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What Enap-H 10 mg / 25 mg is and what it is used for
The Enap-H 10 mg / 25 mg tablets are used to lower blood pressure. Enalapril belongs to the group of angiotensin converting enzyme (ACE) inhibitors. This drug suppresses the activity of angiotensin converting enzyme. During treatment with enalapril, the blood vessels are enlarged, causing lower blood pressure and increased blood and oxygen flow to the heart muscle and other organs. Hydrochlorothiazide belongs to a group of medicines that increase urine output (diuretics). This drug boosts urinary output and reduces blood pressure. The antihypertensive activity of the combination enalapril and hydrochlorothiazide is stronger than the activity of the two medicines alone.
This medicine is recommended for the treatment of high blood pressure (arterial hypertension) when combined treatment is required.
2. What you need to know before you take Enap-H 10 mg / 25 mg
Do not take Enap-H 10 mg / 25 mg
if you are allergic (hypersensitive) to enalapril, hydrochlorothiazide or sulphonamides or any of the other ingredients of this medicine (listed in section 6) or other ACE inhibitors;
if the use of other ACE inhibitors has already triggered allergic reactions with sudden swelling of the lips and face, neck, possibly hands and feet or suffocation and hoarseness (angioedema);
if you have hereditary angioedema or angioedema due to some other, unknown causes;
if you have severe impairment of renal or hepatic function; if you can not urinate;
if you are pregnant after the third month. (It is also good to avoid taking Enap-H 10 mg / 25 mg at the onset of pregnancy - See Pregnancy Point); if you have diabetes or have impaired kidney function and are being treated with a medicine to lower blood pressure containing aliskiren.
Warnings and precautions
Talk to your doctor or pharmacist before taking Enap-H 10 mg / 25 mg: if you have low blood pressure and impaired water-salt imbalance if you suffer from a heart disease called "aortic stenosis", "hypertrophic cardiomyopathy" or "difficulty blood drainage ",
if you have taken medicines that increase the amount of urine (diuretics)
if you have kidney problems or are on dialysis,
if you have had a recent kidney transplant,
if you have liver problems,
if you are being treated for diabetes,
if you suffer from gout,
if you have had an allergic reaction to lactose because lactose is one of the inactive ingredients of this medicine,
if you are being treated for severe connective tissue disease called systemic lupus erythematosus,
if you are on a diet and especially on a low-salt diet,
if you have been told by your doctor that you have an intolerance to some sugars if you are taking lithium used to treat some mental illness if you are taking any of the following medicines used to treat high blood pressure:
- angiotensin II receptor blocker (ARB) (also known as sartens - for example, valsartan, telmisartan, irbesartan), especially if you have kidney problems associated with diabetes, aliskiren.
Your doctor may periodically check your kidney function, blood pressure and the amount of electrolytes (eg potassium) in your blood.
See also the information titled "Do not take Enap-H".
You should also tell your doctor that you are taking enalapril / hydrochlorothiazide:
(even with a dentist), tell your doctor that you are taking Enap-H 10 mg / 25 mg as there is an increased risk of developing hypotension during general anesthesia,
if treatment with Enap-H 10 mg / 25 mg causes prolonged severe diarrhea, vomiting or abdominal sweating, consult your doctor as loss of fluid may lead to hypotension,
before treatment with hemodialysis or any other procedure for blood cleansing (apheresis) and treatment of hypersensitivity to axes or to bee venom (desensitization), tell your doctor that you are taking Enap-H 10 mg / 25 mg because you have an increased risk of the side effects of hypersensitivity before performing parathyroid function tests (these are glands in the neck area that control the blood calcium level), tell your doctor that you are taking Enap-H 10 mg / 25 mg.
During treatment with Enap-H, check your blood pressure regularly. Ask your doctor about your recommended blood pressure and when to review your next appointment.
In addition to measuring your blood pressure, your doctor may ask you to have a blood test to check that your kidneys are working normally before you start taking Enap-H 10 mg / 25 mg and repeat it at regular intervals during treatment.
