BERLIPRIL 20 mg. 30 tablets
BERLIPRIL 20 mg. 30 tablets
What is Berlipril 20 and what is it used?
Berlipril 20 is an ACE inhibitor - a drug that lowers blood pressure and eases the work of the heart.
Berlipril 20se used for:
- The treatment of high blood pressure (hypertension);
- Treatment of cardiac dysfunction (symptomatic heart failure);
- Preventing the developement of heart failure (symptomatic heart failure) in patients with impaired left ventricular function, which has not yet resulted in signs of heart failure (asymptomatic dysfunction of the left ventricle with left ventricular ejection fraction <35%).
2 Before you take Berlipril 20
Do not take Berlipril 20:
- If you are allergic (hypersensitive) to the active ingredient enalapril maleate, another ACE inhibitor or any other ingredients of Berlipril® 20.
- If there has been tissue swelling (angioedema) to previous treatment with an ACE inhibitor;
- If you have a hereditary tendency to tissue edema or tissue swelling of unknown cause (hereditary or idiopathic angioedema);
- During the last six months of pregnancy.
Take special care with Berlipril 20
If you suffer from any of these diseases or any of these conditions apply to you, please tell your doctor before taking this medicine. Your doctor will take appropriate measures.
- If there is a risk for large decreases in blood pressure due to impaired water-salt balance, e. when taking medications that increase urine output in low-salt diet or due to vomiting or diarrhea;
- If the heart valve into the left ventricle are narrowed or if there is a narrowing of the outlet of the left ventricle;
- If you suffer from heart disease by impaired blood flow (ischemia);
- If you suffer from poor circulation in the brain (cerebrovascular disease sydova);
- If you have impaired kidney function (creatinine clearance <80 ml / min);
- If the renal arteries are narrowed (both sides or one side of a solitary kidney);
- If you have recently had a kidney transplant;
- If the increase in liver enzymes or jaundice;
- If the decreased number of white blood cells (leucopenia) and / or a strong reduction of certain white blood cells have a tendency to infections and severe generalized symptoms (agranulocytosis);
- If you suffer from certain diseases of connective tissue (collagen) affecting the blood vessels;
- If you are taking drugs that suppress the immune system;
- At the same time taking allopurinol (a drug for gout), procainamide (a medicine for irregular heartbeat) or lithium (a medicine for some forms of depression);
- If during the treatment with 20 Berlipril hypersensitivity reaction occurs or tissue swelling (angioedema);
- If you have diabetes;
- In the manifestation of persistent, dry cough;
- At risk to increase potassium levels in the blood;
- An unsatisfactory control of blood pressure due to racial reasons (especially in black patients).
If you need desensitization treatment against insect poisons (eg. Bee or wasp) Berlipril 20 should be temporarily replaced by a suitable medicine containing the active substance from another class. Otherwise may occur life-threatening hypersensitivity reactions (eg. Drop in blood pressure, shortness of breath, vomiting, allergic skin reactions). These reactions may occur after an insect sting (eg. Bee or wasp).
Coadministration of Berlipril 20 during dialysis with certain dialysis membranes (high-flux membranes) or in the treatment of high levels of blood lipids (LDL apheresis with dextran sulphate absorption) can result in severe hypersensitivity reactions and life-threatening shock.
In case of emergency dialysis, or hemofiltration, or in need of LDL apheresis prior to treatment should be replaced with another drug suitable for this purpose (not ACE inhibitor) or to use other dialysis membrane.
Tell your doctor that you are taking Berlipril 20 or need dialysis to mind when treating.
If elective surgery or anesthesia (including a dentist), tell your doctor that you are taking Berlipril 20 as anesthesia may experience a sharp drop in blood pressure.
Tell your doctor immediately if you experience any of the following symptoms:
- Swelling of the face, extremities, lips, mucous membranes, tongue and / or larynx, shortness of breath;
- Yellowing of the skin and mucous membranes;
- Fever, swollen lymph nodes and / or sore throat;
In these cases, you should not continue to take Berlipril 20 and the doctor will take the necessary merki.Prilozhenieto this drug requires regular monitoring by your doctor. Therefore, you must follow the laboratory studies and surveys that your doctor has appointed.
Data about the use of enalapril maleate in children with high blood pressure are limited. No data for use in other indications. There are only data on the tolerability and efficacy of enalapril maleate for the treatment of high blood pressure in children over 6 years of age. Berlipril 20 is only recommended for the treatment of this disease in detsa.Novorodeni and children with renal disease should not be treated with Berlipril® 20.
