Enalapril

  • 75847-73-3
  • 76095-16-4 ( enalapril maleate (1:1) )

C09AA02

White solid ( maleate )

Antihypertensives

ACE inhibitor

143 to 144.5 ° C ( enalapril maleate )

Soluble in water: 25 g · l-1

Maleate

2973 mg · kg -1 ( LD50, rat, oral)

Template: Infobox chemical / molecular formula search available

Enalapril is a drug from the group of ACE inhibitor for the treatment of hypertension (high blood pressure) and heart failure is used. Enalapril itself is an inactive prodrug. Its active principle is based upon activation by hydrolysis from ethanol to enalaprilat on the inhibition of the angiotensin- converting enzyme (ACE).

Chemistry

Enalapril was the ACE - inhibiting active peptides of the venom of the jararaca - lance (Bothrops jararaca ), a Brazilian snake modeled. Enalapril contains a stabilized dipeptide and is a condensation product of amino acids (S)- proline and (S)- alanine, and from 2- oxo-4- phenylbutyrate.

Enalapril is an inactive prodrug, which was achieved by esterification of the free carboxylic acid function with ethanol. This ethanol group is cleaved by esterases in the organism in the liver, whereby the active enalaprilat is formed.

Enalapril three stereocenters and, consequently, there are eight different stereoisomers. Only the stereochemically uniform ( all-S )-isomer is used as a drug. The seven other stereoisomers are meaningless.

Pharmacology

Areas of application

Enalapril is used alone (monotherapy ) and in combination with other blood pressure lowering drugs ( combination therapy, especially with diuretics or calcium channel blockers ), primarily for the treatment of high blood pressure. Also for the treatment of heart failure, it is considered as the first choice. Unlike some other ACE inhibitors such as ramipril, enalapril showed no efficacy of myocardial infarction in the prophylaxis (prevention).

Mechanism of Action

Enalapril performs as an inhibitor of angiotensin converting enzyme in a reduced formation of angiotensin II from angiotensin I. This reduced formation of angiotensin II causes a decrease in the tonus of the blood vessels and thus a decrease in blood pressure. Also the decrease in angiotensin II levels leads to a reduction of aldosterone release from the adrenal cortex and thus to influence the water budget (see also the renin -angiotensin -aldosterone system ).

Side effects

Most side effects of enalapril to be associated with a conditional by ACE inhibitors slow degradation and the accumulation of bradykinin. These include skin reactions such as rashes and hives, and also angioneurotic edema. Severe allergic skin reactions are, however, only very rarely observed.

Among the side effects on the respiratory system include dry cough, hoarseness and sore throat. Asthma attacks and shortness of breath may also, though rarely, occur.

As a result, the main effect of enalapril can lead to excessive reduction in blood pressure. As a result, can be observed occasionally dizziness, headache and dizziness. From serious cardiovascular events such as angina pectoris, myocardial infarction, and syncope have been reported only in individual cases.

By engaging in the water and Elektrolyhaushalt kidney dysfunction can be observed occasionally. Proteinuria ( excretion of proteins in urine ), however, only rarely observed.

Since enalapril can cause in pregnancy and Others growth and bone formation disorders associated with the child with increased mortality, enalapril should not be used at this time and should be replaced with other suitable therapeutic measures.

Interactions

Enalapril increases the blood glucose lowering effect of insulin and oral hypoglycemic agents and the blood- changing effects of immunosuppressants.

By intervening in the water and Elektrolyhaushalt the excretion of electrolytes can be slowed down, which in therapy should be considered especially with lithium and potassium-sparing diuretics.

In combination with other antihypertensive drugs increased blood pressure reduction should be considered.

Trade names

ACEpril (CH), Alapril (A), Benalapril (D), Corvo (D), Elpradil (CH), Epril (CH), Jutaxan (D), Mepril (A), Renistad (A), Renitec (A), RENITEC (CH), Xanef (D ), numerous generics (D, A, CH)

Veterinary medicine: Enacard, Enadog, Enalatab, Prilenal

Baroprine (A), Benalapril PLUS ( D ), Carmen ACE ( D), Cenipress (A), co- Acepril (CH), Co - Renitec (A), co- Mepril (A), co- Renistad (A), Coenytyrol (A), HCT Corvo (D), Elpradil HCT (CH), Epril plus (CH), Lercaprel (A), Renacor (D), Renitec plus (A), RENITEC plus (CH), Zaneril (D), Zanipress (D), Zanipril (A ) and various generics with the appendages "comp ", " HCT " or " plus" (D, A, CH ) or the prefix " co- " (A, CH )

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