You should tell your doctor if you think you are (or may be) pregnant.
Enap-H 10 mg / 25 mg is not recommended in early pregnancy and should not be taken if you are pregnant after the third month, as this may cause serious harm to your baby if used during this period (see section Pregnancy).
Children and adolescents
Enap-H is not recommended for use in children.
Other medicines and Enap-H 10 mg / 25 mg
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
other medicines to treat high blood pressure;
potassium supplements, capillary-containing salt substitutes or potassium-sparing diuretics (eg spironolactone, amiodarone);
analgesic and anti-inflammatory medicinal products (NSAIDs, eg ibuprofen, diclofenac);
medicines for the treatment of depression (eg lithium, tricyclic antidepressants, antipsychotics);
medicines that increase the amount of urine (diuretics);
cholesterol lowering drugs (eg cholestyramine, cholestipol resins);
drugs for suppressing tumor growth (cytostatics, for example cyclophosphamide, methotrexate);
medicines used to treat certain diseases such as rheumatism, arthritis, allergic conditions, asthma or certain blood diseases (corticosteroids); medicines used to treat abnormal heart rhythm (procaine, amiodarone or sotalol);
medicines used to treat rhythm disorders (digitalis); medicines used in some combination cough and cold medicines (sympathomimetics) or noradrenaline and adrenaline used in low blood pressure, shock, heart failure, asthma or allergies. If these medicines are used with Enap-H 10 mg / 25 mg concomitantly, they can keep your blood pressure high.
antidiabetic medicines such as insulin. Enap-H 10 mg / 25 mg may cause blood sugar to fall if you take it at the same time as anti-diabetic medicines, muscle relaxants (eg tubocurarine used for anesthesia); gold by injection for the treatment of arthritis (sodium aurothio-impotence); mTOR inhibitors (eg temsirolimus, sirolimus, everolimus), as co-administration may increase the risk of angioedema - a serious allergic reaction.
Your doctor may need to change your dose and / or take other precautions: if you are taking an angiotensin II receptor blocker (ARB) or aliskiren (see also "Do not take Enap H 10 mg / 25 mg" and "Warnings and precautions ").
Taking Enap-H 10 mg / 25 mg with food, drink, and alcohol
You can take the medicine during or after a meal.
Do not drink alcohol during treatment because it increases the effect of Enap-H 10 mg / 25 mg on lowering blood pressure.
Pregnancy, breastfeeding and fertility
If you are pregnant or are breast-feeding, think you may be pregnant or plan to become pregnant, ask your doctor or pharmacist for advice before taking this medicine.
You should tell your doctor if you think you are (or may be) pregnant. Your doctor will usually advise you to stop taking Enap-H 10 mg / 25 mg before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Enap-H 10 mg / 25 mg. Enap-H 10 mg / 25 mg is not recommended during pregnancy and should not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.
Tell your doctor if you are breast-feeding or intend to breast-feed. Enap-H 10 mg / 25 mg is not recommended for mothers who are breast-feeding.
Driving and using machines
In individual patients, Epan-H 10 mg / 25 mg may cause dizziness or weakness, especially at the beginning of treatment, and thus indirectly and transiently impair the ability to drive a car or drive machines. Until you determine how you respond to treatment, do not drive or operate machinery.
Enap-H 10 mg / 25 mg contains lactose
If you have been told by your doctor that you have an intolerance to some sugars, talk to your doctor before taking this medicine.
3. How to take Enap-H 10 mg / 25 mg
Always take this medicine exactly as your doctor has told you. If you are not sure, ask your doctor or pharmacist.
The recommended dose is 1 to 2 tablets once a day. You should take the tablets as a whole, during or after a meal, with some liquid. You should get used to taking the medicine regularly, best morning and always at the same time.
Treatment with Enap-H 10 mg / 25 mg is a long-term treatment until there are circumstances requiring its discontinuation. Since you need to take the medicine regularly, make sure you always have enough tablets to continue the treatment.
