Препарат Энап относится к ингибиторам АПФ, используется для снижения артериального давления у пациентов с различными заболеваниями сердца и сосудов. При наличии противопоказаний к применению данного лекарства больным назначают аналоги Энап. Современная фармацевтика предлагает широкий выбор препаратов, которые являются аналогичными по своему составу и действию, оказывают гипотензивный эффект. В статье рассмотрим информацию о том, какие препараты входят в этот список.
Несколько слов о действии препарата
Энап – это быстродействующее гипотензивное средство, включающее в свой состав активное вещество – эналаприла малеат. Механизм действия медикамента заключается в подавлении синтеза гормона ангиотензина II, что позволяет поддерживать диастолическое и систолическое давление на нормальном уровне. Во время лечения с помощью препарата удается снять нагрузку с миокарда, предотвратить регрессию функционирования левого желудочка сердца, предупредить другие опасные для жизни осложнения.
Иногда случается так, что по различным причинам Энап не помогает или вызывает побочные эффекты у человека. В таких ситуациях доктор подбирает заменители средства, обладающие похожим терапевтическим действием.
Энап Н
Таблетки Энап Н производятся в России и Словении. В состав средства входит несколько активных компонентов. Это – гидрохлоротиазид и эналаприла малеат.
Таблетки имеют плоскую, круглую форму со скошенными краями, без явственного вкуса и запаха. Пакуются по 10 штук в блистеры. Картонная упаковка содержит несколько пластин.
- устранение спазмов;
- расширение сосудов;
- нормализация давления;
- снижение пост- и преднагрузки с миокарда.
После нормализации давления нарушения кровотока в области головного мозга не происходит. Частота сердечных ударов остается в норме. Кроме этого, Энап Н восстанавливает нормальное кровообращение в области почек, но процесс клубочковой фильтрации не нарушается.
Среди показаний к применению препарата следует назвать любые формы артериальной гипертензии.
Запрещено использовать лекарство среди больных с тяжелыми патологиями почек, печени, детям до 18 лет, во время беременности и лактации.
Дозировка лекарства определяется лечащим врачом. Средство следует принимать регулярно, стараться делать это в одно время суток. Разжевывать таблетки не нужно. Лекарство следует запить достаточным количеством чистой воды.
Энап НЛ
Препарат Энап НЛ входит в список лекарств заменителей Энапа. Средство производится словенской компанией KRKA. В состав препарата вошли компоненты – идрохлоротиазид и эналаприла малеат. Фармакологическая группа – ингибитор ангиотензин-превращающего фермента.
- предотвращает переход ангиотензина I в ангиотензин II;
- снижает количество гормона альдостерона в крови человека;
- восстанавливает функцию калликреин-кининовой системы;
- оказывает сосудорасширяющее действие.
- легкий мочегонный эффект;
- усиление выведения ионов калия почками;
- сохранение в организме ионов кальция;
- повышение выведения ионов магния.
После употребления таблетки препарат всасывается довольно быстро слизистой оболочкой желудка. Связь балка крови с активными компонентами лекарства составляет около 60%. Выводится препарат почками.
Показания к использованию – артериальная гипертензия различной этиологии.
Эналаприл
Таблетки Эналаприл – это относительно дешевый заменитель Энапа, выпускаемый российской компанией «Нижфарм». Главный действующий компонент лекарства — эналаприла малеат (20 мг в 1 таблетке).
- торможение синтеза гормона альдостерона корой надпочечников;
- расширение сосудов;
- снижение давления заклинивания в легочных капиллярах;
- уменьшение сопротивления легочных сосудов;
- повышение толерантности к физическим нагрузкам.
При регулярном использовании Эналаприла отмечается снижение тяжести недостаточности сердца, повышается устойчивость человека к стрессам, приостанавливается прогрессирование умеренной степени сердечной недостаточности.
Метаболизируется препарат в печени с образованием активного метаболита эналаприлата. Связь действующего вещества с белками плазмы составляет до 60%. Выводится остаток медикамента почками.
Показания к применению:
- гипертензия в любых проявлениях;
- сердечная недостаточность хронического типа;
- нарушение функционирования желудочков сердца;
- профилактика осложнений после инфаркта миокарда.
