Generic Medication guide:
What is the formulation named Vasotec?
Vasotec is a trademark of Canadian pharmaceutical company Valeant Pharmaceuticals. The active agent of the formulation is Enalapril. It is an angiotensin-converting-enzyme inhibitor (ACE inhibitor). It is a group of natural and synthetic chemical compounds used for the therapy and prophylaxis of heart and kidney failure, as well as to drop elevated arterial tension.
The substance Enalapril is also produced and marketed by other drug-makers so if you need to get the pills cheaper, you can buy generic Vasotec (the name under which you can find the medication from another company) instead of the branded one.
When is Vasotec prescribed?
- Essential hypertension of any severity;
- Renovascular hypertension;
- Heart failure of any severity (in individuals with manifestations of heart failure, it is also known to increase survival, slow the worsening of the disease, and substantially drop the frequency of hospitalizations for heart failure);
- Prophylaxis of heart failure (in individuals without manifestations with left ventricular failure, Enalapril is appointed to slow the onset of the manifestations of the disorder, drop the frequency of hospitalizations for heart failure);
- Prevention of coronary ischemia in left ventricular failure to diminish the danger of myocardial infarction and the frequency of hospitalization for angina.
Prohibitions for Vasotec use
- Allergy to the active or supplementary elements of the pills or other formulations from the group;
- History of allergic edema (swelling);
- Glucose-galactose malabsorption;
- Gestation and lactation;
- Kidney failure with creatinine clearance lower than 60 ml per minute;
- Lactose intolerance;
- Lactase deficiency;
- Use of Aliskiren-containing medications.
The medication can be used but cautiously and only upon the approval of a doctor in:
- Narrowing of renal arteries;
- Kidney transplant;
- Aortic or mitral stenosis (with impaired hemodynamic parameters);
- Age under eighteen years;
- Cerebrovascular diseases;
- Kidneys dysfunction with creatinine clearance lower than 80 ml per minute;
- Ischemic heart disease;
- Oppressed bone marrow;
- Connective tissue diseases (e.g. lupus);
- Therapy to suppress the immune response of the body;
- Use of allopurinol or procainamide;
- Liver failure;
- Raised level of potassium in the serum;
- Use of potassium-saving diuretics, or other potassium level promoting substances, and lithium formulations;
- Allergic history or angioedema;
- Diminished blood volume (including during diuretic therapy, a diet with restricted salt, diarrhea, and so on);
- On dialysis with high-flow membranes;
- After major surgery;
- Advanced age (> 65 years);
- Primary aldosteronism;
- People of African descent.
Can Vasotec be used when expecting a baby?
No, the medication is strictly contraindicated for pregnant women. If a woman gets pregnant while using the formulation, she must immediately discontinue using it as it can cause severe birth defects in a fetus.
Possible adverse reactions to Vasotec use
The majority of adverse reactions that are related to the use of Enalapril are minor and temporary and do not need the quitting of the therapy.
However, before you buy Vasotec and start using it you should know that you may develop:
- Anemia, neutropenia, decreased hemoglobin, decreased hematocrit, bone marrow suppression, pancytopenia, lymphadenopathy, and autoimmune diseases.
- Depression, headache, confusion, sluggishness, lightheadeness, insomnia, irritability, sleep disorders, abnormal dreams, unclear vision.
- Hypotension chest pain, heart rhythm disorder, fast heartbeat, infarction or stroke, possibly due to excessive reduction of arterial pressure in individuals with high risk, Raynaud's syndrome.
- Cough, shortness of breath, nasal congestion or runny nose, sore throat, bronchospasm.
- Nausea, diarrhea, pain in the abdomen, pancreas dysfunction, vomiting, constipation, loss of appetite, indigestion, dryness of the mouth, peptic ulcers, hepatitis, and jaundice.
- Rash, swelling of different body parts, enhanced sweating, hair loss, dermatitis, and others.
- Renal failure, protein in urine, difficulty urinating.
- Impotence, gynecomastia.
- Asthenia, fatigue; muscle cramps, hot flashes, tinnitus, discomfort.
- Hyperkalemia, elevated serum creatinine; raise of blood urea, hyponatremia, raise of liver enzymes and bilirubin.
The recommended dosages depend on the disease treated, age, and weight of the patient. Please consult your doctor for individual instructions before you buy Enalapril. Here you can find the general recommendations for use:
- Hypertension. The dosage is from 5 to 20 mg based on the severity of hypertension and the individual’s condition. The prescribed dosage is taken once a day. For mild severity hypertension, the initial dosage is 5-10 mg with a subsequent increase if the formulation is well tolerated and the dosage insufficiently lowers arterial tension. Individuals with renovascular hypertension, impaired saline and/or fluid balance, decompensation of cardiac function, or severe arterial hypertension should start the use of the medication from 5 mg a day or lower dosage and raise the dosage only under a doctor’s supervision. Individuals who had been using diuretics before this ACE inhibitor are recommended to take a break of two to three days before starting Vasotec use take the daily dosage of 5 mg. The general maintenance dosage is 20 mg a day and the maximal daily dose is 40 mg a day.
