Enalapril

Enalapril
Enalapril memiliki efek melebarkan pembuluh darah dan memperlancar aliran darah, sehingga tekanan darah menjadi turun.

Bagikan :


Brand/Nama Lain

Renacardon, Tenaten, Tenace, Co-Renitec, Enalapril Maleate, Inoprilat 10, Meipril.

 

Cara Kerja

Enalapril adalah obat antihipertensi atau penurun tekanan darah. Enalapril termasuk ke dalam suatu golongan obat yang dikenal sebagai penghambat enzim pengubah Angiotensin-I atau ACE Inhibitor. Golongan obat ini bekerja dengan menghambat kerja enzim ACE yang berperan penting dalam suatu sistem yang yang mengatur tekanan darah dan jumlah cairan di tubuh.

Pada penderita hipertensi, sistem pengatur tekanan darah ini mengalami gangguan sehingga tekanan darah mereka menjadi tinggi. Obat-obatan dalam golongan ACE inhibitor termasuk enalapril yang akan melebarkan pembuluh darah serta mengurangi kadar air yang diserap kembali oleh ginjal. Efeknya aliran darah menjadi lebih lancar, kadar air di tubuh berkurang dan tekanan darah akan menurun perlahan.

 

Indikasi

Hipertensi

Obat ini digunakan untuk mengatasi kondisi hipertensi atau tekanan darah tinggi. Seseorang dikatakan memiliki tekanan darah tinggi bila setelah dua kali pengukuran di hari yang berbeda, tekanan darah sistolik ≥140 mmHg dan/atau tekanan darah diastolik ≥90 mmHg. Konsultasikan diagnosis hipertensi dengan dokter Anda sebelum memulai terapi dengan obat ini.

 

Gagal Jantung

Obat golongan ACE inhibitor juga terbukti baik digunakan pada pasien dengan gagal jantung dan yang mengalami serangan jantung (infark miokard). Umumnya enalapril dikombinasikan dengan obat lain sebagai terapi pasien jantung. Namun, enalapril harus digunakan secara hati-hati pada pasien yang memiliki gangguan ginjal atau sedang meminum obat diuretik (obat yang meningkatkan pengeluaran cairan melalui urine). 

 

Kontraindikasi

  • Riwayat reaksi angioedema (pembengkakan di bawah kulit yang terjadi cepat) yang berhubungan dengan penggunaan ACE inhibitor.
  • Memiliki alergi atau hipersensitivitas terhadap ACE inhibitor.
  • Memiliki angioedema, baik yang diturunkan keluarga atau yang timbul sendiri tanpa sebab yang jelas.
  • Wanita hamil di trimester kedua dan ketiga.

 

Efek Samping

Efek samping yang sering terjadi adalah batuk, mual, pandangan kabur dan pusing. Efek samping lain yang mungkin terjadi adalah:

  • Gangguan darah seperti anemia.
  • Nyeri kepala.
  • Sesak napas.
  • Depresi.
  • Tekanan darah rendah.
  • Nyeri dada.
  • Ruam kulit.

Enalaparil juga dapat menyebabkan kondisi meningkatnya kalium (hiperkalemia) dalam darah yang sering terjadi pada pasien dengan gagal ginjal kronik dan diabetes.

Cari bantuan medis segera bila Anda mengalami reaksi alergi berat seperti:

  • Pembengkakan di daerah wajah, tenggorokan, kaki atau tangan.
  • Ruam kulit di seluruh tubuh.
  • Sesak napas.
  • Kehilangan kesadaran.

 

Sediaan

Obat ini tersedia di Indonesia dalam bentuk:

  • Tablet 5 mg.
  • Tablet 10 mg.
  • Tablet kombinasi dengan HCT 25/10 mg.

 

Dosis

Berikut adalah dosis obat berdasarkan kondisi penyakitnya. Perlu diketahui bahwa dosis obat akan disesuaikan dengan profil pasien, respon pasien terhadap pengobatan yang diberikan, serta kondisi kesehatannya saat itu.

