Different types of medications are used to treat high blood pressure. Among them, there are some called ACEIs or Angiotensin Converting Enzyme Inhibitors. These, as their name implies, prevent the enzyme from doing its job, which is to transform angiotensin I into angiontensin II. For its part, angiotensin II performs a vasopressor function and also increases blood volume by stimulating the production of aldosterone in the adrenal glands. Thus, by inhibiting the production of Angiotensin II, ACEIs prevent this molecule from fulfilling its functions and thus help to lower the pressure.
The first Angiotensin Converting Enzyme inhibitor substance was discovered by a group of Brazilian scientists in the venom of the Bothrops jararaca snake in 1939. Other studies, together with an English team, shed more light on the molecules and finally an American company He designed captopril, the commercial name of the first ACEI, in the 70s. This produced strong side effects, which is why enalapril, ramipril, lisinopril were later created, with milder effects.
At FastlyHealwe tell you about Enalapril: what it is for, dosage and side effects.
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What is Enalapril for
Currently, ACE inhibitors are widely used medicines around the world. In Spain, enalapril is the most widely used drug to treat hypertension , and is in position number ten on the list of Active Principles; it is the antihypertensive par excellence. Enalapril can be a very good treatment option in about 75% of people with high blood pressure , as this percentage corresponds to patients with high levels of angiotensin II.
The mechanism of action of enalapril, and of the other molecules of the ACEI family, is to prevent the formation of this enzyme that acts by increasing blood pressure, by acting by contracting the blood vessels and favoring the passage of sodium to the kidneys . The remaining 25% is made up, in part, of Afro-descendants and older people who suffer from high blood pressure but with low levels of angiotensin II. This group will not benefit from exclusive treatment with enalapril or other ACE inhibitors. If this treatment is used, it will probably be prescribed at the same time as a diuretic.
Furthermore, enalapril is indicated as part of the treatment of heart failure and to treat asymptomatic functional deficit of the left ventricle, as it slows down the process of enlargement of the ventricle. Research in this regard shows that the drug in these cases helps to improve and prolong the life of patients. As well as when used after a myocardial infarction .
On the other hand, enalapril fulfills a protective function of the kidneys in people with diabetes, preventing the waste of proteins or proteinuria. For this reason, it is used in cases of diabetic nephropathy and chronic kidney failure .
Enalapril is marketed in different presentations, the composition of which varies from one country to another. Its active ingredient is enalapril maleate and it is usually combined with sodium bicarbonate, lactose, cornstarch, red and yellow iron oxide and magnesium stearate in different proportions. It can be found in 5 mg, 10 mg, and 20 mg tablets. To prescribe the appropriate dose, the doctor should review the patient’s symptoms and the medications he takes.
Depending on the condition to be treated, different doses are used and in any case it is recommended not to exceed 40 mg / day :
- For hypertensive patients , 5 to 20 mg are used once a day. Although some patients may need to start treatment with less.
- To treat heart failure, it is recommended to start with 2.5 mg and adjust until you reach the appropriate amount, which is usually 20 mg daily taken in one or two parts.
- To protect the kidney in diabetic patients , the creatinine concentration presented by the patient will be taken into account and doses ranging between 2.5 and 10 mg will be recommended, depending on whether it is a dialysed patient.
This treatment requires some getting used to, which is why it starts with low doses that are adjusted. Side effects may appear that prevent the person from performing certain activities safely, so it is necessary to be vigilant and know what the side effects and contraindications of this medicine are.
What side effects does Enalapril have?
The use of captopril, the first ACEI, produced very strong side effects, so the researchers concentrated their efforts on reducing them. Thus, the other ACEIs were created, which although they continue to generate adverse effects, these are milder. The enalapril , is considered a well tolerated medication, although often produces the following side effects :
- Cough and burning in the throat: affects 5 to 10% of people treated. This effect appears 1 to 2 weeks after starting enalapril and can last up to 6 months. It can even cause shortness of breath.
- Hypotension : about 2% of patients will be affected by the decrease in tension, which will be reflected in dizziness, weakness, fatigue, blurred vision and general malaise. This unwanted effect is more common when starting with a very high dose or if people are: Over 60 years old, have dehydration, use diuretics at the same time, or have heart failure.
- High blood potassium or hyperkalemia: This unwanted effect results in severe arrhythmias and affects 3 to 4% of patients. On some occasions, adjusting the diet, reducing the consumption of foods rich in potassium, can minimize this effect. But treatment is usually stopped because it is a dangerous condition.
- Rash and urticaria: both are skin reactions that can occur as an adverse effect. The rash occurs in 0.1 to 1% of cases, and urticaria can affect up to 10%. Although skin conditions do not usually progress, it may happen that the patient develops other allergic reactions such as swelling of the face, extremities, lips, tongue, glottis or larynx.
- Other common side effects: They are headache, depression, nausea, diarrhea, abdominal pain and taste disturbance.
It is of the utmost importance when taking any medical treatment to be attentive to the changes that appear in the body, however slight they may seem. In the specific case of enalapril, do not hesitate to call your specialist if you experience an effect such as a major allergic reaction, either with:
- Swelling that makes it impossible for you to breathe or swallow.
- Reddened skin
- Swelling is also a red flag.
If you are of African descent, be even more alert as these effects can be greater.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
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I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.