Эналаприл применяется в роли комплексной или самостоятельной терапии. Дозировка и схема приема подбирается индивидуально с учетом особенностей течения патологии у того или другого пациента. Обычно начальная доза лекарства составляет от 2,5 до 5 мг в сутки. Постепенно норма увеличивается до наступления желаемого терапевтического эффекта.
- отек Квинке в истории болезни;
- сужение одностороннего или двустороннего характера почечных артерий;
- острая дисфункция почек;
- беременность на любом сроке;
- грудное вскармливание;
- недостижение 18 лет.
При нарушении инструкции развиваются такие побочные эффекты, как боли в области желудка, тошнота, метеоризм. Иногда отмечается нарушение мочеиспускания, изменение состава крови, ухудшение дыхательной функции, аллергические высыпания на теле и прочие проявления.
Рассматривая вопрос, чем заменить Энап, нельзя оставить без внимания его прямой аналог Энам. Средство выпускается в форме белых или сероватых таблеток, края скошены, посредине видна маркировка «ЕМТ». На другой стороне таблетки указана дозировка действующего компонента – эналаприла малеата – 2,5; 5; 10 и 20 мг.
Как и другие представители ингибиторов АПФ, Энам предотвращает переход ангиотензина I в ангиотензин II. Благодаря этому отмечается расширение сосудов, артериальное давление человека приходит в норму. Кроме этого, препарат оказывает легкое мочегонное действие. При регулярном применении лекарства отмечается снижение пред- и постнагрузки с миокарда, замедление прогрессирования сердечной недостаточности и ишемической болезни сердца.
Эффективно работает Энам при реноваскулярной гипертензии и других формах болезни. При сердечной недостаточности средство применяют в составе комплексного лечения для предотвращения дальнейшего развития патологии, предотвращения инфаркта миокарда и других тяжелых последствий.
- митральный и аортальный стеноз;
- отек Квинке в анамнезе на фоне лечения ингибиторами АПФ;
- детский возраст;
- лактация;
- период вынашивания ребенка;
- индивидуальная чувствительность к препарату.
Дозировка медикамента определяется специалистом, зависит от тяжести течения заболевания и индивидуальных особенностей организма.
Багоприл
Таблетки Багоприл – еще один аналог, включающий в состав действующее вещество эналаприл. Производится лекарство аргентинской компанией «Laboratorios BAGO S.A.».
Таблетки имеют круглую двояковыпуклую форму с гравировкой в виде логотипа компании. Фасуется препарат в блистеры или пластиковые банки по 100 или 1000 штук.
Показания к применению:
- комбинированное лечение сердечной недостаточности с острым или хроническим течением;
- артериальная гипертензия, включая реноваскулярный тип.
Начальная дозировка средства обычно составляет 2,5–5 мг в утки. При хорошей переносимости и достижении желаемого лечебного эффекта доза увеличивается до 10–20 мг на протяжении дня. Максимальная суточная доза – 80 мг.
Противопоказания – стеноз почечных артерий, острое нарушение функционирования почек, все триместры беременности, лактация, возраст до 18 лет, непереносимость эналаприла, ангионевротический отек в истории болезни.
Среди побочных действий следует выделить головные боли, хроническую усталость. Иногда отмечается сухость во рту, приливы, эпигастральные боли, тошнота. Редко развивается нарушение мочеиспускания, функции дыхания.
Периндоприл
Замена Энапа в медицинской практике часто осуществляется с помощью Периндоприла. Лекарство производится российской компанией «ВЕРТЕКС АО». Производится препарат в форме плоскоцилиндрических таблеток, активным компонентом которых выступает периндоприла эрбумин.
Препарат относится к группе пролекарств, из которых после попадания в организм метаболизируется метаболит периндоприлат. Это позволяет достичь мощного сосудорасширяющего эффекта, благодаря чему давление человека приходит в норму. Средство ведет к уменьшению синтеза гормона альдостерона корой надпочечников.
Действие Периндоприла отмечается уже через 60 минут после употребления таблетки. Длительность эффекта лекарства сохраняется до 24 часов.
Показания к применению:
- гипертония;
- хроническая недостаточность сердца;
- профилактика инсульта и других осложнений у пациентов с заболеваниями сердечно-сосудистой системы;
- ишемическая болезнь.
