
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Enaloside
Medical expert of the article
Last reviewed: 04.07.2025

Enalozide is a complex antihypertensive agent with diuretic properties.
ATC classification
Active ingredients
Pharmacological group
Pharmachologic effect
Pharmacodynamics
The drug contains 2 active elements that mutually potentiate each other’s medicinal effects and reduce the degree of negative manifestations.
Enalapril is a prodrug that undergoes metabolic processes inside the human body, during which the pharmacoactive substance, enalaprilat, is formed. The active component can improve blood circulation inside the kidneys, reduce pre- and post-load in relation to the cardiac muscle of the myocardium and has a powerful antihypertensive activity. At the same time, the substance reduces the volume of potassium loss due to the use of hydrochlorothiazide. The therapeutic effect is produced by slowing down a specific component of ACE, as a result of which the production of angiotensin-2, which has a vasoconstrictor effect, decreases.
Due to the introduction of Enalozide, the systemic resistance of peripheral vessels decreases and vascular vasodilation occurs, which does not lead to the development of reflex tachycardia. The effect of the drug helps to prevent the breakdown of bradykinin and reduce the release of aldosterone.
Hydrochlorothiazide is the second element of the drug, a diuretic substance from the thiazide category. The active component has a diuretic and natriuretic effect, reduces the amount of circulating blood and has hypotensive activity, reducing the sodium ion levels inside vascular membranes, as a result of which vascular sensitivity to vasoconstrictor agents is weakened.
Pharmacokinetics
The active components of the drug are well absorbed, penetrating into the digestive system. During the exchange processes, therapeutically inactive metabolic products with the active substance enalaprilat are formed. After oral administration, plasma values of Cmax of enalaprilat are observed after 3-4 hours. The medicinal effect develops after 2 hours, reaching a peak level after 4 hours. The resulting antihypertensive effect can persist for 24 hours, due to which Enalozide can be taken once a day.
The half-life of hydrochlorothiazide is 10 hours, and that of enalaprilat is 11 hours. The excretion period of the active ingredients is increased in people with kidney disease.
Dosing and administration
Enalozide is taken orally. Therapy begins with the use of minimal doses of enalapril with hydrochlorothiazide. Over the course of 14 days, it is necessary to monitor blood pressure values and the strength of the drug effect; if necessary, the therapeutic regimen is adjusted. The dose should be increased at 2-week intervals, if necessary. The daily dose is taken in 1 dose.
Antihypertensive treatment begins with the use of a 10+12.5 dose. A maximum of 20 mg of enalapril and 25 mg of hydrochlorothiazide per day is allowed.
If the patient has kidney problems, it is necessary to adjust the dosage of Enalozide, because its action is based on CC indicators.
To prevent the risk of orthostatic collapse, you should avoid any sudden movements and lie down for a while after using the drug (if possible). You should stop using other diuretics before starting therapy. You should also be sure to monitor the values of electrolytes, glucose, the main indicators of a general blood test, as well as the condition of the kidneys.
[ 22 ]
Use Enalapril during pregnancy
Enalozide should not be prescribed in the 2nd and 3rd trimesters of pregnancy. The drug can be used in the 1st trimester, but only if there are strict indications, for symptomatic reduction of high blood pressure values, if other treatment options are not available. Women of reproductive age must use reliable contraception. If pregnancy has been established, the drug should be discontinued.
The medicine should not be used while breastfeeding.
Contraindications
Main contraindications:
- severe personal intolerance associated with enalapril, hydrochlorothiazide and other thiazide-type diuretics;
- diabetes mellitus;
- glucose-galactose malabsorption;
- hypolactasia or galactosemia;
- gout or anuria;
- conditions after kidney transplantation;
- kidney disease and liver failure;
- Conn's syndrome;
- porphyria;
- use in people undergoing hemodialysis procedures that use specific high-flux membranes and LDL apheresis with the addition of dextran sulfate;
- stenosis associated with renal arteries;
- after performing desensitization procedures for bee and wasp venom.
