What does Lerkamen help with and where can you buy it at an affordable price?

To effectively lower blood pressure, the drug “Lerkamen” is used. This is an effective remedy that is recommended by more than 70% of buyers. It is produced in the form of tablets, which can be purchased with a prescription. The standard course of treatment takes 14 days, after which a second appointment is possible in consultation with the doctor.

pharmachologic effect

The tablets have a pronounced hypotensive effect. The mechanism of action is based on selective blocking of calcium receptors. Lercanidipine is able to slow down the flow of calcium ions in smooth muscle tissue and cardiomyocytes.

Lerkamen reduces total peripheral vascular resistance and gradually expands the lumen of blood vessels, preventing the development of reflex tachycardia and collapse . The medication does not have a negative inotropic effect.

General information and composition

"Lerkamen", the composition of which can be read in the instructions, is highly effective compared to other drugs in this group.
The main active ingredient is lercanidipine hydrochloride, which belongs to the group of Ca2 ion antagonists. They prevent the absorption of calcium by muscle tissue, as a result of which the blood vessels dilate and blood flow significantly improves, and the pressure gradually normalizes. Today, Lerkamen is one of the most effective and fast-acting drugs compared to other drugs in this group. Thanks to this, it can be used for the prevention and treatment of many diseases of the heart and circulatory system among patients of any age category.

“Lerkamen”, reviews of the drug by cardiologists confirm its high effectiveness, is available only in the form of tablets, the dosage of the active substance in which can be 10 or 20 milligrams.

Pharmacodynamics and pharmacokinetics

The medicine Lerkamen is well absorbed from the digestive system. The maximum plasma concentration is recorded after 1.5-3 hours. Up to 98% of the active substance binds to plasma proteins.

The bioavailability of the drug increases after eating, which is why it is recommended to take the tablets on an empty stomach. As the dose increases, bioavailability increases. Initially, the drug is metabolized in the hepatic system, which explains the low absolute bioavailability of 10%.

The hypotensive effect is observed throughout the day. The active component is excreted through the renal system; the half-life is 10 hours.

Contraindications

• heart failure;
• obstruction of the vessels leaving the left ventricle;
• individual hypersensitivity to lercanidipine ;
• lactase deficiency;
• pregnancy;
• unstable form of angina ;
• acute myocardial infarction ;
• sick sinus syndrome (in patients without a pacemaker);
• lactation;
• age limit – 18 years.

Side effects

Nervous system:

• migraine;
• dizziness;
• sleep and wakefulness disorders.

Digestive tract:

• stool disorders;
• gastralgia;
• dyspepsia (vomiting, nausea);
• increased ALT, AST;
• disruption of food digestion.

The cardiovascular system:

• discomfort behind the sternum;
• increased heart rate;
• increase in angina ;
• drop in blood pressure;
• chest pain.

Allergic responses, frequent urination , development of polyuria , swelling, hyperemia , gum hyperplasia , and muscle pain are also possible.

Side effects of the drug Lerkamen

Those registered during clinical studies are shown in the following table:

In isolated cases (≤1/10,000), gingival hyperplasia and a reversible increase in the activity of liver transaminases in the blood plasma are detected (no other clinically significant deviations in laboratory tests of liver function were detected). There have been reports of increased urinary frequency. In isolated cases, the use of some dihydropyridines leads to angina attacks. Very rarely, unstable progressive angina may develop, in some cases even leading to the development of myocardial infarction. Lercanidipine does not significantly affect the levels of glucose and lipids in the blood plasma.

Instructions for use of Lerkamen (Method and dosage)

The tablets are intended for oral administration. It is not allowed to crush the drug or damage the protective shell. The effectiveness of the drug increases when lercanidipine is taken on an empty stomach. The duration of therapy is determined by the doctor.

1 tablet of 10 mg is taken 1 time every 24 hours. If there is insufficient reduction in blood pressure, after 14 days you can switch to a single dose of 20 mg.

Take the tablets with water on an empty stomach. When the dose of the drug is increased (more than 20 mg per day), an increase in the hypotensive effect is not observed, but an increase in the frequency and severity of undesirable side reactions is recorded.

If the medication is ineffective in the treatment of arterial hypertension, it is recommended to prescribe additional antihypertensive drugs from other pharmacological groups.