Начальная терапия проводится с дозировкой 1–2 мг на продолжении суток. Лекарство употребляют в один прием. При застойных процессах на фоне сердечной недостаточности дозировка препарата составляет 4–8 мг средства.
Вазолаприл
Как и другие препараты аналоги Энапа, Вазолаприл включает в состав действующий компонент эналаприл, относится к представителям группы АПФ. Средство влияет на процесс перехода фермента ангиотензин I в ангиотензин II. При этом происходит расширение преимущественно артерий, а не вен, повышения частоты сердечных сокращений не возникает. Гипотензивное действие препарата более выражено при повышенном количестве ренина в крови, чем при его нормальном уровне или недостатке.
- нормализация показателей артериального давления;
- усиление почечного и коронарного кровотока;
- снижение выработки альдостерона корой надпочечников;
- уменьшение пред- и постнагрузки с миокарда;
- замедление развития дисфункции левого желудочка сердца.
Среди противопоказаний следует отметить почечную недостаточность, состояния после трансплантации почки, стеноз почечных артерий, избыток калия в организме, беременность и детский возраст.
Начальная дневная норма препарата обычно составляет от 2,5 до 5 мг. При отсутствии должного лечебного эффекта дозировку постепенно увеличивают до 40 мг на протяжении дня.
- снижение аппетита;
- боли в животе;
- аритмия;
- нарушение дыхательной функции;
- головная боль, подавленность;
- раздражительность, апатия, быстрая утомляемость.
При употреблении слишком большой дозы лекарства развивается передозировка, сопровождающаяся сильным снижением давления, спутанностью сознания, нарушением дыхания. При развитии такого состояния следует немедленно доставить человека в больницу.
Медикаментозные средства, относящиеся к группе ангиотензин-превращающего фермента, являются сильнодействующими препаратами, отпускаются из аптек преимущественно по рецепту врача. Принимать Энап или его любой аналог следует в четком соответствии с рекомендациями специалиста. Бережное отношение к своему организму поможет предотвратить негативные последствия и осложнения, достичь желаемого эффекта лечения.
Чтобы нормализовать артериальное давление, укрепить сосуды и стимулировать сердечную деятельность, врачи нередко назначают гипотензивные препараты, например, Энам или Энап. Эти средства относятся к группе АПФ-ингибиторов, и у них одинаковый механизм действия. Однако между медикаментами существуют и отличия.
Чтобы нормализовать артериальное давление, укрепить сосуды и стимулировать сердечную деятельность, врачи нередко назначают гипотензивные препараты, например, Энам или Энап.
Характеристика Энама
Это гипотензивное средство, которое производится в виде таблеток. Основной компонент — эналаприла малеат. Препарат угнетает ангиотензинпревращающий фермент, в результате чего снижается активность АПФ-фермента, и уменьшается выработка ангиотензина-II. Медикамент оказывает диуретическое действие и эффективно снижает давление, а также уменьшает нагрузку на миокард при сердечной недостаточности.
Кроме того, Энам обладает следующими свойствами:
- стимулирует дыхательную функцию организма;
- усиливает кровообращение малого круга;
- нормализует ток крови в сосудах почек.
Это лекарственное средство не позволяет развиваться диабетической нефропатии и усиливает почечный кровоток, благодаря чему снижается сердечная смертность. Максимальная концентрация медикамента наблюдается через 4 часа после его приема. Действует лекарство в течение суток, после чего выводится почками.
Показания к применению:
- артериальная гипертензия;
- хроническая сердечная недостаточность (в комплексной терапии).
К противопоказаниям относят:
- ангионевротический отек;
- сниженную функцию почек;
- беременность;
- грудное вскармливание;
- митральный и аортальный стеноз;
- чрезмерную чувствительность к составляющим средства.
Энам оказывает диуретическое действие и эффективно снижает давление, а также уменьшает нагрузку на миокард при сердечной недостаточности.
Осторожность при приеме медикамента следует проявлять при следующих заболеваниях:
- гиповолемия;
- стеноз почечных артерий;
- сниженная функция почек;
- сердечная недостаточность;
- нарушение водно-солевого баланса;
- ишемическая болезнь сердца;
- нарушение церебрального кровотока.
