Anapril
Generic Name
Enalapril Maleate
Manufacturer
Acme Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| anapril 10 mg tablet | ৳ 2.70 | ৳ 27.00 |
Description
Overview of the medicine
Anapril 10 mg Tablet contains Enalapril Maleate, an ACE inhibitor used to treat high blood pressure (hypertension), symptomatic heart failure, and to prevent symptomatic heart failure in patients with asymptomatic left ventricular dysfunction.
Uses & Indications
Dosage
Adults
Hypertension: Initial 5 mg once daily, adjusted according to response; usual range 10-40 mg daily in single or two divided doses. Heart Failure: Initial 2.5 mg once daily, gradually increased to usual range of 5-20 mg daily.
Elderly
Lower initial doses (e.g., 2.5 mg once daily) may be considered, especially if renal function is impaired.
Renal_impairment
Dosage adjustment is necessary. For mild to moderate impairment (CrCl 30-80 mL/min), initial dose 5 mg once daily. For severe impairment (CrCl < 30 mL/min), initial dose 2.5 mg once daily.
How to Take
Take orally, once daily, with or without food. It is recommended to take it at the same time each day.
Mechanism of Action
Enalapril is a prodrug that is hydrolyzed to enalaprilat, which inhibits angiotensin-converting enzyme (ACE). This inhibition prevents the conversion of angiotensin I to angiotensin II, leading to reduced vasoconstriction, decreased aldosterone secretion, and lower blood pressure.
Pharmacokinetics
Onset
Onset of action is usually within 1 hour.
Excretion
Primarily excreted by the kidneys, approximately 60-80% as enalaprilat and enalapril in urine and faeces.
Half life
Effective half-life of enalaprilat is approximately 11 hours.
Absorption
Rapidly absorbed orally. Peak plasma concentration of enalaprilat occurs within 3 to 4 hours. Bioavailability is approximately 60%.
Metabolism
Enalapril is a prodrug; it is rapidly and extensively hydrolyzed in the liver to enalaprilat, the active ACE inhibitor.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m²)
- Pregnancy (second and third trimesters)
Drug Interactions
Lithium
Increased serum lithium levels and lithium toxicity.
Aliskiren
Concomitant use is contraindicated in patients with diabetes or renal impairment.
Diuretics
Increased antihypertensive effect, possibly leading to symptomatic hypotension.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal function deterioration.
Potassium-sparing diuretics/potassium supplements
Increased risk of hyperkalemia.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension. Management involves symptomatic treatment, including intravenous saline infusion to restore blood pressure. Hemodialysis can effectively remove enalaprilat from the circulation.
Pregnancy & Lactation
Pregnancy Category D (second and third trimesters) due to risk of fetal injury and death. Contraindicated during these periods. Use with caution during lactation; small amounts are excreted in breast milk.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m²)
- Pregnancy (second and third trimesters)
Drug Interactions
Lithium
Increased serum lithium levels and lithium toxicity.
Aliskiren
Concomitant use is contraindicated in patients with diabetes or renal impairment.
Diuretics
Increased antihypertensive effect, possibly leading to symptomatic hypotension.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal function deterioration.
Potassium-sparing diuretics/potassium supplements
Increased risk of hyperkalemia.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension. Management involves symptomatic treatment, including intravenous saline infusion to restore blood pressure. Hemodialysis can effectively remove enalaprilat from the circulation.
Pregnancy & Lactation
Pregnancy Category D (second and third trimesters) due to risk of fetal injury and death. Contraindicated during these periods. Use with caution during lactation; small amounts are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on manufacturer specifications.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated Enalapril's efficacy in reducing blood pressure, improving outcomes in heart failure, and slowing the progression of diabetic nephropathy.
Lab Monitoring
- Monitor blood pressure regularly.
- Assess renal function (serum creatinine, BUN) before and periodically during treatment.
- Monitor serum potassium levels, especially in patients with renal impairment, diabetes, or those taking potassium-sparing diuretics.
Doctor Notes
- Educate patients on the importance of adherence and not abruptly discontinuing therapy.
- Advise patients about the symptoms of angioedema and to seek immediate medical attention if they occur.
- Monitor blood pressure, renal function, and serum potassium levels regularly.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking Anapril suddenly without consulting your doctor, even if you feel well.
- Report any unusual side effects, especially swelling of the face, lips, or tongue, or a persistent dry cough.
- Avoid becoming dehydrated, as this can lead to low blood pressure.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Anapril may cause dizziness, especially at the start of treatment or when the dose is increased. Patients should exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy diet low in sodium.
- Engage in regular physical activity as advised by your doctor.
- Limit alcohol consumption.
- Quit smoking.
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