Compatibility with other drugs

"Lerkamen", reviews of which by cardiologists note that side effects when taking the drug are very rare, can react with quite a large number of drugs, due to which it is often combined to increase the effectiveness of therapy.
As a rule, it is combined with the following medications:

1. In some cases, the drug is prescribed together with diuretics and angiotensin-converting enzyme inhibitors.
2. In the treatment of some diseases, Lerkamen is prescribed together with cardiac glycosides, but in this case, treatment is carried out under the strict supervision of a cardiologist.
3. Good compatibility of the drug is observed together with Cimetidine. In this case, no significant changes in the blood plasma are observed.
4. It is necessary to be extremely careful when taking the drug simultaneously with inhibitors of the CYP3A4 group, since in this case the effectiveness of the drug may be noticeably reduced.
5. While taking Lerkamen, it is recommended to avoid drinking grapefruit juice and any alcoholic beverages, as they also reduce the effect of the medicine on the body.

It costs about 5 mg - this is the minimum dosage of the drug; it is not recommended to combine it with any other medications on your own, as this can cause various negative manifestations that can pose a threat to human health and life.

Overdose

There is a drop in blood pressure, drowsiness , ischemic changes in myocardial tissue, nausea, and the development of cardiogenic shock . Induction of vomiting, administration of laxatives and enterosorbents are recommended.

In case of severe intoxication, Dopamine , catecholamines , and diuretics are prescribed. It is possible to administer Atropine bradycardia develops , a drop in blood pressure and loss of consciousness. Treatment is carried out in a hospital. Hemodialysis has not proven effective.

Interaction

Absorption of the drug is enhanced during treatment with midazolam . Inducers of CYP3A4, ethanol, Cyclosporine and grapefruit juice are strictly contraindicated when taking Lerkamen.

Caution is required when taking high doses of cimetidine (more than 800 mg).

The bioavailability of the active substance increases simultaneously with an increase in the negative inotropic effect during therapy with beta-blockers.

A mandatory dose adjustment of Digoxin after starting lercanidipine therapy.

To reduce the risk of negative interactions, it is necessary to maintain a 10-hour window when taking Simvastatin and lercanidipine.

Features of application

As medical practice shows, “Lerkamen”, reviews from cardiologists do not contain negative information about the drug, it can cause deterioration of attention and a decrease in the ability of spatial orientation in patients, therefore, while taking the drug, it is recommended to refrain from driving, since people may experience sometimes dizziness, drowsiness and neuropsychic weakness appear. When drinking grapefruit juice, these manifestations will only intensify.

Ethyl alcohol neutralizes the effect of lercaledilin, therefore the consumption of any alcoholic beverages is strictly prohibited during treatment.

Analogues of Lerkamen

Level 4 ATC code matches:
Lacipil

Cordafen

Azomex

Nimodipine

Felodipin

Nifedipine

Farmadipin

Amlotop

Nimotop

Tenox

Nifecard HL

Cordipin

Felodip

Normodipine

Phenigidine

Norvask

Cordaflex

Corinfar

Vero-Amlodipine

Amlodipine

Analogues of Lerkamen, produced and prescribed in Russia and other countries:

• Zanidip-Recordati
• Lercanorm
• Lernikor
• Lerkaton
• Lervask
• Zanikor

Reviews of analogues are positive and indicate the high effectiveness of the drugs in the treatment of hypertension.

Drug price

Every person who has been diagnosed with any disease of the vascular system is interested in the question of how much Lerkamen costs. You can buy this drug in almost every pharmacy, and its average cost is 390 rubles, which is not much in these days. Therefore, given the high effectiveness of the drug, there is absolutely no point in replacing it with similar medications.

Reviews about Lerkamen

Thematic portals and medical forums, where patients share their impressions of taking medications, contain only positive reviews.

The drug is well tolerated and stabilizes blood pressure after 2 weeks of regular use in patients with stage 1 arterial hypertension.

The incidence of adverse reactions is low; the drug is considered highly effective in the treatment of grade 2.3 hypertension in combination with other antihypertensive drugs.

Indications for use

More and more cardiologists are prescribing Lerkamen to their patients.

Indications for use of this drug are as follows:

• arterial hypertension, which is at the initial and progressive stages;
• essential hypertension of the first and second stages.

The drug shows excellent results because, in addition to being highly effective and long-lasting, it causes virtually no side effects regardless of the duration of treatment. To increase the effectiveness of therapy and speed up the patient’s recovery, cardiologists can prescribe Lerkamen together with other antihypertensive drugs.