Энам чаще всего переносится неплохо, но иногда могут развиться следующие побочные эффекты:
- ринорея, сухой кашель, одышка, глоссит, фарингит;
- инфаркт миокарда, брадикардия;
- запор, диарея, нарушение пищеварения, боль в эпигастрии, панкреатит, сухость слизистой рта, тошнота;
- изменение вкуса, стоматит;
- депрессивное состояние, звон в ушах, нарушение сна, головная боль;
- уменьшение количества гемоглобина, нейтропения;
- бронхоспазм, зуд кожного покрова, крапивница;
- повышенная потливость, синдром Рейно, облысение, агранулоцитоз.
При передозировке может развиться артериальная гипотензия.
Действие Энапа
Это гипотензивный препарат, который производится в виде таблеток. Основной компонент — эналаприла малеат. Механизм действия лекарства основан на угнетении активности АПФ, в результате чего снижается давление и нагрузка на миокард. Медикамент расширяет артерии, при этом не способствует увеличению частоты сокращений сердца. При снижении давления под действием Энапа не нарушается мозговое кровообращение. Также препарат усиливает кровоснабжение коронарного и почечного кровотока.
При длительном приеме медикамента наблюдаются следующие благоприятные эффекты:
- уменьшаются миоциты стенок артерий;
- снижается гипертрофия левого желудочка миокарда, и замедляется развитие его дилатации;
- улучшается кровообращение миокарда;
- предотвращается возникновение сердечной недостаточности.
Препарат не позволяет склеиваться тромбоцитам и оказывает небольшое диуретическое свойство. Максимальная концентрация средства наблюдается через 1 час после его приема, а лечебный эффект длится сутки.
Показания к применению:
- артериальная гипертензия;
- эссенциальная гипертензия;
- хроническая сердечная недостаточность;
- профилактика коронарной ишемии у больных с дисфункцией левого желудочка.
Показанием к применению Енапа является артериальная гипертензия.
Дневная норма препарата — 10-20 мг/сут., который принимают 2 раза в день.
К противопоказаниям относят:
- отек Квинке в анамнезе;
- недостаток лактазы, непереносимость лактозы, синдром глюкозо-галактозной мальабсорбции;
- идиопатический ангионевротический отек;
- чрезмерную чувствительность к составляющим средства;
- беременность;
- грудное вскармливание;
- возраст до 18 лет.
Осторожность следует проявлять при приеме медикамента при следующих заболеваниях и состояниях:
- стеноз почечных артерий;
- ишемическая болезнь сердца;
- гипертрофическая обструктивная кардиомиопатия;
- первичный гиперальдостеронизм;
- после пересадки почки;
- гиперкалиемия;
- почечная недостаточность;
- угнетение кроветворения;
- сахарный диабет;
- системные патологии соединительной ткани.
Во время лечения Энапом возникает риск побочных эффектов:
- лимфаденопатия, аутоиммунные заболевания, панцитопения, угнетение кроветворения, снижение количества гемоглобина и гематокрита, нейтропения, анемия;
- гипогликемия;
- депрессивное состояние, нарушение сна, вертиго, сильная возбудимость, бессонница, сонливость, головная боль;
- синдром Рейно, инфаркт миокарда, инсульт, нарушение сердечного ритма, стенокардия, боль в груди, сильное понижение давления;
- нечеткость зрения, шум в ушах, изменение вкуса;
- диарея, сухость слизистой полости рта, анорексия, рвота, запор, метеоризм, тошнота;
- кашель, ринит, одышка, бронхоспазм, боль в горле;
- сыпь, эритродермия, крапивница, облысение, зуд, повышенное отделение пота, отек Квинке;
- олигурия, гинекомастия, импотенция, почечная недостаточность, протеинурия, нарушение работы почек;
- мышечные судороги.
При передозировке может сильно снизиться давление, развиться коллапс, брадикардия, сильное сердцебиение.
В чем разница и сходство Энама и Энапа?
Оба препарата содержат одинаковый активный компонент, поэтому они оказывают аналогичный механизм действия: угнетают ангиотензинпревращающий фермент, который способствует повышению давления. Энам производится в Индии, а Энап — в Словении. Выпускают медикаменты в виде таблеток. Переносятся они хорошо, поэтому разрешены для длительного использования. У препаратов практически одинаковые противопоказания и большое количество побочных эффектов.
Что лучше принимать — Энам или Энап?
