Berlipril instructions for use
Berlipril is an antihypertensive drug of the group of angiotensin converting enzyme (ACE) inhibitors. It is used to treat high blood pressure and heart failure.
Release form and composition
Berlipril is available in tablets, in dosages of 5 mg, 10 mg and 20 mg. In packs of 20, 30, 50 and 100 tablets (10 pieces per blister).
The main active ingredient is enalapril maleate.
Auxiliary components: lactose monohydrate, magnesium carbonate, magnesium stearate, gelatin, sodium carboxymethyl starch, pigments.
Pharmacodynamics. Enalapril, which is the active substance of Berlipril, belongs to the group of angiotensin-converting enzyme inhibitors. The substance inhibits the production of angiotensin II from angiotensin I, resulting in reduced production of aldosterone. This decreases the total peripheral vascular resistance, blood pressure, the load on the heart muscle.
Under the action of the drug, the blood vessels dilate (the arteries are larger than the veins), while the heart rate does not increase. The antihypertensive effect of the drug is accompanied by increased coronary and renal blood flow, but does not affect cerebral circulation.
Enalapril also has mild diuretic properties.
Prolonged use of Berlipril helps reduce left ventricular myocardial hypertrophy, prevents heart failure and inhibits the development of left ventricular dilatation. Improves the blood supply to the myocardium in ischemic disease. Tangible therapeutic effect of the drug in heart failure occurs after a long therapeutic course (6 months or more).
Pharmacokinetics. When taking pills absorbed up to 60% enalapril. Absorption rates are not affected by meal times. Enalapril is cleaved in the liver to the active metabolite - enalaprilat (it inhibits ACE) and inactive chemical compounds. With plasma proteins binds up to 60% of the active substance. The antihypertensive effect develops 60 minutes after taking the pills, the maximum therapeutic effect is noted after 4–6 hours, and it lasts a day.
60 minutes after administration, the maximum concentration of enalapril in the blood is reached. After 3-4 hours, the maximum plasma concentration of enalaprilat is noted. The half-life of enalaprilat is 11 hours. 60% of the drug is excreted by the kidneys, 33% through the intestines. In this case, some of enalapril displayed in unchanged form. Enalaprilat does not penetrate the blood-brain barrier, in small quantities passes through the placental barrier and into breast milk.
Indications for use
- patients with arterial hypertension, including renovascular form;
- patients with chronic heart failure (in combination with other drugs);
- in patients with asymptomatic left ventricular dysfunction to prevent the development of severe heart failure (in complex therapy).
Contraindications to the use of Berlipril are:
- hypersensitivity to enalapril or one of the auxiliary components of the drug, other ACE inhibitors;
- angioedema (idiopathic, hereditary, caused by taking ACE inhibitors;
- lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
- pregnancy and breastfeeding;
- age under 18 years old.
Dosing and Administration
Tablets are taken by mouth, regardless of the time of the meal. The exact dosage of the drug is determined by the doctor for each patient individually, taking into account the type and severity of the pathology, the patient's condition.
The initial daily dose of Berlipril is from 5 mg to 20 mg. In mild hypertension, 5–10 mg enalapril is usually prescribed. In severe forms - 20 mg. Maintenance dosage is also 20 mg. The maximum permissible daily dose is 40 mg (once or in two doses).
The initial daily dosage of Berlipril should not exceed 2.5-5 mg. Gradually, the optimal dosage for the patient is selected depending on the response of the body to treatment. Most often, the maintenance dose of the drug is 20 mg per day. The maximum permissible daily dose is 20 mg.
Patients taking diuretics, it is necessary to cancel the diuretics for 2-3 days before taking Burlipril. If this is not possible, then the initial dose of Berlipril should not exceed 2.5 mg. The same initial dosage is recommended for patients with low serum sodium concentration (below 130 mmol / l) or high creatinine concentration (above 0.14 mmol / l).
Chronic heart failure and asymptomatic dysfunction of the left ventricle
The recommended initial dosage of Berlipril is 2.5 mg per day. This requires strict control of blood pressure. If the drug does not cause hypotension, the dose is gradually increased to 20 mg per day (once or in two doses). Selection of the optimal dosage is carried out for 2-4 weeks. With a pronounced decrease in blood pressure, the dose is gradually reduced. The duration of treatment is set individually.