 

Obat Minum Hipertensi

  • Dewasa
    • Dosis awal 5 mg sekali sehari.
    • Dosis pemeliharaan 10-20 mg per hari yang dapat diberikan dalam dua dosis.
    • Dosis maksimal 40 mg per hari.
  • Anak-Anak
    • Berat badan 20-49 kg: dosis awal 2,5 mg sekali sehari, dapat ditingkatkan hingga 20 mg sekali sehari bila perlu.
    • Berat badan ≥50 kg: dosis awal 5 mg sekali sehari, dapat ditingkatkan hingga 40 mg sekali sehari,
  • Lansia
    • Dosis awal 2.5 mg sekali sehari.

 

Gangguan Jantung

Berikut adalah dosis obat untuk gagal jantung dan gangguan bilik jantung kiri yang tidak bergejala:

  • Dewasa
    • Dosis awal 2,5 mg sekali sehari, dapat ditingkatkan hingga 20 mg sekali sehari.
    • Dosis maksimal 40 mg per hari dalam dua dosis.
  • Lansia:
    • dosis awal 2,5 mg sekali sehari.

 

Keamanan

Pada kehamilan, obat ini tergolong ke dalam kategori D, yang berarti bahwa terdapat bukti menimbulkan risiko gangguan pada janin. Enalapril juga tidak direkomendasikan untuk diberikan pada ibu menyusui.

 

Interaksi Obat

  • Dapat meningkatkan risiko peningkatan kalium dalam darah bila digunakan bersama obat diuretik (obat yang meningkatkan pengeluaran cairan melalui urine).
  • Efek penurunan tekanan darah bisa semakin besar dan bisa menimbulkan tekanan darah rendah, bila enalapril diberikan bersama obat antihipertensi golongan ARB, seperti candesartan atau valsartan.
  • Dapat meningkatkan risiko gula darah rendah jika digunakan bersama obat antidiabetes atau insulin.
  • Dapat meningkatkan risiko kerusakan ginjal jika digunakan bersama antinyeri golongan NSAID, seperti aspirin atau ibuprofen.
  • Dapat meningkatkan risiko reaksi alergi berat dan infeksi jika dipakai bersama allopurinol (penurun kadar asam urat).
  • Alkohol meningkatkan efek penurunan tekanan darah pada obat ini.

 

Mau tahu informasi seputar obat-obatan lainnya? Cek di sini, ya!

 

 

Writer : dr Arifin Muhammad Siregar
Editor :
  • dr Hanifa Rahma
Last Updated : Jumat, 14 April 2023 | 14:34

Pusat Informasi Obat Nasional. ENALAPRIL MALEAT. (2022). Retrieved 20 August 2022, from https://pionas.pom.go.id/monografi/enalapril-maleat.

MIMS Indonesia. Enalapril: Indication, Dosage, Side Effect, Precaution. (2022). Retrieved 20 August 2022, from https://www.mims.com/indonesia/drug/info/enalapril?mtype=generic.

World Health Organization. Hypertension. (2022). Retrieved 20 August 2022, from https://www.who.int/news-room/fact-sheets/detail/hypertension#:~:text=Hypertension%20is%20when%20blood%20pressure,the%20heart%20rests%20between%20beats.

Katzung, B., & Vanderah, T. (2021). Basic & clinical pharmacology (pp. 187-188). McGraw-Hill.

European Medicines Agency. (2022). Renitec Referral Summary Product Characteristics. Retrieved 20 August 2022, from https://www.ema.europa.eu/documents/referral/renitec-article-30-referral-summary-product-characteristics_en.pdf.

European Medicines Agency. Renin-angiotensin-system (RAS)-acting agents - European Medicines Agency. (2022). Retrieved 20 August 2022, from https://www.ema.europa.eu/en/medicines/human/referrals/renin-angiotensin-system-ras-acting-agents. 

Drugs.com. (2022). Enalapril Drug Interactions. Retrieved 20 August 2022, from https://www.drugs.com/drug-interactions/enalapril-index.html.

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      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.single-post-healthpedia:37
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
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      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new10.03msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5873 and `categories`.`deleted_at` is null
      Bindings
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      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
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      Bindings
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      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
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      Hints
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      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
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      Hints
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      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
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      Hints
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      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
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      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      Hints
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      Backtrace
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      Hints
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      Backtrace
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      Hints
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      Backtrace
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      Hints
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      Backtrace
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
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      Hints
      • Use SELECT * only if you need all columns from table
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      Backtrace
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      Backtrace
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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