, patients under 18 years of age, with hereditary Quincke's edema, during pregnancy.

Despite its high efficacy, this medicine can cause headaches, occasional dizziness, drowsiness, weakness, dry cough, nausea, vomiting, pruritus, fever, palpitations.

The drug "Lizinopril" is often used in the treatment of patients with high blood pressure. Neither doctors nor patients refuse his appointments. It gently affects the body, although there are side effects, but according to people's reviews, they are rare and incomparable with the high effect of the drug.

This is a relatively inexpensive drug, so many people prefer it for manifestations of arterial hypertension. People who are prescribed the drug for the treatment of heart failure take it in combination with other drugs, so their improvement is associated not only with the use of Lisinopril.

Preparations "Lizinopril-teva", "Lizinopril ratiopharm", "Lizinopril actavis": description and reviews

All analogues of "Lizinopril" (patient reviews also note this), the name of which begins with the word "lisinopril", are identical drugs, that is, they are similar in composition, in terms of effects on the human body. The difference lies only in the manufacturer and packaging.

We are talking about the drug "Lizinopril-teva", it is produced in Hungary, the manufacturer is the pharmaceutical plant Teva Private Co. Ltd. Released by prescription. Analogues of "Lizinopril-Teva" - the drug "Lizinopril Actavis", is produced in Iceland, the manufacturer is JSC "Aktavis Group" and the drug "Lizinopril ratiopharm", is produced in Germany, the manufacturer is Merckle GmbH. They are also released strictly on doctor's orders.

Patients note the high quality of the German medicine Lisinopril ratiopharm. Analogues of the drug "Lizinopril" have different names from it. They are described below.

Medication "Irumed"

This is an analogue of the drug "Lizinopril" in terms of the active substance. Produced in Croatia by Belupo. The principle of action on the body is identical to the main drug. Appointment is given once a day. Tablets may contain 5 mg, 10 mg or 20 mg of lisinopril.

Medicine "Dapril"

This is also an analogue of the drug "Lizinopril" in terms of the main active substance. The medicine is produced in Cyprus, the manufacturer is Medochemie. Available in tablets containing 5 mg, 10 mg, 20 mg of active ingredient. You need to take the medicine at the same time, no matter before or after meals. Reception is scheduled once a day.

Means "Sinopril"

This medicine also contains the active substance lisinopril in its composition, it is prescribed once a day. Available in the form of tablets (5 mg, 10 mg, 20 mg). It has the same indications for use as the drug Lisinopril. Tablets are made in Turkey by ECZACIBASI.

The medicine "Captopril": instructions

Many people are interested today, what helps better: the drug "Lizinopril" (analogues and replacement) or "Captopril"? This medicine is also classified as an ACE inhibitor.

The main active ingredient captopril has the same properties as lisinopril. This is an analogue of the drug in question in terms of its effect on the stabilization of blood pressure.

The drug "Captopril" is produced in India, the manufacturer is Shreya Life Sciences Pvt. Ltd. He has a more complex reception scheme. It is drunk before meals two or three times a day. Available in the form of tablets 25 mg, 50 mg, 100 mg.

Not suitable for the treatment of patients with diabetes mellitus, has a longer list of side effects.

The drug "Amlodipine"

Sometimes doctors prescribe Amlodipine instead of Lisinopril. It is not always possible to find analogues with a minimum number of side effects. This drug can act as a substitute, but it has more negative effects. The use of this remedy can negatively affect the patient's vision, cause impotence in men, chest pain, and cause jaundice. The active ingredient in this drug is amlodipine. Produced in Ukraine, manufacturer PJSC KhFZ Krasnaya Zvezda.

Produced in tablets of 5 mg and 10 mg. Lisinopril, amlodipine are analogues, but the effect of amlodipine is not as gentle on the patient's body as lisinopril, and is slower.

Having considered the list of analogues of the drug "Lizinopril", you can understand that there are a lot of them. More confidence is caused by drugs made in Germany. Their quality is always confirmed in practice. The Indian counterparts are doubtful.

Do not forget that both Lisinopril and its substitutes are prescribed only by a doctor, self-treatment can harm health, there may be cases of overdose, which can even lead to death. Do not forget about the side effects.

The above drugs are the most popular in the treatment of arterial hypertension.