Weakness, hypersensitivity reactions (angioedema, thrombocytopenic purpura, urticaria, pruritus), necrotizing vasculitis. fever, respiratory distress syndrome, including pneumonitis and pulmonary edema, anaphylactic reactions.
Cardio-vascular system, heart, various arrhythmias, marked reduction in blood pressure of heart, orthostatic hypotension, cardiac arrest, myocardial infarction, cerebrovascular stroke, angina, Raynaud’s syndrome. On the part of the digestive tract: dry mouth, glossitis, stomatitis, inflammation of the salivary glands, anorexia, nausea, vomiting, diarrhea, constipation, flatulence, epigastric pain, intestinal colic, ileus, pancreatitis, hepatic failure, hepatitis, jaundice, melena. The proviron side effects respiratory system: rhinitis, sinusitis, sore throat, hoarseness, bronchospasm, pneumonia, pulmonary infiltrates, eosinophilic pneumonia, pulmonary embolism, pulmonary infarction, pulmonary edema, non-productive “dry” cough.
With the genitourinary system: oliguria, gynecomastia, reduced potency , renal failure, renal failure, interstitial nephritis. For the skin: sweating, rash, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme, Stevens-Johnson syndrome, herpes zoster, alopecia, photosensitivity. From the senses: blurred vision, taste disturbance, disturbance of smell, tinnitus, conjunctivitis, dryness of the conjunctiva, lacrimation. On the part of the central nervous system:depression, ataxia, drowsiness, insomnia, anxiety, nervousness, peripheral neuropathy (paresthesia, dysesthesia), dizziness. Laboratory findings: hypokalemia, hyperkalemia, hypomagnesemia, hypercalcemia, hyponatremia, gipohloremichesky alkalosis, hyperglycemia, glycosuria, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, increased activity of “liver” enzymes, hyperbilirubinemia, leukocytosis, eosinophilia, neutropenia, leukopenia, agranulocytosis, anemia, pancytopenia, decreased Occupational hemoglobin and hematocrit. Other: lupus-like syndrome described in the literature (fever, myalgia and arthralgia, serositis, vasculitis, increased erythrocyte sedimentation rate, leukocytosis, and eosinophilia, skin rash, a positive test for antinuclear antibodies), muscle sudorgi, gout.
Overdosing Symptoms: increased diuresis, marked reduction in blood pressure with bradycardia or other cardiac arrhythmias, convulsions, paresis, paralytic ileus, impaired consciousness (including someone), renal insufficiency, disturbance of acid-base balance, disturbance of electrolyte balance of blood. Treatment: the patient is transferred to horizontal position with a low headboard. In mild cases shown gastric lavage and ingestion of saline, in more serious cases -meropriyatiya to stabilize blood pressure – in / in a saline solution, plasma substitutes. The patient must be monitored blood pressure level, heart rate, respiratory rate, plasma concentrations of urea, creatinine, electrolytes and diuresis, when necessary -to / from proviron side effects administration of angiotensin II, hemodialysis (enalaprilat elimination rate – 62 mL / min).
Interactions with other medicinal products
Co-administration of other antihypertensive drugs, barbiturates, tricyclic antidepressants, phenothiazines, and narcotics, increases the antihypertensive effect .
Analgesics and non-steroidal anti-inflammatory drugs, a large amount of salt in the diet, concomitant use of cholestyramine or colestipol reduce . Concomitant use with drugs lithium may lead to lithium intoxication as enalapril and hydrochlorothiazide reduce the excretion of lithium. Necessary to control the concentration of lithium in blood serum and its dosage is corrected accordingly. If possible, avoid simultaneous treatment Prilenapom ® and lithium drugs.
Simultaneous use proviron side effects and nonsteroidal anti-inflammatory drugs and analgesics (due to inhibition of prostaglandin synthesis) can reduce the effectiveness of enalapril and increase the risk of deterioration of renal function and / or current heart failure. In some patients, while treatment may also decrease the antihypertensive effect of enalapril, therefore patients should be monitored closely.Simultaneous treatment with potassium-sparing diuretics (spironolactone, amiloride, triamterene) or the addition of potassium can lead to hyperkalemia.
Co-administration with allopurinol, cytostatics, immunosuppressants or systemic corticosteroids may cause leukopenia, anemia or pancytopenia, requiring periodic inspection of hemogram.
Reported acute renal failure in 2 patients after renal transplantation while receiving enalapril and cyclosporine. It is assumed that acute renal failure is a result of reduction in renal blood flow caused by cyclosporin and decrease in glomerular filtration caused by enalapril. Therefore, care should be taken while using enalapril and cyclosporine.
Co-administration of sulfonamides and oral hypoglycemic agents from the group of sulfonylureas may cause hypersensitivity reactions (possible cross-hypersensitivity).
Care should be taken while using with cardiac glycosides. Possible gidrohlorotiazidindutsirovannaya hypovolemia, hypokalemia and hypomagnesemia may increase the toxicity of glycosides.
Co-administration with corticosteroids increases the risk of hypokalemia.
With simultaneous use with theophylline, enalapril may reduce the half-life of theophylline.
In an application with cimetidine may increase the half-life of enalapril.
The risk of arterial hypotension increases in while the use of general anesthesia or muscle relaxants nedepolyariziruyuschih proviron side effects (eg, tubocurarine).