Lerkamen price, where to buy

The cost varies depending on the region and pharmacy network. The price of Lerkamen 10 mg is about 400 rubles. for 28 tablets. The price of Lerkamen 20 mg is about 700 rubles. for 28 tablets.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Lerkamen 20 tablets p.p.o.
  60 pcs. Berlin-Chemie AG/Menarini Group RUR 1,140 order
• Lerkamen 20 tablets p.p.o. 28 pcs.Berlin-Chemie AG/Menarini Group
  Read also:  Instructions for use PREDUCTAL® MR (PREDUCTAL MR)

  RUR 682 order

• Lerkamen Duo tab. p/o captivity. 10mg + 10mg No. 28Recordati Chemical and Pharmaceutical Industry S.p.A.

  RUR 536 order

Pharmacy Dialogue

• Lerkamen (tab.p.pl/vol. 20mg No. 28)Berlin-Chemie AG/Menarini

  720 rub. order

• Lerkamen (tab.p.pl/vol. 20mg No. 60)Berlin-Chemie AG/Menarini

  RUB 1,079 order

• Lerkamen (tab.p.pl/vol. 10mg No. 60)Berlin-Chemie AG/Menarini

  RUR 668 order

• Lerkamen Duo (tab.p.pl/vol.10mg+20mg No. 28)Recordati

  RUR 597 order

• Lerkamen (tab.p.pl/vol. 10mg No. 28)Berlin-Chemie AG/Menarini

  422 rub. order

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Pharmacy24

• Lerkamen 10 mg No. 28 tablets Berlin Chemi AG, Nimechchina
  164 UAH.order
• Lerkamen 10 mg N60 tablets Berlin Chemi AG, Nimechchina

  297 UAH order

• Lerkamen 20 mg No. 28 tablets Berlin Chemi AG, Nimechchina

  263 UAH order

PaniPharmacy

• Lerkamen tablets Lerkamen tablets. p/o 10 mg No. 60 Germany, Berlin-Chemie

  343 UAH. order

• Lerkamen tablets Lerkamen tablets. p/o 10 mg No. 28 Germany, Berlin-Chemie

  179 UAH. order

• Lerkamen tablets Lerkamen tablets. p/o 20 mg No. 28 Germany, Berlin-Chemie

  284 UAH order

• Lerkamen tablets Lerkamen tablets. p/o 20 mg No. 60 Germany, Berlin-Chemie

  509 UAH. order

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Lerkamen® Duo

Patients who require special attention when treating arterial hypertension:

- with severe arterial hypotension (systolic blood pressure less than 90 mm Hg);

- with decompensated heart failure.

The drug Lerkamen® Duo should not be used to relieve a hypertensive crisis.

Aortic stenosis/mitral stenosis/hypertrophic obstructive cardiomyopathy

Like all drugs that have a vasodilating effect, ACE inhibitors and BMCCs should be used with caution in patients with left ventricular outflow tract obstruction.

Lerkamen® Duo should be used with extreme caution in patients with aortic stenosis, mitral stenosis or hypertrophic obstructive cardiomyopathy. In patients with hemodynamically significant obstruction of the left ventricular outflow tract (for example, with severe aortic stenosis), the use of the drug is contraindicated.

Alcohol

During treatment, you should avoid drinking alcoholic beverages, since ethanol enhances the antihypertensive effect of vasodilating antihypertensive drugs.

Lactose

The drug Lerkamen® Duo contains lactose monohydrate, therefore its use in patients with rare hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome is contraindicated.

Lercanidipine

Sick sinus syndrome

Lercanidipine should be used with extreme caution in patients with sick sinus syndrome (without a pacemaker).

Left ventricular dysfunction

Although controlled hemodynamic studies have not revealed any abnormalities in left ventricular function, the use of BMCC in patients with signs of left ventricular dysfunction should be carried out with extreme caution.

Cardiac ischemia

Patients with coronary heart disease receiving short-acting BMCCs, dihydropyridine derivatives, represent a high-risk group for developing complications from the cardiovascular system. Although lercanidipine is a long-acting drug, caution should be exercised when used in patients with coronary artery disease.

In rare cases, in patients with angina pectoris, when using blockers of “slow” calcium channels, an increase in the frequency, duration and/or severity of angina attacks was observed, as well as, in isolated cases, the development of myocardial infarction (see section “Side Effects”).