Taking other medicines
Tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
During concomitant administration of Berlipril 20 with other drugs should be considered:
- Drugs that increase urine output at a reduced excretion of potassium (potassium-sparing diuretics) and potassium preparatiASE inhibitors reduce excretion of potassium in the urine after administration of diuretics. Some diuretics (potassium-sparing diuretics, such as. Spironolactone, triamterene or amiloride), potassium supplements and potassium-containing salt substitutes or heparin (a drug that inhibits blood clotting) may lead to a strong increase of potassium in the blood. Co-administration should be approached with caution and frequent monitoring of potassium levels in the blood.
- Other medicines that increase urine output (thiazides or loop diuretics) Prior treatment with high dose diuretics may result in lack of fluids and the risk of a sharp drop in blood pressure at the beginning of treatment with 20 Berlipril blood pressure lowering effect can reduced if the stop diuretic if the deficiency of liquid, if used, or if the salt treatment with enalapril begin with low doses.
- Other drugs that lower blood pressure (antihypertensives) Coadministration of Berlipril 20 with lowering drugs, blood pressure can increase the blood pressure lowering effect of Berlipril 20 Concomitant administration of nitroglycerin and other nitrates, or other drugs to dilate blood vessels (vasodilators) may further reduce blood pressure.
- Lithium (a medicine for depression) during concomitant administration of ACE inhibitors and lithium reported reversible increase in lithium levels in the blood and harmful (toxic) effects. Concomitant use with certain diuretics (thiazides) may increase the concentration of lithium in the blood and this increase the risk of adverse effects of lithium with ACE inhibitors. Therefore the application of Berlipril 20c lithium is not recommended.
However, if you need the application of this combination, potassium levels should be carefully monitored.
- Drugs used to treat depression and other mental diseases against, drugs, anesthetics (tricyclic antidepressants, neuroleptics, anesthetics, narcotics) Co-administration of ACE inhibitors may result in a greater reduction in blood pressure.
- Medicines for pain and inflammation (NSAIDs) Prolonged use of drugs for pain and inflammation can reduce the blood pressure lowering effect of ACE inhibitors. Co-administration may lead to increased levels of potassium in the blood and to the deterioration of renal function, which is usually reversible. Acute renal failure is also rare, especially in patients with impaired renal function, eg. in elderly patients and in patients with volume depletion.
- Sympathomimetic agents (drugs that lead to effects similar to mediators in the body noradrenaline and adrenaline, eg. Hypertension) Sympathomimetic may reduce the blood pressure lowering effect of ACE inhibitors.
- Drugs that lower blood sugar and insulin (antidiabetics) Concomitant administration of ACE inhibitors may enhance the effect ponizhavashtiyakravnata sugar; there is a risk of decreased blood sugar levels below normal (hypoglycemia). These cases usually occur during the first weeks of combined treatment and in patients with impaired renal function.
- Acetylsalicylic acid (medicine used in low doses for the prevention of heart disease), for the destruction of blood clots (thrombolytic), beta-blockers (medicines to treat high blood pressure)
Can be co-administered with Berlipril® 20.
Taking Berlipril 20 with food and drink
Food does not affect absorption of Berlipril® 20 in the body. Alcohol potentiates the blood pressure lowering effect of ACE inhibitors.
Pregnancy and lactation
Ask your doctor or pharmacist before taking any medicine.
Berlipril 20 should not be used during the first three months of bremennostta.Ako you are pregnant, planning to become pregnant or suspect that you are pregnant, please consult your doctor to change lechenieto.Berlipril 20 should not be used during the last six months of pregnancy because it may harm deteto.Ako still Berlipril 20 was taken in the last six months of pregnancy is recommended ultrasound check of renal function and skull.
The active substance of Berlipril 20 passes into breast milk. Treatment is not recommended during lactation.
Driving and using machines
Use of this medication requires regular monitoring by a doctor. Speed of reactions due to individual differences, can be changed to such an extent as to reduce the ability to drive, use machines or work without safe support. This applies more to the beginning of treatment, dose increase or change in planning as well as for combination with alcohol.
Important information about some of the ingredients of Berlipril 20
Berlipril 20 contains lactose and therefore should not be used in patients with lactase deficiency galactosemia or reduced absorption of glucose / galactose.
3 How to take Berlipril 20?
Always take Berlipril 20tochno as prescribed by your doctor. If you are not sure, ask your lekar.Mnogo is important to take Berlipril 20 as long as prescribed by your doctor will choose lekar.Vashiyat individually for you starting dose, depending on the condition and severity of the disease and will adjust the dose gradually according to the drug effect on blood pressure.
Unless otherwise specified, the usual dose is:
High blood pressure
The starting dose is 5 mg enalapril maleate once daily to a maximum of one tablet Berlipril 20 (equivalent to 20 mg enalapril maleate) depending on the severity of the disease and condition.