Оба медикамента хорошо избавляют от проявления гипертонической болезни, но давление быстрее приходит в норму при использовании Энапа. Однако только врач должен решать, какое средство лучше, подбирая дозировку с учетом уровня давления.
Что дешевле?
Цена Энама — 60 руб., Энапа — 550 руб.
Можно ли заменить Энам на Энап?
В некоторых случаях Энам заменяют Энапом, что позволяет добиться максимального терапевтического результата.
Мнение врачей
Татьяна, 54 года, терапевт, Москва: «Препарат Энам хорошо помогает снизить повышенное давление, но он считается сильнодействующим средством, поэтому запрещено превышать рекомендованную дозу. После приема медикамента пациент находится под моим наблюдением около 3 часов, т. к. нередко развивается аритмия».
Виктория, 49 лет, терапевт, Ярославль: «Препарат Энап чаще всего назначаю на ранних стадиях артериальной гипертензии. Принимать его следует 1 раз в день, а длительность лечения определяю индивидуально. Медикамент имеет много побочных эффектов, поэтому при необходимости его заменяю на другое средство».
Отзывы пациентов
Александр, 59 лет, Санкт-Петербург: «У меня постоянно повышается давление, поэтому врач назначил препарат Энам. Принимаю его утром 1 раз в день. Стоит он недорого, а помогает лучше дорогих лекарственных средств. Никогда не возникало побочных явлений».
Екатерина, 61 год, Тверь: «Месяц назад лежала в больнице в терапевтическом отделении с высоким давлением. Врач назначил препарат Энап, который я принимала дважды в день по 10 мг. Давление после приема таблеток быстро приходит в норму».
Число людей, страдающих артериальной гипертензией, с каждым годом увеличивается. Заболевание диагностируют не только у пожилых людей — повышенное давление все чаще выявляется у молодого поколения, и даже детей. К основным методам лечения патологии относят назначение гипотензивных препаратов. Лидирующее место среди них занимают средства, принадлежащие к группе ингибиторов АПФ (природных и синтетических соединений, использующихся для лечения повышенного АД и профилактики сердечной недостаточности). Их популярные медикаментозные формы — Энап или Эналаприл.
Характеристика Энапа
Эффективность средства основана на действии его активного вещества эналаприла малеата и входящих в состав дополнительных ингредиентов:
- гидрокарбоната натрия;
- стеарата магния;
- лактозы;
- крахмала;
- гипролозы;
- талька.
Энап производится в виде раствора (1,25 мг/мл) и таблеток (по 2,5, 5, 10 и 20 мг), которые показаны при эссенциальной гипертензии и хронической сердечной недостаточности, а также в качестве профилактики (при комплексной терапии):
- коронарной ишемии;
- инфаркта миокарда;
- стенокардии.
Таблетки рекомендуется принимать в одно и то же время, независимо от еды, запивая водой. Схема зависит от диагноза, состояния пациента, параллельно назначенных лекарств. Рекомендации к употреблению таблеток:
- при гипертонии допускается разовый прием по 2,5-10 мг (желательно утром);
- чтобы исключить резкое понижение давления, лучше начинать с дозы, не превышающей 5 мг/сут.;
- объем препарата необходимо повышать постепенно;
- поддерживающая дозировка при хронической гипертонии — 20 мг ежедневно (за 1 или 2 раза);
- максимальный объем лекарства — не больше 40 мг в день;
- прием таблеток Энап можно назначать совместно с диуретиками, бета-адреноблокаторами, сердечными гликозидами;
- в процессе терапии необходимо контролировать работу почек, содержание калия в сыворотке.
Курс инъекционного введения показан по 1,25 мг через каждые 6 часов. Для выявления случаев, опасных резким понижением давления, рекомендована начальная доза инъекции — 625 мг. Спустя 1 час при адекватном результате дозу можно повторить в том же объеме, после чего продолжить лечение классическим способом (1,25 мг через 6 часов).
Характеристика Эналаприла
Эналаприл — это препарат, выпускаемый в таблетках (по 5, 10 и 20 мг). Таблетка содержит активный компонент эналаприл малеат и дополнительные ингредиенты:
- гидрокарбонат натрия;
- стеарат магния;
- лактозу;
- крахмал;
- кроскармеллозу.
