Enap 20 mg tablets 20

Size chart
Women's clothing size
Euro 32/34 36 38 40
USA 0/2 4 6 8
Bust(in) 31-32 33 34 36
Bust(cm) 80.5-82.5 84.5 87 92
Waist(in) 24-25 26 27 29
Waist(cm) 62.5-64.5 66.5 69 74
Hips(in) 34-35 36 37 39
Hips(cm) 87.5-89.5 91.5 94 99
How To Measure Your Bust

With your arms relaxed at your sides, measure around the fullest part of your chest.

How To Measure Your Waist

Measure around the narrowest part of your natural waist, generally around the belly button. To ensure a comfortable fit, keep one finger between the measuring tape and your body.

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Active ingredient
20 mg
Active substance: enalapril maleate 20 mg.
Excipients: lactose monohydrate, hydroxypropyl cellulose,
corn starch, sodium bicarbonate, talc, magnesium stearate.
Pharmacological properties

ACE inhibitor. It is a prodrug from which the active metabolite enalaprilate is formed in the body. It is believed that the mechanism of antihypertensive action is associated with competitive inhibition of ACE activity, which leads to a decrease in the rate of conversion of angiotensin I to angiotensin II (which has a pronounced vasoconstrictor effect and stimulates the secretion of aldosterone in the adrenal cortex).

As a result of a decrease in the concentration of angiotensin II, there is a secondary increase in renin activity plasma by eliminating negative feedback on the release of renin and a direct decrease in the secretion of aldosterone. In addition, enalaprilate appears to have an effect on the kinin-kallikrein system, preventing the breakdown of bradykinin.

Due to the vasodilating effect, it reduces OPSS (afterload), jamming pressure in the pulmonary capillaries (preload) and resistance in the pulmonary vessels; increases the minute volume of the heart and exercise tolerance.

In patients with chronic heart failure with prolonged use, enalapril increases exercise tolerance and reduces the severity of heart failure (assessed according to the NYHA criteria). Enalapril in patients with mild to moderate heart failure slows down its progression, and also slows down the development of left ventricular dilatation. With left ventricular dysfunction, enalapril reduces the risk of developing major ischemic outcomes (including the incidence of development myocardial infarction and the number of hospitalizations for unstable angina).

Indications for use

Arterial hypertension (including renovascular), chronic heart failure (as part of combination therapy).

Essential hypertension.

Chronic heart failure (as part of combination therapy).

Prevention of the development of clinically severe heart failure in patients with asymptomatic left ventricular dysfunction (as part of combination therapy).

Prevention of coronary ischemia in patients with left ventricular dysfunction in order to reduce the incidence of myocardial infarction and reduce the frequency of hospitalizations for unstable angina.

  • hypersensitivity to enalapril or other components of the drug,
  • Increased sensitivity to other ACE inhibitors,
  • angioedema in the anamnesis, including associated with the use of ACE inhibitors (allergic reaction with a sharp swelling of the lips, face, neck and, possibly, hands and feet, accompanied by suffocation and hoarseness of the voice),
  • Porphyria
  • patients who have ever had angioedema.
Use in pregnancy and lactation

During pregnancy and lactation, you can not prescribe the drug.

If pregnancy occurs during the period of treatment with Enap, you should inform your doctor as soon as possible. He will prescribe another antihypertensive treatment.

Special instructions

Arterial hypotension (a sharp decrease in blood pressure) can be observed (even a few hours after taking the first dose) in patients with severe heart failure or severe impaired function kidneys, as well as in patients with impaired water-electrolyte balance due to treatment with diuretics, salt-free diet, diarrhea, vomiting or those on hemodialysis. A pronounced decrease in blood pressure (BP) usually manifests itself in the form of nausea, increased heart rate (heart rate) and fainting.

In the case of arterial hypotension, the patient needs to take a horizontal position, with a low headboard and call a doctor.

Arterial hypotension and its severe consequences are rare and transient. Transient arterial hypotension is not a contraindication to further treatment with the drug. As soon as the blood pressure stabilizes, the patient normally tolerates subsequent doses of the drug. Arterial hypotension can be avoided by interrupting treatment with diuretics and abandoning a salt-free diet before starting treatment with Enap, if possible.

If there are relapses of arterial hypotension, accompanied by symptoms such as nausea, increased heart rate (HEART rate) and fainting, you should consult a doctor.

Kidney function should be monitored before treatment and during treatment with Enap.

During the period of treatment with Enap, an increase in the level of potassium in the blood serum is possible, especially in patients with chronic renal failure, diabetes mellitus, with the simultaneous appointment of potassium-sparing diuretics (such as spironolactone, amiloride and triamterene) or tablets containing potassium. Therefore, when taking Enap and these drugs at the same time, it is necessary to strictly follow the doctor's instructions. If the patient feels muscle weakness or irregular heartbeats during the period of such treatment, you should immediately inform your doctor.

Allergic reactions can develop due to the use of certain types of filter membranes used in hemodialysis or other types of blood filtration (apheresis). If the doctor plans such treatment, you should warn him about the simultaneous treatment with Enap.

During the treatment of allergies (desensitization) to aspen or bee venom, hypersensitivity reactions may be noted. If the doctor plans such treatment, you should warn him about the simultaneous treatment with Enap.
The efficacy and safety of the drug in the treatment of children has not been established, so it should not be prescribed to children.