- Slightly increased blood pressure
The recommended dose is 5 mg enalapril maleate once daily to 10 mg enalapril maleate once daily.
- Patients with a strongly activated system regulating blood pressure, for example. hypertension in renal disease, salt and / or volume depletion, uncompensated heart failure or severe high blood nalyaganeLechenieto begins with 5 mg enalapril maleate once a day or at a lower dose, once daily. At the beginning of treatment may occur a decrease in blood pressure and need close medical supervision.
- Patients treated with high doses of diuretics
Treatment is started with 5 mg enalapril maleate once a day or at a lower dose, once daily. Prior treatment with high dose diuretics may result in volume depletion and a risk of a fall in blood pressure at the beginning of treatment. Whenever possible these drugs should be discontinued for 2-3 days prior to initiation of treatment with Berlipril 20 should be investigated renal function and potassium levels in the blood.
The normal maintenance dose is one tablet Berlipril 20 (equivalent to 20 mg enalapril maleate) per day. The maximum daily dose of 40 mg enalapril maleate is not to be nadvishava.Za no-low dose tablet has a lower content of the active substance.
Heart failure (symptomatic heart failure), left ventricular dysfunction (asymptomatic left ventricular dysfunction)
Berlipril 20 is used for the treatment of heart failure, usually in addition to diuretic, digitalis or beta-blockers.
The initial dose is 2,5 mg enalapril maleate once dnevno.Lechenieto begins under direct medical supervision to determine the initial effect on the blood pressure.
Maintenance dozaV early treatment Berlipril 20 patients with heart failure, the blood pressure can be lowered. When this persists, the dose should be increased gradually over 2-4 weeks to a maintenance dose of 20 mg enalapril maleate daily. This dose should be administered once daily or divided into two doses, depending on ponosimostta.Maksimalnata dose is twice per tablet Berlipril® 20 (equivalent to 40 mg enalapril maleate), in two divided doses and should not exceed .
For lower doses have tablets with a lower content of the active substance.
You must be very careful when taking the first dose or dose increase. If you feel dizzy or dizziness, consult with your doctor!
Before starting treatment with Berlipril 20 and then should be monitored blood pressure and renal function, as reductions in blood pressure and in rare cases - subsequent renal failure. If you are treated with diuretics, possibly before the application of 20 Berlipril dose should be reduced. Reduction of blood pressure at the beginning of treatment Berlipril 20 does not mean that such effects will be monitored during prolonged treatment with Berlipril 20 and do not preclude further dosing. It should also be monitored levels of potassium in the blood and kidney function.
Dosage in impaired renal function
Intervals between doses of 20 Berlipril should always be extended and / or the dose be reduced.
The doctor will appoint an individual treatment for you.
With moderate renal impairment, the recommended dose of 5-10 mg enalapril maleate once dnevno.Pri severely impaired renal function, the recommended dose 2,5 mg enalapril maleate once dnevno.Pri dialysis patients in the days of dialysis dose of 2.5 mg enalapril maleate once daily. The dosage is determined by the reduction of blood pressure in the days free from dialysis.
Dosage in the elderly
The dosage is determined by the patient's renal function.
Dosage in children
If the child can take tablets, the dose should be adjusted by the physician according to the child's condition and lowering blood pressure.
The recommended starting dose for children with high blood pressure and telesnoteglo from 20 to 50 kg is 2,5 mg enalapril maleate once daily. Children weighing more than 50 grams. Receive enalapril maleate 5 grams daily. Then adjust your dosage by the physician according to the needs of the child. But should not be nadvishavatmaksimalni daily doses of 20 mg enalapril maleate for children weighing 20-50 kg and 40 mg enalapril maleate for children weighing more than 50 kg.
Infants and children with kidney disease should not be treated Berlipril 20.
The tablets should be swallowed whole with a sufficient amount of fluid (eg. With a glass of water). The tablets can be taken with or without food. Usually, the daily amount taken in the morning of a dose, but if necessary can be divided into two doses - morning and vecher.Vashiyat doctor will determine the duration of treatment. Treatment with Berlipril -? 0 usually lasts longer.
Please consult your doctor if you feel that the effect of Berlipril 20 is too strong or too weak.
If you take more than you should Berlipril 20
If you accidentally take too many tablets or if a child accidentally has taken several tablets, immediately contact a doctor or seek emergency medical attention. Depending on the degree of intoxication, the doctor will decide what measures are neobhodimi.V depending on the degree of overdose are possible following symptoms: sudden drop in blood pressure, circulatory shock, fast or slow heartbeat, palpitations, renal failure, shortness of breath, dizziness, anxiety and cough. Of suspected overdose seek emergency doctor!