Прием Эналаприла способствует сосудорасширяющему эффекту, поэтому является незаменимым лекарством для пациентов, страдающих:
- сердечной недостаточностью;
- артериальной и эссенциальной гипертензией;
- нестабильной стенокардией;
- риском развития инфаркта миокарда.
Прием препарата нельзя проводить самостоятельно (во избежание острой гипотензии). Классическая схема назначения Эналаприла предполагает начальный прием — 5 мг (1 раз в сутки). При дальнейшем лечении возможна средняя доза — 10-20 мг (за 1 или 2 раза). Максимальная дозировка — 80 мг в сутки.
Сравнение
Эналаприл и Энап — самые популярные из ингибиторов АПФ. Оба средства применяются в качестве антигипертензивных препаратов, контролирующих кровяное давление и нормализующих кардиальную активность. Действующий компонент этих лекарств способствует формированию в организме специальных защитных функций, улучшающих дыхание, снижающих нагрузку на сердце, предотвращающих сердечно-сосудистые проблемы.
Сходство
У препаратов идентичный механизм действия. Гипотензивные свойства достигаются путем ингибирования активности АПФ, провоцирующих снижение скорости превращения ангиотензина I в ангиотензин II. В результате уменьшения концентрации ангиотензина II, вызывающего сужение сосудов, происходит:
- увеличение активности ренина;
- торможение секреции альдостерона;
- снижение распада брадикинина;
- улучшение ренального кровотока.
После попадания Энапа или Эналаприла в организм их активный компонент хорошо всасывается. Максимальное его содержание обнаруживается в крови через 1 час. Торможение активности АПФ наступает через 2-4 часа после приема даже 1 таблетки. Гипотензивное действие продолжается 8-12 часов (это зависит от дозировки). Гемодинамический (противошоковый) эффект поддерживается в течение суток. Выводится препарат почками.
На фоне приема лекарств:
- расширяются сосуды;
- падает давление;
- нормализуется частота сокращений сердца;
- увеличивается почечный кровоток;
- у людей, страдающих нефропатией, уменьшается количество белка в моче;
- у пациентов с сердечной недостаточностью снижается ОПСС;
- повышается физическая выносливость организма (при длительном применении);
- тормозится дилатация (увеличение) левого желудочка;
- минимизируется риск ишемических инсультов.
Энап и Эналаприл имеют одинаковые противопоказания:
- аллергия на лактозу и другие компоненты;
- ангионевротический отек (наследственный отек Квинке);
- порфирия (нарушение синтеза гемоглобина);
- беременность и лактация;
- детский и подростковый возраст до 18 лет (ввиду отсутствия испытаний).
Назначают средства с осторожностью и под наблюдением врача при следующих состояниях:
- патология надпочечников;
- гиперкалиемия;
- трансплантация почки;
- склеродермия;
- сахарный диабет;
- пожилой возраст (после 70);
- последствия заболеваний (в т. ч. инсульта), приведшие к развитию слабоумия.
Побочные действия (отмечаются при передозировке):
- гипотония;
- инсульт или инфаркт (у группы высокого риска);
- снижение гемоглобина;
- головокружение;
- шум в ушах;
- потеря остроты зрения (редко);
- синдром Рейна (редко);
- кашель;
- расстройство ЖКТ (диарея, запоры, метеоризм, колики);
- синдром Стивенса-Джонсона;
- судороги.
Препараты отпускаются по рецепту.
В чем разница?
Отличия у лекарств несущественные. Хотя Энап зарекомендовал себя, как более популярное средство, поскольку:
- можно купить этот препарат не только отечественного производства, но и фармацевтической компании КРКА (Словения), которая славится качеством и гарантирует потребителю защиту от подделок;
- реже вызывает аллергию, т.к. в состав таблеток входит гипролоза — натуральное вещество на основе целлюлозы, получаемое из дерева;
- имеет большее разнообразие объемов (начиная от 2,5 мг);
- производится как в твердых формах, так и инъекциях.