Effect on the ability to drive vehicles and control mechanisms: in some patients, the drug can cause severe arterial hypotension and dizziness, especially at the beginning of treatment, thus exerting an indirect and transient effect on the ability to drive vehicles and machinery.

Dosage and Administration

Tablets should be taken orally, washed down with a small amount of liquid. Tablets can be taken before, in time or after eating. You should get used to taking the drug regularly and at the same time.

If the patient missed taking the drug, it should be taken as soon as possible, but not if there are several hours left before taking the next dose according to the scheme. In this case, you should take only the dose following the scheme and do not take the missed dose. Doses should never be doubled.

Treatment with Enap requires regular medical examinations, especially at the beginning of treatment and / or when determining the most appropriate dose of the drug. The frequency of medical examinations is determined by the attending physician. The dose of the drug is always adjusted depending on the patient's condition.

Treatment of arterial hypertension: the recommended initial dose is 5 mg once a day. After taking the initial dose, patients should be under medical supervision for 2 hours and an additional 1 hour until the arterial stabilizes. pressure. Dose adjustment depends on the achievement of a therapeutic effect (lowering blood pressure) and in the absence of a clinical effect, increase after 1-2 weeks by 5 mg. Usually the maintenance dose is from 10 to 20 mg, if necessary and with sufficiently good tolerability, the dose can be increased to 40 mg per day. The maximum daily dose is 40 mg. At higher doses, it is advisable to divide into 2 doses.

Treatment of arterial hypertension in special clinical cases: the initial dose for patients who could not interrupt the use of diuretics before the start of treatment with Enap is 2.5 mg in a single dose. Patients with hyponatremia (serum sodium ion concentration less than 130 mmol / l) or serum creatinine concentration of more than 0.14 mmol / l initial dose - 2.5 mg 1 time per day. In elderly patients, a more pronounced hypotensive effect and an extension of the duration of action of the drug are more often observed, which is associated with reducing the rate of excretion of enalapril, so the recommended initial dose to the elderly is 1.25 mg.

Treatment of congestive heart failure: the recommended initial dose is 2.5 mg once a day. The dose of Enap should be increased gradually until maximum clinical effect is achieved, usually after 2 to 4 weeks. The usual maintenance dose is 2.5 mg to 10 mg as a single dose; the maximum maintenance dose is 20 mg twice a day.

Treatment of asymptomatic left ventricular dysfunction: the recommended initial dose is 2.5 mg twice a day; some dose adjustment depends on the tolerability of the drug to patients. Usually, the maintenance dose is 10 mg twice a day.

Treatment of arterial hypertension in kidney diseases: the dose of Enapa is determined depending on renal function and / or creatinine clearance. For patients with creatinine clearance of more than 0.5 ml / s (30 ml / min) the initial dose is 5 mg per day. For patients with creatinine clearance less than 0.5 ml / s (30 ml / min), the initial dose is 2.5 mg per day and is gradually increased until a clinical effect is achieved.

Treatment of patients on hemodialysis: for patients on the day of hemodialysis - 2.5 mg; on other days, the doctor adjusts the dose in accordance with blood pressure indicators.
Treatment with Enap is long-term, usually throughout life, unless circumstances arise that require its cancellation.


If the patient has taken too many tablets at one time, you should immediately call a doctor.

Symptoms: excessive lowering of blood pressure (BP) up to the development of collapse, myocardial infarction, acute cerebral circulation disorders or thromboembolic complications, convulsions, stupor.

Treatment: the patient is transferred to a horizontal position with a low headboard. In mild cases, gastric lavage and ingestion of saline are indicated, in more serious cases - measures aimed at stabilizing blood pressure (BP), intravenous administration of saline, plasma substitutes, if necessary - intravenous administration of angiotensin II, hemodialysis (rate of excretion of enalaprilate - 62 ml / min).

Side effects

From the nervous system: dizziness, headache, feeling tired, increased fatigue; very rarely when used in high doses - sleep disorders, nervousness, depression, imbalance, paresthesia, tinnitus.

From the cardiovascular system: orthostatic hypotension, fainting, palpitations, pain in the heart; very rarely when used in high doses - hot flashes.

From the digestive system: nausea; rarely - dry mouth, pain in abdomen, vomiting, diarrhea, constipation, impaired liver function, increased activity of hepatic transaminases, increased concentration of bilirubin in the blood, hepatitis, pancreatitis; very rarely when used in high doses - glossitis.

On the part of the hematopoietic system: rarely - neutropenia; in patients with autoimmune diseases - agranulocytosis.

From the urinary system: rarely - impaired renal function, proteinuria.

From the respiratory system: dry cough.

From the reproductive system: very rarely when used in high doses - impotence.

Dermatological reactions: very rarely when used in high doses - hair loss.

Allergic reactions: rarely - skin rash, angioedema.

Other: rarely - hyperkalemia, muscle cramps.

Storage conditions
At a temperature not exceeding 25 ° C, in the original packaging.

Store in out of reach of children.

Shelf life 3 years.

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Product Details

Data sheet

Dosage form
20 mg
Number of tablets
INN Russian
Russian title
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