Among the conditional contraindications:
- alcoholism in a chronic form;
- vascular lesions of atherosclerotic nature;
- aortic stenosis;
- disorders of cerebral blood flow processes;
- idiopathic form of stenosis in the muscle area, which is subaortic in nature;
- conditions in which dehydration develops (hemodialysis processes, taking diuretic drugs, diarrhea syndrome or vomiting).
The drug should be discontinued before parathyroid examination procedures.
Side effects Enalapril
The medication is often tolerated without complications. Only occasionally are side effects noted:
- digestive system disorders: abdominal pain, hyperbilirubinemia, nausea, epigastric discomfort, bowel disorders, increased liver enzyme levels, hepatitis with cholestasis, and in addition vomiting, pancreatitis and digestive disorders;
- problems affecting the function of the cardiovascular system and hematopoietic processes: orthostatic collapse, decreased blood pressure, rhythm disorders, angina attacks, anemia, decreased platelet count, neutropenia and hyperemia in the face and upper body;
- PNS or CNS lesions: asthenia, vertigo, convulsive syndrome, visual disturbances, dizziness and severe headaches;
- allergic disorders: itching, urticaria, photophobia, rashes, angioedema and psoriasis-like symptoms;
- Other adverse effects include dyspnea, hypercreatininemia, proteinuria, and also Raynaud's disease, impotence, changes in blood electrolyte and glucose levels, structural changes in the nails, dry cough (often develops when using ACE inhibitors), and acute renal failure.
[ 21 ]
Overdose
In case of poisoning with the drug, there is a marked decrease in blood pressure. In case of orthostatic collapse, hypokalemia, headaches, renal dysfunction and dizziness appear.
Enalozide has no antidote. Measures related to gastric lavage and the use of enterosorbents (activated carbon, polysorb and baktistatin) can be performed.
If the patient is diagnosed with low blood pressure, he should be laid horizontally with his legs raised. If the disorder is severe, 0.9% NaCl should be administered. Angiotensin-2 can also be used if the patient is in a serious condition. The active components of the drug are excreted during hemodialysis.
Interactions with other drugs
The drug weakens the activity of pressor amines.
The antihypertensive effect of Enalozide is potentiated when combined with diuretics, ethanol, barbiturates, other antihypertensive drugs, phenothiazines, and also tricyclics and MAOIs.
The opposite effect develops when used together with cholestyramine or NSAIDs, as well as when consumed with food containing a large amount of salt.
An increased risk of anemia, leukopenia or pancytopenia, as well as other diseases affecting the hematopoietic system, is expected when combining the drug with allopurinol, immunosuppressants, cytostatics and systemic GCS (hypokalemia may additionally develop).
The drug can prolong the half-life of non-depolarizing muscle relaxants, as well as increase the toxic effects of Li and SG drugs (the effect occurs due to a slowdown in the excretion of metabolic products).
The drug may change blood glucose levels in diabetics. It has been found that Enalozide affects the effectiveness of oral hypoglycemic agents with insulin. It is necessary to additionally adjust the dosage regimen of antidiabetic drugs.
The activity of allopurinol, terazosin, and estrogen-containing oral contraceptives is reduced by the use of hydrochlorothiazide.
An increased risk of developing hyperkalemia is observed when using the drug in combination with potassium-sparing diuretics and potassium drugs.
Use in children
The medication cannot be used in pediatrics (under 14 years of age).
Analogues
Analogues of the drug are the medications Enam N, Berlipril Plus, as well as Co-renitek with Enap N.
[ 39 ], [ 40 ], [ 41 ], [ 42 ], [ 43 ], [ 44 ], [ 45 ], [ 46 ]
Reviews
Enalozide effectively lowers blood pressure to optimal levels, thereby ensuring a stable condition in people with hypertension. The drug can also be used in cardiology. Patients in their reviews note that the drug is tolerated without noticeable complications - pronounced negative signs do not occur (especially with long-term treatment).
Manufacturer
Attention!
To simplify the perception of information, this instruction for use of the drug "Enaloside" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.