Отличительные качества препарата Эналаприл:
- средство продается только в форме таблеток (но если спросить в аптеке уколы с эналаприлом, то специалисты их предложат под торговым названием Энап);
- в составе компонентов содержится натрия кроскармеллоза (вместо гипролозы) — это малотоксичный дезинтегрант химического происхождения, позволяющий таблетке быстрее растворяться;
- отечественный Эналаприл стоит недорого;
- в аптеках можно встретить Эналаприл Гексал — это продукт из Германии (производитель Салютас Фарма);
- в продаже есть индийский Эналаприл от фирмы Интас;
- из представленного разнообразия лучше выбрать лекарство немецкой фабрики, даже если оно дороже.
Что дешевле?
Цена раствора для инъекций Энап (1,25 мг/мл) 1 мл № 5 — 498 руб. А стоимость твердых форм:
- 2,5 мг № 20 — 55 руб.;
- 5 мг № 20 — 65 руб.;
- 10 мг № 20 — 76 руб. (Энап Н — 170 руб.);
- 20 мг № 20 — 118 руб. (Энап НЛ — 185 руб.).
Цена на таблетки Эналаприл:
- 5 мг № 28 — 46 руб.;
- 10 мг № 20 — 53 руб. (Эналаприл Гексал — 70 руб.);
- 20 мг № 20 — 90 руб.
Можно ли заменить Энап на Эналаприл?
Чтобы определить взаимозаменяемость препаратов, ученые провели ряд исследований. В них участвовали 2 группы пациентов, нуждающихся в лечении гипотензивными средствами. Одна группа принимала регулярно Энап, а другая — Эналаприл. Через 2 недели эксперимента участники поменялись препаратами. Результаты для обеих групп были идентичными, из чего специалисты вывели заключения:
- Эффект от действия Энапа и Эналаприла одинаковый.
- Оба препарата переносятся пациентами хорошо.
- Исследования подтверждают, что Энап и Эналаприл взаимозаменяемы.
Некоторые врачи даже взяли за правило в период длительной терапии чередовать назначение этих лекарств-аналогов, что, по их мнению, обеспечивает достижение максимального эффекта.
Что лучше Энап или Эналаприл?
Оба представителя группы ингибиторов ангиотензинпревращающего принципа действия имеют одинаковый состав, поэтому являются аналогами.
Выбирая препарат, лучше ориентироваться на форму выпуска, дозировку, стоимость и производителя.
Чаще всего потребители отдают предпочтение лекарству Энап из Словении.
Мнение врачей
Песков В. М., кардиолог, г. Мурманск
Эналаприл и Энап — эффективные гипотензивные средства, мягко снижающие артериальное давление, нормализующие кардиальную активность и предупреждающие развитие сердечной недостаточности. Рекомендую к приему.
Старостина Л. С., терапевт, г. Чехов
Любые препараты, в т. ч. и эти, не следует принимать без назначения специалиста, поскольку здесь важны адекватные дозировки. Учитывая опасность состояний, для снятия которых предназначены Энап и Эналаприл, наличие широкого ряда противопоказаний, возможных осложнений со стороны других органов, самолечением заниматься не советую.
Климов, невролог, г. Москва
Противопоказания и побочные явления в статье освещены не полностью. Так что перед употреблением внимательно изучайте аннотацию. Препараты доступные, имеют хорошую переносимость, разницы в эффекте нет. Но даже врач не сможет спрогнозировать, какие побочные реакции могут спровоцировать сопутствующие заболевания. Гипертоникам подходящее средство подбирают кропотливо и тщательно.
Отзывы пациентов об Энапе и Эналаприле
Мария, 49 лет, г. Кимры: «Скачет давление. Из этих 2 составов советую Энап. Возможно, действие зависит от производителя, где составы отличаются качеством, но Эналаприл считаю препаратом слабым и кратковременным. А принимаю Энап — достаточно 1 таблетки по утрам, и весь день держится нормальное давление».
Лариса, 61 год, г. Москва: «При диагнозе сердечная недостаточность 10 лет принимала Эналаприл, но организм вдруг перестал на него реагировать. Хотя побочных явлений не замечаю, просто нет эффекта и все. Врач посоветовал перейти на другую группу гипотензивных средств — сартаны. Это Лозартан, Телмисартан, Микардис и др. Теперь подбираем новое лечение».
Анна, 55 лет, г. Мичуринск: «Лекарства с окончанием -прил в названии не всем подходят. У меня в качестве побочного эффекта проявился сухой кашель. Давление корректирую Лерканидипином. Но лучше посоветоваться со специалистом».
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