- Heart Failure. The formulation is combined with water pills and, if needed, with digitalis or beta-blockers. The starting dosage is 2.5 mg, while the use of the medication should be carried out under a doctoral supervision to establish the primary effect of the pills on arterial tension. If there is no effect, or after appropriate correction of hypotension that occurred at the beginning of therapy, the dose should be raised little by little to the recommended supporting dosage of 20 mg, administered once or divided into two doses depending on what the patient tolerates better. The adjustment of the dose is encouraged to be done within 2-4 weeks. Such a therapeutic regimen effectively reduces the mortality rates of individuals with clinically severe heart failure. The maximal dosage is 40 mg per day in two intakes. It is required to monitor blood tension, the level of potassium and renal function.
Dosage adjustment of Enalapril
- Individuals with kidney failure should receive either lowered dosages or make longer intervals between the intakes. The recommended dosages are:
- Creatinine clearance from 80 to 30 ml per minute – 5-10 mg a day;
- Creatinine clearance from 30 to 10 ml per minute – 2.5 mg a day.
- Severe kidney failure with cc less than 10 ml per minute – 2.5 mg at the day of dialysis.
- Dosages for senior patients should be adjusted based on their kidney function.
- Children can be given the individually chosen dosages. The common initial dosage is 2.5 mg for kids with the body mass from 20 to 50 kg and 5 mg for kids over 50 kg. The dosages should be altered by a doctor based on the tolerance and response of a treated individual up till 20 mg a day for kids with the body mass from 20 to 50 mg and up to 40 mg for kids with the body mass over 50 kg.
Vasotec overdose symptoms and treatment
The data on the medication overdose is limited. However, there are presumable symptoms that can develop when taking an increased dosage of the medication: the most pronounced symptom is the blood pressure drop below the norm which develops around six hours after the high dosage intake. Other possible symptoms are an electrolyte imbalance, renal failure, lung hyperventilation, tachycardia, rapid heartbeat, bradycardia, lightheadedness, anxiety, and cough.
The first measure that should be taken if an overdose occurred not more than 30 minutes ago is to induce vomiting. Besides, gastric lavage, and intake of absorbents are recommended.
If the manifestations of overdose are severe, it is required to seek emergency help and lie the patient down. At the hospital, the following measures can be undertaken: IV of isotonic solution, angiotensin II infusions and/or catecholamine administration, hemodialysis. For bradycardia resistant to therapeutic agents, therapy with a pacemaker is needed. Important vital signs, electrolyte levels, and serum creatinine levels must be monitored.
Before you buy generic Enalapril, verify that you take it only with the medications and substances it is compatible with.
- The medication is incompatible with Aliskiren and Aliskiren-containing formulations;
- The medication enhances the action of ethanol (alcohol);
- It slows down the washing down of lithium;
- Enalapril lowers the effect of medications that contain Theophylline;
- The blood tension-lowering effect of the medication is lowered by NSAIDs and estrogens;
- The effect of the medication is enhanced with water pills, other blood pressure formulations (beta-blockers, nitrates, hydralazine, and prazosin), anesthesia, and ethanol.
- The use of the formulation with potassium-sparing diuretics or any formulations that promote potassium levels rise in the body increase the risk of hyperkalemia.
- The use of the formulations that cause inhibition of bone marrow function heightens the danger of developing neutropenia and/or agranulocytosis.
- Immunosuppressants, allopurinol, and cytostatics increase hematotoxicity (toxic effect on the blood).
If you use any other medications, please consult your doctor.
Hypotension related to the use of the medication is rarely observed in individuals with uncomplicated hypertension. It can develop in hypovolemia (decreased blood volume), which occurs, for example, as a result of diuretic therapy, while limiting salt intake, in patients on hemodialysis, as well as in patients with diarrhea or vomiting.
Drop of arterial tension due to the use of the medication can also develop in individuals with heart failure accompanied or not accompanied by kidney dysfunction. Drop of arterial tension is developed more frequently in individuals with more severe forms of heart failure, who used higher doses of loop diuretics, with hyponatremia or impaired renal function.
For such individuals, Enalapril use must be made under a physician’s control. When altering the dosage, the control should be particularly careful. Similarly, individuals with coronary heart disease must be monitored, as well as with vascular diseases of the brain, in which an excessive drop in blood pressure can cause myocardial infarction or stroke.
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