CONVERTEN ® is a drug based on Enalapril maleate.
THERAPEUTIC GROUP: Antihypertensives - ACE inhibitors not associated
Indications CONVERTEN ® Enalapril maleate
CONVERTEN ® is used, both in monotherapy and in combined therapy, in the treatment of arterial hypertension.
CONVERTEN ® can also be used in the treatment of symptomatic heart failure and in the prevention of this pathology in patients at high risk, with asymptomatic left ventricular dysfunction and with an ejection fraction of less than 35%.
Mechanism of action CONVERTEN ® Enalapril maleate
The oral intake of CONVERTEN ® ensures a good absorption of its active ingredient enalapril, estimated at around 60% of the dose taken. Despite the fact that the plasma peak of this molecule is registered already after one "hour from" intake, so that the active ingredient can carry out its biological action must necessarily be metabolized in its active form, known as enalaprilat, whose plasma peak is observed only after 4 hours from the oral intake of CONVERTEN ® In light of the aforementioned pharmacokinetic properties, the antihypertensive effect of the drug begins after about an hour after its intake, to be optimized around the fourth / sixth hour when the levels of the pharmacologically active ingredient are maximum. The antihypertensive effect is mainly due to the inhibitory action of enalaprilat on the ACE enzyme, with consequent drop in levels of angiotensin II and aldosterone, responsible for the increase in peripheral vascular resistance and hydrosaline ion. Furthermore, several studies show how this active ingredient can reduce microalbuminuria and urinary secretion of IgG in patients with diabetic nephropathy, and above all reduce the progressive cardiac dilation in patients with mild and moderate heart failure, preventing the progression of the disease.
Once its action is over, the active ingredient is eliminated mainly through the urine in the form of enalaprilat for 40% and enalpril for 20%.
Studies carried out and clinical efficacy
1. ENALAPRIL / FOLIC ACID, A WINNING COMBINATION
Nutrition. 2008 Nov-Dec; 24 (11-12): 1088-96. Epub 2008 Jul 24.
Efficacy of folic acid and enalapril combined therapy on reduction of blood pressure and plasma glucose: a multicenter, randomized, double-blind, parallel-controlled, clinical trial.
Mao G, Hong X, Xing H, Liu P, Liu H, Yu Y, Zhang S, Jiang S, Wang X, Xu X.
This study conducted on about 430 patients with hypertension and treated with concomitant administration of enalapril (10mg) and folic acid (400mcg), shows how this combination can be more effective - than the drug alone - in reducing systolic and diastolic blood pressure and in balancing blood glucose levels in patients with hyperglycemia.
2. ENALAPRIL / HYDROCHLOROTHIAZIDE IN THE TREATMENT OF HYPERTENSION
Ter Arkh. 2009; 81: 60-4.
Combined treatment of arterial hypertension (results of the international program CLIP-ACCORD)
Chazova IE, Ratova LG.
The concomitant administration of multiple antihypertensive drugs is used in most therapeutic protocols for hypertension. This Russian study, carried out on nearly 8000 patients suffering from hypertension and cardiovascular complications, demonstrated how the combined therapy of hydrochlorothiazide / enalapril, at constant dosage, guarantees a decrease in blood pressure levels up to the achievement of standard eupressor values in as many as 77% of the patients treated.
3. ENALAPRIL AND TREATMENT OF DIABETIC NEPHROPATHY
Bangladesh Med Res Counc Bull. 2009 Aug; 35: 44-8.
Effect of enalapril and losartan on proteinuria in type 2 diabetic nephropathy patients.
Hoque R, Rahman MS, Iqbal M.
One of the therapeutic indications of ACE inhibitors is the treatment of diabetic nephropathy. The study in question shows how the administration of enalapril can be particularly effective both in reducing blood pressure and in reducing proteinuria in patients with diabetic nephropathy.