In some cases, the use of Berlipril may cause the development of undesirable side effects from various organs and body systems.
Since the cardiovascular system:
- severe decrease in blood pressure;
- heart rhythm disorder;
- chest pain;
- tachycardia ;
- angina pectoris ;
- feeling of heartbeat; Raynaud's syndrome ;
- cerebral stroke;
- myocardial infarction.
From the hemopoietic system:
- anemia (including hemolytic, plastic);
- lowering hemoglobin and hematocrit;
- bone marrow suppression;
- swollen lymph nodes;
- autoimmune pathology.
On the part of the respiratory system:
- hoarseness and sore throat;
- allergic alveolitis;
- eosinophilic pneumonia.
From the nervous system:
- increased nervous irritability;
- sleep disturbance - drowsiness or insomnia;
From the digestive system:
- nausea and vomiting;
- abdominal pain and diarrhea;
- change in taste;
- dryness of the oral mucosa;
- loss of appetite;
- dyspeptic symptoms (flatulence, heartburn);
- pancreatitis ;
- peptic ulcer;
- intestinal obstruction;
From the hepatobiliary system:
- liver failure;
- cholestatic or hepatocellular hepatitis (including hepatic necrosis);
- cholestasis (including jaundice).
From the skin:
- pruritus and rash;
- hypersensitivity reaction;
- urticaria ;
- increased sweating;
- erythema multiforme;
- exfoliative dermatitis;
- toxic epidermal necrolysis.
From the excretory system:
- impaired renal function;
- renal failure.
From other organs and systems:
- accommodation disturbance (the ability to clearly distinguish objects at different distances);
- reduced potency;
- muscle cramps ;
- noise in ears;
With an overdose, there is a strong decrease in blood pressure (up to collapse, heart attack, acute cerebrovascular accident), stupor, convulsions. For mild intoxication, gastric lavage is performed, saline is applied orally. In case of severe poisoning with a drug to stabilize blood pressure, physiological saline and plasma substitutes are injected intravenously, if necessary, angiotensin II. Hemodialysis is performed.
In the appointment and application of Burlipril, it is important to consider:
- the drug can be used both independently and in combination with other antihypertensive drugs;
- in older people, enalapril is more slowly excreted from the body; therefore, the initial dosage of Berlipril for this category of patients should be 1.25 mg;
- in chronic renal failure, the maximum daily dosage should not exceed 10 mg;
- during treatment, periodic monitoring of blood pressure and blood composition (potassium, hemoglobin, creatinine, urea), urine protein content should be carried out;
- Patients with a severe form of chronic heart failure, pathologies of cerebral vessels and coronary heart disease during treatment should be under medical supervision (a sharp decrease in pressure can cause renal dysfunction, stroke, heart attack);
- patients taking diuretics, who are on a salt-free diet, during hemodialysis, diarrhea, vomiting, the drug is prescribed with caution (taking Berlipril even in minimal initial doses can cause a sharp and strong decrease in blood pressure in these categories of patients)
- during treatment can not drink alcohol (increases the hypotensive effect);
- Before any surgical (including dental) intervention, the doctor should be warned by the patient about the use of Berlipril;
- Sudden discontinuation of Berlipril does not cause withdrawal (a sharp decrease in blood pressure);
- for people whose activity requires concentration of attention and speed of reactions, including the manager of transport or other mechanisms, use the drug with caution;
- the use of Berlipril during pregnancy is prohibited (taking ACE inhibitors in the II and III trimesters can lead to illness or death of the fetus or newborn);
- if necessary, use Berlipril during lactation breastfeeding should be stopped.
Similar drugs containing enalapril include: Enap, Enam, Renitec, Ednit, Enapril, Vasotec.
Terms and conditions of storage
The drug is stored in a place protected from sunlight, inaccessible to children at a temperature below 25 ° C. Shelf life - 3 years. Do not take pills after the expiration date indicated on the package.
Berlipril 5 tablets 5 mg, 30 pcs. - from 78 rubles.
Berlipril 10 tablets 10 mg, 30 pcs. - from 118 rubles.
Berlipril 20 tablets 20 mg, 30 pcs. - from 169 rubles.