Miscellaneous

Enalapril analogues and substitutes without side effects

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Content

  1. Basic instructions
  2. Are there any substitutes without side effects?
  3. Analogs
  4. Renipril
  5. Berlipril
  6. Renitek
  7. Price of funds
  8. Video about the drug Enalapril

Enalapril is an antihypertensive drug, belongs to the group of ACE inhibitors. It is used in cardiology to treat high vascular pressure and chronic heart failure. Its use is also relevant for the prevention of coronary ischemia, myocardial infarction and heart muscle failure.

The main effect is to normalize blood pressure, eliminate headache, tinnitus, weakness, excessive fatigue against the background of arterial hypertension. There are several analogs, substitutes on the pharmaceutical market. Each of them has its own characteristics of reception. The quality of the raw materials used may also vary.

Basic instructions

Statistics show that about 44% of the adult population of Russia suffers from arterial hypertension. In the world, 9.4 million people die annually from complications of the disease. Hypertension is a chronic disease with an increase in blood pressure above 140 / 90mm. rt. Art. Often, the disease is asymptomatic. High vascular pressure affects the brain, heart, organs of vision, and lower extremities.

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Timely and correctly selected treatment tactics is the main way to prevent the development of such complications such as stroke, heart attack, heart and renal failure, hypertensive crisis, lethal Exodus. Regular treatment is carried out in only 8% of sick patients. That is why Russia is in the top countries in terms of the number of people suffering from cerebrovascular accidents. This pathology occurs in 70% of patients with arterial hypertension.

Enalapril, analogs and substitutes belong to the group of angiotensin-converting enzyme inhibitors. This compound leads to vasoconstriction and an increase in blood pressure. These drugs convert the inactive peptide angiotensin 1 to angiotensin 2, resulting in a decrease in vascular pressure.

Enalapril analogues and substitutes without side effects

Enalapril has the following indications for use:

  • Arterial hypertension of any etiology of origin.
  • As part of complex treatment, it is effective in chronic heart failure.
  • For prophylactic purposes, it can be used in patients with impaired left ventricular function to prevent the development of heart failure and coronary artery disease.

Are there any substitutes without side effects?

Enalapril has been on the pharmaceutical market for several decades. It has proven itself in medical practice as a drug with a pronounced hypotensive effect. However, Enalapril causes a number of undesirable side reactions.

Namely:

  • Dizziness, headache.
  • Increased fatigue, drowsiness.
  • Dry cough.
  • Allergic reactions.

As a rule, such side effects do not require discontinuation of the drug, with the exception of allergies.Enalapril analogues and substitutes without side effects

However, in patients undergoing treatment with Enalapril, there is a risk of occurrence of such phenomena as:

  • Orthostatic hypotension. In this condition, an excessive decrease in blood pressure occurs when the patient assumes an upright position. Systolic pressure may decrease by more than 20 mm. rt. Art., and the diastolic may be lower by 10 mm. rt. Art. compared to the norm. In the absence of timely medical care, this condition can be dangerous to health and life.
  • Pain in the region of the heart.
  • Convulsions.
  • Abdominal pain, diarrhea, vomiting.
  • Changes in the composition of the blood (a decrease in the number of neutrophils, an increase in potassium ions).
  • Excretion of protein in the urine.

If the patient has chronic diseases (renal failure, diabetes mellitus), the drug can aggravate their course, so some are trying to find a safer therapy for arterial hypertension.

Enalapril (this should be taken into account) has no substitutes and analogues that would not cause any side reactions. Each similar drug will be considered below separately.

Analogs

Enalapril has many analogues presented on the pharmacy shelf.

All substitutes can be divided into 2 main categories:

  • Structural analogs. These are drugs that have the same composition and a similar release form.
  • Functional analogs. These include drugs containing a different active substance, but with a similar pharmacotherapeutic effect.

If it is necessary to replace Enalapril with another antihypertensive drug, the doctor first pays attention for 1 group of funds, since they have the same mechanism of action, scope and mode dosing.

Functional analogues are used in cases where drugs based on enalapril maleate do not work, cause severe side effects or allergies, and are contraindicated for a specific patient. The article will consider the main representatives of structural substitutes.

These include:

  • Renipril produced by Pharmstandard-Leksredstva OJSC.
  • Berlipril, which is manufactured by the German pharmaceutical company Berlin-Chemie, AG.
  • Renitek of the "Merck Sharp & Dohme" plant, the Netherlands.