Method of use and dosage
CONVERTEN ® 5/20 mg tablets of enalapril maleate:
- for the treatment of arterial hypertension we recommend doses between 5 and 20 mg, via tablets taken once a day. It is necessary to consider that the precise formulation of the dosage should be established by the doctor after a careful evaluation of the severity the disease, the possible susceptibility to the drug and the presence of factors interfering with the therapeutic process (concomitant or previous administration of diuretics, elderly age, volume-depleted patients or patients suffering from kidney diseases)
- for the treatment of heart failure and left ventricular dysfunction, the dosage generally tends to decrease; the appropriate therapeutic scheme must in any case be decided by the doctor, taking into account the patient's disease history and any association with other active drugs on the cardiovascular system.
IN ANY CASE, BEFORE TAKING CONVERTEN ® Enalapril maleate - YOU NEED THE PRESCRIPTION AND CONTROL OF YOUR DOCTOR.
Warnings CONVERTEN ® Enalapril maleate
Particular attention should be paid to the correct dosage formulation in case of concomitant administration of antihypertensive drugs, in particular diuretics. In fact, the blood volume depletion induced by these drugs could increase the incidence of hypovolaemic episodes accompanied by hypotensive crises. In addition, any conditions of hyperkalaemia could occur following the simultaneous intake of potassium-sparing diuretics; therefore, constant monitoring of potassium-sparing diuretics is recommended. blood levels of potassium and blood pressure.
The same monitoring modalities, with the addition of creatinine, should be undertaken in case of use of CONVERTEN by patients with reduced renal function and undergoing therapy with enalapril, in whom, given the renal metabolism of the active ingredient, could be sufficient lower doses of the drug.
It is also advisable to check the blood levels of granulocytes frequently in immunocompromised patients receiving CONVERTEN ® in order to minimize the possible occurrence of neutropenia or agranulocytosis, which in rare cases has been observed following the administration of ACE inhibitors.
The different therapeutic efficacy of ACE inhibitors, therefore also of enapril, between black and Caucasian patients, could be explained by the low basal renin levels in blacks, which considerably reduce the therapeutic efficacy of this medicinal category.
It should also be remembered that some of the side effects associated with antihypertensive therapy, such as dizziness, headache and drowsiness, could reduce the patient's perceptive and reactive abilities, making the use of machinery and driving cars dangerous.
PREGNANCY AND BREASTFEEDING
The various studies in the literature suggest a potential increase in the risk of teratogenicity and fetal toxicity if ACE inhibitors are taken during pregnancy; therefore it is not recommended to use it during the entire gestation period, opting for drugs with a higher safety profile.
Both enalapril and enalaprilat are secreted into breast milk, with effects not yet clarified, thus suggesting the interruption of breastfeeding during therapy with CONVERTEN ®.
Interactions
The enalapril contained in CONVERTEN ® can interact with numerous other active principles, sometimes causing a significant variation in the normal functionality of the drug.
As already mentioned, enalapril can interact with:
- potassium-sparing drugs and potassium supplements, significantly increasing blood levels of this mineral;
- diuretics and antihypertensive drugs, mutually enhancing the hypotensive efficacy;
- non-steroidal anti-inflammatory drugs, reducing their therapeutic effect;
- antidiabetic drugs, with an increase in their hypoglycemic action, probably due to an improved insulin sensitivity;
- lithium, increasing its cytotoxicity.
Contraindications CONVERTEN ® Enalapril maleate
CONVERTEN ® is contraindicated in case of hypersensitivity to one of its components, in case of angioedema, severe renal impairment and during pregnancy and lactation.
CONVERTEN ® contains lactose; therefore, it should not be taken by patients with lactose / galactose intolerance, malabsorption and lactase deficiency.
Undesirable Effects - Side Effects
Side effects observed during CONVERTEN ® therapy are generally transient and clinically insignificant. The most common include cough, headache, depression, dizziness, blurred vision, abdominal pain, nausea and hypotension.
In particular categories of patients at risk, potentially dangerous side effects may occur - albeit rarely - such as angioedema, hypoglycemia, neutropenia, anemia and renal dysfunction.
In case of hypersensitivity to the drug, dermatological reactions may occur - such as skin rash and erythema, accompanied by fever, itching and facial angioedema - which could hamper normal breathing capacities.
Note
CAPOTEN ® can only be sold under medical prescription.
The information on CONVERTEN ® Enalapril maleate published on this page may be out of date or incomplete. For a correct use of this information, see the Disclaimer and useful information page.