Chronic heart failure

In patients with chronic heart failure, lercanidipine should be used with extreme caution. Before starting to use the drug, it is necessary to achieve compensation for chronic heart failure.

Unstable angina/myocardial infarction

There is no experience with the clinical use of lercanidipine in acute myocardial infarction and unstable angina, and therefore the use of the drug in these diseases is contraindicated.

Impaired liver or kidney function

Particular caution should be exercised when initiating treatment in patients with mild or moderate renal impairment. Although the usual recommended dose of 10 mg is generally well tolerated by patients, increasing the daily dose of lercanidipine to 20 mg should be approached with caution.

In patients with mild or moderate hepatic impairment, the antihypertensive effect may be enhanced, and therefore caution should be exercised and the need for dosage adjustment of lercanidipine should be considered.

Lercanidipine is contraindicated in patients with severe hepatic impairment or severe renal impairment (GFR < 30 ml/min), as well as in patients on hemodialysis (see sections "Dosage and Administration" and "Contraindications").

Peritoneal dialysis

Patients on peritoneal dialysis may experience cloudiness of the peritoneal exudate, which is due to increased concentrations of triglycerides in the exudate. Although the mechanism is unknown, exudate opacities tend to resolve soon after discontinuation of lercanidipine. This is important to remember, since cloudy peritoneal exudate can be mistakenly regarded as one of the symptoms of infectious peritonitis, followed by unnecessary hospitalization and empirical prescription of antibiotics.

CYP3A4 inducers

Inducers of CYP3A4, such as anticonvulsants (eg, phenytoin, carbamazepine) and rifampicin, may decrease plasma concentrations of lercanidipine; therefore, the effectiveness of lercanidipine may be reduced.

Enalapril

Symptomatic hypotension

Symptomatic hypotension is rarely observed in patients with uncomplicated hypertension. In patients with arterial hypertension taking enalapril, arterial hypotension develops more often against the background of dehydration, which occurs, for example, as a result of diuretic therapy, restriction of dietary salt intake, in patients on dialysis, as well as in patients with diarrhea or vomiting.

Symptomatic hypotension has been observed in patients with chronic heart failure (CHF) with or without chronic renal failure.

Arterial hypotension is more likely to develop in patients with more severe CHF with hyponatremia or impaired renal function in whom higher doses of loop diuretics are used. In such patients, treatment with enalapril should be initiated under medical supervision, which should be especially careful when changing the dose of enalapril and/or diuretic.

Similarly, patients with coronary artery disease or cerebrovascular disease, in whom an excessive decrease in blood pressure may lead to the development of myocardial infarction or stroke, should be monitored.

If arterial hypotension develops, the patient should be placed in a horizontal position and, if necessary, administered a 0.9% sodium chloride solution. Transient arterial hypotension when taking enalapril is not a contraindication to further use and increasing the dose of enalapril, which can be continued after fluid volume is replenished and blood pressure is normalized.

In some patients with CHF and normal or low blood pressure, enalapril may cause an additional decrease in blood pressure. This reaction to taking enalapril is expected and is not a reason to stop treatment. In cases where arterial hypotension becomes stable, the dose should be reduced and/or discontinued use of the diuretic and/or enalapril.

Renal dysfunction

In patients with impaired renal function (creatinine clearance <80 ml/min), the initial dose and/or frequency of enalapril should be reduced depending on the creatinine clearance. In such cases, renal function (creatinine and potassium levels in the blood) should be regularly monitored during the first few weeks of treatment.

In some patients, hypotension that develops after initiation of treatment with ACE inhibitors may lead to deterioration of renal function. Cases of the development of oliguria, progressive azotemia and acute renal failure (including fatal outcomes) have been described with the use of ACE inhibitors, mainly in patients with chronic heart failure or concomitant kidney disease (including renal artery stenosis). With timely detection and appropriate treatment, acute renal failure caused by the use of ACE inhibitors is usually reversible.

In some patients without signs of kidney disease before treatment, the use of enalapril in combination with diuretics caused an increase in the concentration of urea and creatinine in the blood serum. In such cases, it may be necessary to reduce the dose and/or discontinue the diuretic and/or enalapril. It is recommended to conduct an appropriate examination, since these abnormalities may be a sign that the patient has previously unrecognized renal artery stenosis.

