Enam and Enap: what is the difference between these drugs with the same composition

And Enam, and Enap belong to antihypertensive drugs from the group of ACE inhibitors.

In both medicines, the active ingredient is the same chemical compound containing the amino acid residues alanine and proline, enalapril.

Therefore, if we talk about the composition of the drugs Enam and Enap, what is the difference between them, at first glance, is not obvious.

Indeed, according to the majority of patients, if the active component of medicines is the same, its dosage in the pill is the same, then the drugs do not differ in anything except the price. Really, the mechanism of action of Enam and Enap is the same. They inhibit one of the components of the so-called renin - the angiotensin-aldosterone system, an angiotensin converting enzyme.

Thus, a persistent and long-term decrease in blood pressure is achieved, the load on the heart muscle, myocardium and their oxygen demand is reduced. In addition, these drugs indirectly affect the kidneys, providing a mild diuretic effect, while excess sodium is excreted in the urine.

Enam is a drug produced by the Indian pharmaceutical company Dr. Reddy's, Enap is produced by the Slovak company KRKA. These corporations are known to doctors because their medicines are registered almost all over the world, including the United States. However, it should be noted that the low price of Indian drugs is due to less stringent requirements for compliance with production standards required, for example, in Europe.

If we talk about the form of release of analogues Enalapril, drugs Enam and Enap, the difference is noticeable immediately. In addition to the usual tablets of 2.5, 5, 10 and 20 mg, only Enap is produced in the form of a solution for parenteral administration with a dosage of the active ingredient of 1.25 mg in 1 ml. In this form, the drug is used in a hospital setting to provide emergency care for hypertensive crisis.

Both Enam and Enap are absorbed through the gastrointestinal tract mucosa and are converted into active metabolites in the liver. The maximum concentration of the active substance of these drugs in the blood does not depend on the time of the meal and occurs after 2-3 hours. Enap and Enam have a long-lasting effect (half-life is 11 hours). However, according to the reviews of doctors and patients, it is enough to take the medicine once a day, the division into two doses is advisable with a daily dosage above 20 mg.

There is also no definite answer to the question of what is the difference between Enam and Enap in terms of side effects. Both drugs are contraindicated in pregnancy and breastfeeding, since the active substance of these analogues penetrates through the placenta into the fetal bloodstream and milk. But many patients note more pronounced side effects precisely while taking Enam.

First of all, it is a headache, dizziness, dry cough, stool disorders and other complications from the digestive system. Experts attribute this fact to the fact that for the production of Enam they use the enalapril substance with a lower degree of purification. It is clear that this is necessary to reduce the cost of production of the medication.

Enap or Enalapril, which is better

If you do not become attached to brand names of drugs, drugs containing enalapril are most often prescribed for the treatment of hypertension. It is not surprising that today there are more than 60 medicines registered in Russia containing this ACE inhibitor. In medical directories used by doctors, information about medicines is presented as follows.

A complete description of the active ingredient is given, which includes a description of the mechanism of action, pharmacokinetics and pharmacodynamics (that is, its distribution in the body, the rate and method of excretion), dosage for certain pathologies. Then there is a list of medicinal products containing this substance. So, according to indications for use, it is difficult to say which is better from the analogs of Enalapril, Enap or Enam.

They are prescribed for such diseases:

• hypertension associated with damage to the cardiovascular system and kidneys;
• as part of complex therapy to improve prognosis heart failure any degree of severity;
• dysfunction or hypertrophy of the left ventricle of the heart;
• prevention of angina attacks and coronary ischemia.

The dosage recommended according to the instructions for the Enam and Enap tablets is also standard for all enalapril preparations. The initial amount is 1.25-2.5 mg, maximum up to 40 mg, supporting 10-20 mg. Therefore, not every specialist can distinguish between these drugs.

However, practicing cardiologists note that Enam is less effective at the recommended therapeutic dosage. To understand why this is happening, you should dwell on the features of the original drugs and the so-called generics. The original medicine for enalapril is Renitek by MERCK SHARP & DOHME, the Netherlands.

This means that this product has passed all preclinical trials that evaluate not only short-term effect of the drug but also a therapeutic effect against the background of its use in the long-term perspective. After the expiration of the license for the original drug, roughly speaking, any pharmaceutical company gets the right to release enalapril under other trade names.

In our country, to register a generic drug, it is enough to provide data on pharmaceutical equivalence (compliance by composition) and biological equivalence (compliance of pharmacokinetics with a single dose) to the original the drug. Nobody requires information about therapeutic equivalence. In 2010, clinical trials of generics of Renitec were conducted, including Enam and Enap, the results of which were presented for discussion in medical forums.

According to these studies, in order to achieve the desired effect, the dosage of Enam had to be increased to 36.6 mg per day, while only 15 mg of Enap was sufficient for a sustained reduction in pressure. These numbers speak for themselves. Thus, even with the low cost of the Indian drug, the full course of treatment will be more expensive.

The price for a pack of 20 Enam tablets is:

• 2.5 mg - 20-30 rubles;
• 5 mg - 34-47 rubles;
• 10 mg - 57-65 rubles;
• 20 mg - 90-110 rubles.

The cost of Enap medicine ranges from:

• 2.5 mg - 57-68 rubles;
• 5 mg - 65-80 rubles;
• 10 mg - 75-95 rubles;
• 20 mg - 130-155 rubles;
• ampoules 1.25 mg / 1 ml (5 pieces) - 480-485 rubles.

Discussing the question, Enam, Enap or Enalapril, which is better, many cardiologists agree that it is preferable to prescribe the medicine Enap. This takes into account the lower dosage required to obtain the desired result, the lower risk of side effects. However, the foreground should always be the individual tolerance of the medication.