Enalapril itself is produced in the Russian Federation by several factories:

  • LLC "Ozon" Moscow.
  • CJSC "Kanonpharma production" Moscow.
  • JSC "Valenta Pharmaceuticals" Moscow.
  • JSC "Sintez" Moscow.

Renipril

This drug contains enalapril maleate as an active ingredient in an amount of 10 mg or 20 mg per 1 tablet.Enalapril analogues and substitutes without side effects

These drugs have many characteristics in common:

  • The name of the active component.
  • Release form. Both are available as oral tablets.
  • Mechanism of action.
  • Pharmacodynamic and pharmacokinetic properties.
  • Dosing regimen.
  • Indications for use.
  • Contraindications
  • Conditions for dispensing from a pharmacy. Renipril and Enalapril are available only with a doctor's prescription.

However, some points of funds differ:

  • Manufacturer.
  • Composition of auxiliary components. Each manufacturer uses its own technology for creating a finished product. For this reason, the composition of the additional ingredients may vary. This factor does not have a significant effect on the therapeutic effect.
  • Available dosages. Renipril is available in only 10 mg and 20 mg. Enalapril, on the other hand, has a wider selection of the content of the active ingredient in one tablet (5 mg, 10 mg, 20 mg).

Berlipril

Enalapril, analogues and substitutes of which number several dozen positions, can be replaced by a German drug called Berlipril.

Similar characteristics of drugs:

  • Active substance. Both drugs contain enalapril maleate.
  • The concentration of the active substance and the form of release. Both products are available in 5 mg, 10 mg, 20 mg per tablet.
  • Dosing regimen. Enalapril and Berlipril should be taken no more than 1-2 times a day.
  • Pharmacodynamics and pharmacokinetics (metabolism is carried out in the liver, 60% is absorbed from the gastrointestinal tract, the half-life of the drug is approximately 11 hours).
  • Therapeutic effect. Each of the remedies leads to a decrease in blood pressure.
  • Preparations based on enalapril are contraindicated in patients under the age of 18, pregnant and lactating women, patients with angioedema, lactose intolerance, lactase deficiency, high sensitivity to the components of the drug.
  • A list of undesirable side reactions. Both drugs can cause indigestion, irritation of the mucous membrane of the upper respiratory tract, headache, and an excessive drop in blood pressure. However, as practice shows, the German remedy is less likely to lead to such phenomena.Enalapril analogues and substitutes without side effects

Berlipril and Enalapril differ in the following:

  • Different production technology and composition of additional components.
  • Different quality of the raw materials used. The German drug is made on the basis of purer medicinal raw materials. This explains the low risk of allergies and other side symptoms.
  • Manufacturer. Enalapril is a domestic remedy, and Berlipril is manufactured in Germany.
  • Price. As a rule, imported analogues are an order of magnitude more expensive than Russian medicines. The fact is that the manufacturer spends money on the transportation of tablets from Europe to Russia.

Renitek

The drug called Renitek is the original drug among the drugs based on enalapril maleate. The manufacturer of the original product is the Dutch pharmaceutical company Merck Sharp & Dohme. All the drugs analyzed above represent its generics. That is, copies of it. What then is the essential difference between generics and the original, if they all contain enalapril and are able to lower blood pressure.

Renitek has undergone several randomized controlled trials. This proves that the formula of the active ingredient of the Dutch remedy is not only safe, but also effective. Enalapril, Berlipril, Renipril have the same active ingredient, but do not have their own evidence bases, because their chemical formulas and the compound from which they were obtained did not pass such an amount tests.

When the original product is released, the manufacturer becomes the legal owner of the patent. This document does not authorize other pharmaceutical companies to manufacture analogs. However, after the expiration of the patent, this becomes possible, and many substitutes appear on the market.

Enalapril, analogues and substitutes of Renitek differ from the original in production technology. Generics can change the creation algorithm. This is evidenced by the lists of auxiliary components, which are presented in the instructions for use. As a rule, they are very different from each other.

This can significantly affect the quality of the product, because as a result, the rate of entry of the active component into the tissues changes, and its concentration decreases. The requirements in the Russian Federation on this issue are quite flexible. There is no need for manufacturers to completely repeat the clinical experience of the original creators. The main thing is that the biological equivalence of drugs is the same.