Renovascular hypertension

Patients with bilateral renal artery stenosis or stenosis of the artery of a solitary kidney have an increased risk of developing arterial hypotension and renal failure when using ACE inhibitors. Renal failure may initially manifest itself as only slight changes in plasma creatinine levels. The use of enalapril in such patients should be started with low doses, under close medical supervision and monitoring of renal function.

Kidney transplant

There is no experience with the use of enalapril in patients who have recently undergone kidney transplantation. Therefore, the use of enalapril in such patients is not recommended.

Liver dysfunction

The use of ACE inhibitors in rare cases has been accompanied by the development of a syndrome starting with cholestatic jaundice or hepatitis and progressing to fulminant liver necrosis, sometimes with death. The mechanism of development of this syndrome is unknown. If jaundice appears or a significant increase in the activity of “liver” transaminases during the use of the drug, you should stop taking enalapril and prescribe appropriate auxiliary therapy. The patient should be under appropriate supervision.

Neutropenia/agranulocytosis/thrombocytopenia/anemia

Cases of neutropenia/agranulocytosis, thrombocytopenia and anemia have been reported in patients taking ACE inhibitors. In patients with normal renal function and no other complicating factors, neutropenia rarely occurs.

Enalapril should be used with extreme caution in patients with systemic connective tissue diseases (systemic lupus erythematosus, scleroderma, etc.) taking immunosuppressive therapy, allopurinol or procainamide, or a combination of these complicating factors, especially if there are impaired renal function. Some patients developed serious infectious diseases, which in some cases did not respond to intensive antibiotic therapy. When using enalapril in patients with a high risk of neutropenia/agranulocytosis, regular monitoring of the number of leukocytes in the blood is recommended. Patients should be warned to seek immediate medical attention if any signs of an infectious disease (eg, fever, sore throat) occur.

Hypersensitivity reactions/angioedema

Rare cases of angioedema of the face, extremities, lips, tongue, vocal folds and/or larynx have been observed with the use of ACE inhibitors, including enalapril. Angioedema may develop at any time during treatment. In such cases, you should immediately stop taking enalapril and carefully monitor the patient's condition in order to monitor and correct clinical symptoms. Even in cases where only swelling of the tongue is observed without the development of respiratory distress syndrome, patients may require long-term observation, since therapy with antihistamines and corticosteroids may not be sufficient.

Angioedema, associated with swelling of the larynx and tongue, can be fatal in very rare cases. Swelling of the tongue, vocal folds, or larynx can lead to airway obstruction, especially in patients who have undergone respiratory surgery. If airway obstruction develops, appropriate treatment should be immediately prescribed, including subcutaneous administration of 0.3-0.5 ml of a 0.1% solution of epinephrine (adrenaline) and/or ensuring airway patency (intubation or tracheostomy).

In rare cases, intestinal edema (angioedema of the intestine) develops during therapy with ACE inhibitors. In this case, patients experience abdominal pain as an isolated symptom or in combination with nausea and vomiting, in some cases without previous angioedema of the face and with normal levels of C1-esterase. Diagnosis is made using abdominal computed tomography, ultrasound, or surgery. Symptoms disappeared after stopping the ACE inhibitors. The possibility of developing intestinal edema must be taken into account when carrying out the differential diagnosis of abdominal pain in patients taking ACE inhibitors.

Patients with a history of angioedema not associated with ACE inhibitors may be at greater risk of developing angioedema during ACE inhibitor therapy.

In black patients taking ACE inhibitors, angioedema was observed more often than in representatives of other races. An increased risk of angioedema was observed in patients concomitantly taking ACE inhibitors and drugs such as mTOR inhibitors (temsirolimus, sirolimus, everolimus), dipeptidyl peptidase type IV inhibitors (sitagliptin, saxagliptin, vildagliptin, linagliptin), estramustine, neutral endopeptidase inhibitors (racecadotril). ).

Anaphylactoid reactions during desensitization with an allergen from Hymenoptera venom

In rare cases, patients taking ACE inhibitors have developed life-threatening anaphylactoid reactions during desensitization with hymenoptera venom allergen. Adverse reactions can be avoided if you temporarily stop taking the ACE inhibitor before starting desensitization. The use of enalapril should be avoided in patients receiving bee venom immunotherapy.