If you take more Enap-H 10 mg / 25 mg than you should
The most common signs of overdose are nausea, palpitations, dizziness and seizure due to a significant decrease in blood pressure (hypotension).
After taking a large number of tablets, the following may occur: more frequent and more frequent urination, severe hypotension with heart rhythm disturbances, convulsions, partial paralysis and unconsciousness. If the patient is conscious after taking an overdose, try to induce vomiting and call a doctor immediately.
If you forget to take Enap-H 10 mg / 25 mg
If you forget to take a tablet, skip the dose.
Take the next dose as usual.
Do not take a double dose to make up for the missed dose.
If you stop taking Enap-H 10 mg / 25 mg
You should be aware that treatment with any blood-lowering drug will not cure the disease, but it will help to lower blood pressure and keep it at the desired level. Thus, the effects or complications of hypertension will be prevented or reduced.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everyone gets them. The following side effects can be observed when taking this medicine.
It is vital to stop taking Enap-H 10 mg / 25 mg and seek immediate medical attention if you get the following symptom:
allergic reaction - you may get itching, difficulty in breathing or wheezing, swelling of the hands, mouth, throat, face or eyes.
Stop taking Enap-H 10 mg / 25 mg immediately and seek medical advice if you experience any of the following side effects:
severe dizziness, especially when initiating treatment or when increasing the dose or when standing up.
Other possible side effects are:
Very common (may affect more than 1 in 10 people)
blurred vision, dizziness, irritating cough, nausea (feeling sick), weakness (asthenia).
Common (may affect up to 1 in 10 people)
low potassium levels in the blood, increased cholesterol levels, elevated levels of
triglycerides, elevated levels of uric acid in the blood,
headache, depression, loss of consciousness (syncope), change in taste,
low blood pressure (hypotension) and effects related to hypotension, heart rhythm disturbances, chest pain (angina pectoris), rapid heartbeat, difficulty breathing (dyspnoea), diarrhea, abdominal pain, rash, muscle cramps, chest pain, fatigue , increased blood potassium, elevated serum creatinine.
Uncommon (may affect up to 1 in 100 people)
anemia, tinnitus, redness, rapid heartbeats (heart beat), heart attack and stroke, probably due to excessive blood pressure lowering in high-risk patients, nasal discharge (rhinorrhoea), sore throat and hoarse voice asthma, ileus, pancreatic inflammation (pancreatitis), malaise (vomiting), dyspepsia, constipation, anorexia, irritable stomach, dry mouth, stomach ulcer, flatulence (flatulence) impaired renal function, renal insufficiency , urinary protein (proteinuria), itching, sweating, hair loss, joint pain (arthralgia), increased sensitivity or shaking (caused by low blood sugar), low levels of magnesium, gout, impotence, drowsiness, insomnia, nervousness, dizziness (vertigo), tingling or tingling
How to store Enap-H 10 mg / 25 mg
Keep out of the reach and sight of children.
Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.
Store in the original package in order to protect from moisture.
Do not dispose of medicines in the sewage system or in the household waste container. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help to protect the environment.
6. Package Contents and Additional Information
What does Enap-H 10 mg / 25 mg contain?
Active substances: enalapril maleate and hydrochlorothiazide (enalapril maleate and hydrochlorothiazide).
Each Enap-H 10 mg / 25 mg tablet contains 10 mg of enalapril maleate equivalent to 7.64 mg of enalapril and 25 mg of hydrochlorothiazide.
The other ingredients of Enap-H 10 mg / 25 mg are: lactose monohydrate, corn starch, talc, sodium hydrogen carbonate, magnesium stearate, pregelatinized starch.
What Enap-H 10 mg / 25 mg looks like and contents of the pack
Enap-H 10 mg / 25 mg tablets are white, round, flat with a line on one side. The score line is not intended to break the tablet.
Enap-H 10 mg / 25 mg tablets are available in cartons of 20 (2 x 10), 30 (3 x 10), 60 (6 x 10), and 90 (9 x 10) tablets in blister packs.
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