Nuril 5 Tablet (Enalapril 5mg)

INTRODUCTION

NURIL 5MG contains Enalapril which belongs to the group of medicines called Angiotensin-converting enzyme (ACE) inhibitors. It is used in the treatment of high blood pressure (hypertension). It can also be used in the treatment and prevention of heart failure. Heart failure is a chronic condition in which the heart cannot pump adequate amount of blood properly, resulting in shortness of breath, swelling of the ankles and feet or tiredness after mild physical activity such as walking.

Enalapril works by causing relaxation of the blood vessels, leading to lowering of blood pressure. It increases the supply of oxygen and blood to the heart muscles, which prevents heart failure and can lower the need to go to hospital by making some patients live longer. Along with the treatment, your doctor might ask you to make certain lifestyle changes such as quitting alcohol and smoking, improve your sleep at night, eating a healthy diet and manage weight.

This medicine usually starts to work within 1 hour, and its effect may last up to 24 hours. Duration of the treatment may differ from person to person depending upon their health condition. However, for some people, several weeks of treatment are required to see best effect on blood pressure. The most common side effects are dizziness, nausea or blurred vision. These symptoms are usually temporary and disappears with the course of treatment. Before taking this medicine, inform your doctor if you have kidney problems including kidney transplantation, as it may lead to higher levels of potassium in your blood which can be serious. Proper dose adjustments and regular monitoring of blood potassium levels and kidney functions are required in such patients. This medicine is not recommended for use in pregnant or breastfeeding women. Consult your doctor before taking this medicine.

USES OF NURIL 5MG

Treat high blood pressure
Treats and prevents heart failure

HOW NURIL 5MG WORKS

Enalapril is a potent ACE inhibitor which inhibits the activity of the enzyme called Angiotensin-converting enzyme, an enzyme responsible for the conversion of Angiotensin-I to Angiotensin-II in the RAAS system. Angiotensin-II is a potent vasoconstrictor which leads to increase in blood pressure and other heart problems.

Inhibition of ACE enzyme by enalapril, inhibits the production of Angiotensin-II, leading to widening of the blood vessels and reduction of blood pressure. It also increases the supply of oxygen and blood to the heart which reduces the risk of heart failure.

DIRECTIONS FOR USE

Take NURIL 5MG as directed by your physician. It can be taken with or without food. Swallow the medicine as whole with a sip of water. Do not crush or chew the medicine. Your doctor will decide the correct dose for you depending upon your condition. Continue to take this medicine, as long as your doctor tells you to do so, to obtain better results.

SIDE EFFECTS OF NURIL 5MG

SERIOUS
Allergic reaction (such as skin rash, red or peeling of the skin, swelling of the face, lips, tongue or throat and difficulty in breathing or swallowing)
Swelling of the hands, ankles or feet
Tinnitus (ringing in the ears)
Bone marrow depression (low blood cell count)
Jaundice (yellowing of skin and eyes)
Heart attack or stroke
COMMON
Dizziness or fainting
Feeling sick (nausea)
Blurred vision
Cough
Diarrhea or abdominal pain
Headache
Low blood pressure, irregular heartbeat, chest pain
Weakness or fatigue
Depression
Change in taste
Shortness of breath
RARE
Raynaud’s phenomenon (hands and feet may become very cold and pale)
Autoimmune diseases
Sleep problems
Accumulation of fluid in the lungs
Inflammation of nose
Pneumonia (inflammation of lungs leading to difficulty in breathing)
Inflammation of cheeks, gums, lips, tongue and throat
Decreased urine output
Breasts enlargement in men
Swollen glands in neck, armpit or groin
Serious skin allergic reactions

HOW TO MANAGE SIDE EFFECTS

Nausea:

Try taking this medicine with, or just after meals. Stick to simple meals. Do not eat rich or spicy food.

Diarrhea:

Drink lots of fluids, such as water or juice, to avoid dehydration. Do not take any medicines without speaking to a doctor.

Abdominal pain:

Try to rest and relax. You can eat and drink slowly or have smaller and frequent meals. Keeping a heat pad on your stomach may also help. If still pain persists, speak to your doctor.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid traveling, driving or operating any tools or machines while you are feeling dizzy. If the symptom still persists, contact your doctor for advice.

WARNING & PRECAUTIONS

PREGNANCY
NURIL 5MG is not recommended for use in pregnant women unless necessary. Discuss the risks and benefits with your doctor.

BREASTFEEDING
NURIL 5MG is not recommended for use in breastfeeding women unless necessary. Discuss the risks and benefits with your doctor.

DRIVING AND USING MACHINES
Do not drive or operate any machines, because this medicine may make you feel dizzy.

ALCOHOL
Avoid consumption of alcohol while taking this medicine, because it may cause a fall in your blood sugar levels and leads to dizziness, light-headedness or faintness.

KIDNEY
NURIL 5MG is not recommended for use in patients with impaired kidney function. Consult your doctor for advice.

LIVER
NURIL 5MG should be taken with caution in patients with severe liver disease. Consult your doctor for advice.

ALLERGY
Do not take this medicine if you are allergic to enalapril.

HEART DISEASE
NURIL 5MG should be taken with caution in patients with other heart problems. Consult your doctor for advice.

OTHERS

Before taking NURIL 5MG, inform your doctor if you:

Have diabetes
Have any problems in the blood vessels of the brain
Have neutropenia (lack of white blood cells), thrombocytopenia (low blood platelet count) or anemia (low red blood cells)
Have been very sick (vomiting)
Have recently had diarrhea
Have high blood pressure
Have collagen vascular disease (such as lupus erythematosus, rheumatoid arthritis or scleroderma)
Are aged above 65 years
Are going to have any surgery, procedures or receive any anesthetics

INTERACTIONS

Talk to your doctor, if you are taking,

Other medicines used to treat high blood pressure
Medicines that increases the level of potassium in your blood (e.g. potassium supplements, spironolactone, aldosterone)
Medicines used to treat bacterial infection (e.g. trimethoprim and co-trimoxazole)
Medicines used to treat depression (e.g. lithium, amitriptyline, desipramine, nortriptyline, imipramine)
Medicines used to treat mental problems (aripiprazole, clozapine, risperidone or quetiapine)
Medicines used to treat cough and cold (e.g. amphetamine)
Medicines used to treat pain or arthritis (e.g. aspirin, ibuprofen, methotrexate, gold therapy)
Medicines used to treat diabetes (e.g. metformin, vildagliptin, rosiglitazone, gliclazide, insulin)
Medicines used to treat blood clots (e.g. anistreplase, reteplase or streptokinase)
Medicines used to prevent graft rejection (e.g. ciclosporin, sirolimus, everolimus)
Heparin (used to prevent blood thinning)
Non-steroidal anti-inflammatory drugs (used to treat pain) e.g. celecoxib, paracetamol, aspirin
Racecadotril (used to treat acute diarrhea)
Sacubitril/ valsartan fixed-dose combination (used to treat heart failure)
Allopurinol (a medicine used to treat gout or kidney stones)
Procainamide (used to treat arrhythmia)