Anaphylactoid reactions during low-density lipoprotein apheresis (LDL apheresis)

Life-threatening anaphylactoid reactions have rarely been observed in patients taking ACE inhibitors during LDL apheresis using dextran sulfate. The development of these reactions can be prevented by temporarily discontinuing the ACE inhibitor before each LDL apheresis procedure.

Hemodialysis using high-flow membranes

Anaphylactoid reactions have been observed in patients on dialysis using high-flux polyacrylonitrile membranes (such as AN69®) and concomitantly receiving ACE inhibitor therapy. In such cases, it is necessary to use a different type of dialysis membrane or use antihypertensive drugs of other classes.

Diabetes

When using enalapril drugs in patients with diabetes mellitus who are receiving oral hypoglycemic agents or insulin, it is necessary to regularly monitor the concentration of glucose in the blood. Patients taking oral hypoglycemic agents or insulin should be informed before starting the use of ACE inhibitors about the need for regular monitoring of blood glucose concentrations (hypoglycemia), especially during the first month of simultaneous use of these drugs (see section “Interaction with other drugs”). means").

Cough

Cases of cough occurring during therapy with ACE inhibitors have been observed. As a rule, the cough is non-productive, constant and stops after discontinuation of the drug. Cough associated with the use of ACE inhibitors should be considered in the differential diagnosis of dry cough.

Surgery/general anesthesia

During major surgical procedures or during general anesthesia with the use of agents with antihypertensive effects, enalaprilat blocks the formation of angiotensin II caused by the compensatory release of renin. If a pronounced decrease in blood pressure, explained by a similar mechanism, develops, it can be corrected by increasing the volume of circulating blood.

Hyperkalemia

Hyperkalemia may develop during therapy with ACE inhibitors, including enalapril. Risk factors for the development of hyperkalemia are renal failure, old age (over 65 years), diabetes mellitus, some concomitant conditions (decrease in blood volume, acute heart failure in the stage of decompensation, metabolic acidosis), simultaneous use of potassium-sparing diuretics (such as spironolactone, eplerenone, triamterene, amiloride), as well as potassium preparations, potassium-containing table salt substitutes and other drugs that increase the level of potassium in the blood plasma (such as heparin, tacrolimus, cyclosporine; drugs containing co-trimoxazole [trimethoprim + sulfamethoxazole]).

The use of potassium supplements, potassium-sparing diuretics, or potassium-containing table salt substitutes, especially in patients with impaired renal function, can lead to a significant increase in serum potassium levels. Hyperkalemia can cause serious heart rhythm disturbances, sometimes fatal.

If it is necessary to simultaneously use enalapril and the above potassium-containing or increasing potassium levels in the blood plasma, caution should be exercised and the potassium content in the blood serum should be regularly monitored.

Hypokalemia

When using ACE inhibitors simultaneously with thiazide diuretics, the risk of hypokalemia cannot be excluded, therefore, in such cases, regular monitoring of potassium levels in the blood during therapy should be carried out.

Dual blockade of the renin-angiotensin-aldosterone system (RAAS)

Hypotension, syncope, stroke, hyperkalemia and renal dysfunction (including acute renal failure) have been reported in susceptible patients, especially when combined therapy with drugs that affect the RAAS is used. The simultaneous use of ACE inhibitors with medicinal products containing aliskiren is contraindicated in patients with diabetes mellitus and/or with moderate or severe renal impairment (GFR less than 60 ml/min/1.73 m2 body surface area) and is not recommended in other patients.

Concomitant use of ACE inhibitors with angiotensin II receptor antagonists is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.

In cases where the simultaneous administration of two drugs acting on the RAAS is necessary, their use should be carried out under the supervision of a physician with extreme caution and with regular monitoring of renal function, blood pressure and electrolyte levels in the blood plasma.

Lithium preparations

The simultaneous use of enalapril and drugs containing lithium is not recommended (see section “Interaction with other drugs”).

Use in elderly patients

Clinical studies of the efficacy and safety of enalapril were similar in older and younger patients with hypertension.

Ethnic differences

Enalapril, like other ACE inhibitors, has a less pronounced antihypertensive effect in black patients compared to representatives of other races, which may be explained by a higher prevalence of conditions with low plasma renin activity in black patients with arterial hypertension.

Discontinuation of therapy

Sudden cessation of taking enalapril, as a rule, does not lead to the development of withdrawal syndrome.