Anapril
Generic Name
Enalapril Maleate 5 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| anapril 5 mg tablet | ৳ 1.51 | ৳ 15.10 |
Description
Overview of the medicine
Anapril 5 mg Tablet contains Enalapril Maleate, an ACE inhibitor used to treat high blood pressure (hypertension), congestive heart failure, and to prevent heart attacks and strokes. It works by relaxing blood vessels, allowing blood to flow more easily.
Uses & Indications
Dosage
Adults
Hypertension: Initially 5 mg once daily, adjusted based on response up to 10-40 mg daily in single or divided doses. Heart Failure: Initially 2.5 mg once or twice daily, increasing gradually to usual maintenance 5-20 mg daily in single or divided doses.
Elderly
Start with a lower dose (e.g., 2.5 mg) and titrate carefully.
Renal_impairment
Dosage adjustment required based on creatinine clearance. For CrCl < 30 mL/min, initial dose 2.5 mg.
How to Take
Can be taken with or without food. Take at the same time each day.
Mechanism of Action
Enalapril is a prodrug that is hydrolyzed to enalaprilat, a potent angiotensin-converting enzyme (ACE) inhibitor. It prevents the conversion of angiotensin I to angiotensin II, a powerful vasoconstrictor. This leads to decreased vasoconstriction, reduced aldosterone secretion, and increased bradykinin levels, resulting in vasodilation, lower blood pressure, and reduced cardiac workload.
Pharmacokinetics
Onset
1 hour
Excretion
Primarily excreted via urine as enalaprilat and unchanged enalapril.
Half life
11 hours (enalaprilat)
Absorption
Rapidly absorbed after oral administration. Bioavailability is approximately 60%.
Metabolism
Enalapril is a prodrug, hydrolyzed in the liver to enalaprilat, the active metabolite.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes or renal impairment
- Pregnancy (especially second and third trimesters)
Drug Interactions
NSAIDs
Reduced antihypertensive effect, increased risk of renal impairment.
Lithium
Increased serum lithium levels and toxicity.
Aliskiren
Contraindicated in diabetic or renally impaired patients.
Diuretics
Increased hypotensive effect.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension, shock, stupor, bradycardia, electrolyte disturbances, and renal failure. Treatment is symptomatic and supportive, including IV fluid expansion and vasopressors if needed. Hemodialysis can remove enalaprilat from circulation.
Pregnancy & Lactation
Pregnancy: Category D (Fetal toxicity). Not recommended. Discontinue if pregnancy is detected. Lactation: Not recommended due to potential harm to nursing infant.
Side Effects
Contraindications
- History of angioedema related to previous ACE inhibitor treatment
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes or renal impairment
- Pregnancy (especially second and third trimesters)
Drug Interactions
NSAIDs
Reduced antihypertensive effect, increased risk of renal impairment.
Lithium
Increased serum lithium levels and toxicity.
Aliskiren
Contraindicated in diabetic or renally impaired patients.
Diuretics
Increased hypotensive effect.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension, shock, stupor, bradycardia, electrolyte disturbances, and renal failure. Treatment is symptomatic and supportive, including IV fluid expansion and vasopressors if needed. Hemodialysis can remove enalaprilat from circulation.
Pregnancy & Lactation
Pregnancy: Category D (Fetal toxicity). Not recommended. Discontinue if pregnancy is detected. Lactation: Not recommended due to potential harm to nursing infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated Enalapril's efficacy in reducing mortality and morbidity in hypertension and heart failure (e.g., SOLVD trial).
Lab Monitoring
- Blood pressure
- Renal function (creatinine, BUN)
- Serum potassium levels
- Liver function tests (periodically)
Doctor Notes
- Monitor blood pressure and renal function regularly, especially at the initiation of therapy.
- Advise patients about the risk of cough and angioedema.
- Caution in patients with bilateral renal artery stenosis.
- Avoid in pregnant women and those planning pregnancy.
Patient Guidelines
- Take exactly as prescribed.
- Do not stop taking without consulting your doctor.
- Avoid sudden changes in position to prevent dizziness.
- Report any swelling of the face, lips, or throat immediately.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Adopt a healthy diet (low sodium, rich in fruits/vegetables).
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol intake.
- Quit smoking.
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