However, there are many similar points. First of all, we are talking about side effects and the risk of their occurrence. The use of an original product based on enalapril maleate reduces the risk of undesirable side reactions to a minimum, while ensuring the maximum therapeutic effect.

There was no expert comparison of funds under this item. Presumably, the frequency and severity of unwanted side reactions in drugs are the same. Headache, dry cough still occur in some patients, but their severity is usually lower compared to similar drugs.Enalapril analogues and substitutes without side effects

Also, Renitek less often provokes the development of an allergic reaction, which usually manifests itself in the form of a rash, itching, redness and swelling of the mucous membranes. In some cases, drugs based on enalapril can lead to Quincke's edema (a condition requiring immediate medical attention).

The original Renitek remedy practically does not give such symptoms. This is due to the quality of the raw materials used. The manufacturer uses medicinal substances manufactured according to European standards, with the maximum degree of purification. As a rule, the quality of raw materials for domestic counterparts is lower.

Price of funds

Enalapril (analogs and substitutes for the original belong to different price categories) is based on ACE inhibitors, which are available in several dosages. To avoid confusion, the table shows the cost of preparations containing 10 mg of the active ingredient. It is 10 mg that is the commonly prescribed concentration.

Name Price
Enalapril 10 mg, 20 tablets 35-55 rubles
Renipril 10 mg, 30 tablets RUB 65-85
Berlipril 10 mg, 30 tablets RUB 110-130
Renitek 10 mg, 14 tablets 60 - 80 rubles.

Enalapril is produced in several factories, but the cost of the drug does not differ much from different manufacturers. The final cost of one pack may differ, the amount depends on the region and the pricing policy of the pharmacy organization. As you can see from the table, the cost of the drug based on enalapril is very different. In addition, the package may contain a different number of tablets. To understand which of the funds is cheaper, you should calculate the cost of 1 tablet.

To do this, the average amount for 1 package should be divided by the number of tablets it contains.

  • Enalapril: 45/20 = 2.25 rubles.
  • Renipril: 75/30 = 2.5 rubles.
  • Berlipril: 120/30 = 4 rubles.
  • Renitek: 70/14 = 5 rubles.

All of these funds are available on pharmacy shelves. However, ACE inhibitors can only be dispensed from the pharmacy if you provide a prescription form prescribed by your doctor. Self-treatment of arterial hypertension, as well as replacing one drug with another, is strictly prohibited. Since the therapy of this disease can only be carried out by a therapist or cardiologist. With the wrong treatment, the symptoms may be somewhat erased, but the disease will continue to progress and lead to the development of complications.

As you can see, 1 tablet of the drug that can reduce high blood pressure, in any case, will not cost the patient too much. Even 1 tablet of the original product will cost about 5 rubles.

When choosing a treatment for hypertension, economic benefits should not be a priority. Which remedy is still better to choose?

First of all, this decision can only be made by a doctor. As a rule, specialists try to prescribe to patients an original remedy with the maximum therapeutic effect and a minimum of adverse reactions. Therefore, Renitek is a drug that you definitely need to pay attention to.

If the doctor has prescribed to the patient another drug based on enalapril, the patient has the right to clarify why such a choice was made. Yes, the original is somewhat more expensive. But 5 rubles. for the pill, which is the most effective and safest among all such drugs, it is a perfectly reasonable decision. Sometimes it seems too expensive to buy Renitek, because the course of treatment is usually constant. In this case, you should consider taking the German drug Berlipril.

The German remedy is in many ways similar to the domestic Renipril and Enalapril, but still has imported production and a higher quality of medicinal raw materials. This reduces the risk of developing allergies and side effects such as a sharp drop in blood pressure, headache, dry cough.

Renipril and Enalapril are the most inexpensive drugs. The cost of a course of treatment is 2 times cheaper compared to the original. Domestic analogues will undoubtedly lower blood pressure and exert their therapeutic effect. However, don't forget about the increased risk of allergies and unwanted side effects.

Analogs and substitutes for Enalapril may have different production technology, manufacturer and quality of the raw materials used. However, all of them will be effective in the treatment of arterial hypertension, and only a doctor can decide which remedy is needed for a particular patient suffering from this disease. You should not start its treatment and at the first symptoms you should seek the advice of a specialist.

Author: Olga Orlova

Video about the drug Enalapril

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