Chronic arterial hypertension requires urgent drug treatment, so specialists try to select an antihypertensive drug for the patient that is suitable for daily normalization of blood pressure. The most popular drugs from the group of ACE inhibitors are Lisinopril and Enalapril, their action is aimed at inhibiting the production of angiotensin-converting enzyme. Thus, both drugs block the action of an enzyme that takes part in the biological processes that contribute to the narrowing of blood vessels. These drugs are similar in their mechanism of action, but they have some differences in composition and dosage regimen, so the question arises for hypertensive patients, which is better, Lisinopril or Enalapril?
Composition and form of release of medicines
The drug formula Enalapril was created at the end of the 20th century as one of the analogues of Captopril. The drug belongs to the second generation ACE inhibitors. The chemical formula of Lisinopril was created in 1975, and it began to be produced later by a Hungarian pharmacological company.
Available in the form of white tablets with a division in the middle, in the amount of 10 pieces in a blister.
Enalapril is a chemically modified form of the drug, which in the body, as a result of metabolism, is transformed directly into the active component. The main active substance in the medication is enalapril maleate, in concentrations of 5, 10, 20 mg.
The drug also contains additional components, such as:
- sugar;
- lactose monohydrate;
- cellulose;
- talc;
- magnesium stearate;
- sodium bicarbonate.
Additional components may vary depending on the manufacturer.
The chemical components of Lisinopril are not affected by metabolic processes in the body. Thus, the active substance in the drug is lisinopril, in the form of dihydrate at a concentration of 10 mg.
Available in the form of single-color tablets, with cut edges and division on one side
The medicine contains the following auxiliary components:
- lactose monohydrate;
- corn starch;
- magnesium stearate;
- methylene chloride;
- povidone.
The additional components remain unchanged, only their dosage changes depending on the concentration of the active substance.
Amlodipine or Lisinopril: which is better to take?
Amlodipine differs from Lisinopril
In the question of which is better to take - Amlodipine or Lisinopril, there is no precise definition. These tablets are prescribed separately as monotherapy and in accordance with blood pressure levels, complications and concomitant pathologies. The main mechanism of action of Amlodipine is the blocking of calcium-dependent L-channels. The main active ingredient of these tablets has a vasodilator effect on peripheral vessels and cardiac vessels.
Therefore, it is impossible to say which is more effective. Amlodipine is prescribed for angiospastic and angina pectoris, ischemic heart disease, heart failure, bronchospasm, including bronchial asthma. The actions of Lisinopril were described above. These drugs have different purposes and cannot be replaced with each other, nor can they be compared.
Differences in pharmacological properties
Enalapril has a vasoconstrictor effect, which reduces peripheral vascular resistance, reduces the load on the myocardium and stabilizes blood pressure.
Regular use of the medication produces the following effects on the body:
- elimination of spasm of arterial walls;
- normalization of systolic and diastolic pressure;
- reduces the load on the myocardium;
- restores blood circulation in the heart and kidney arteries;
- reduces the risk of progression of heart failure;
- produces a diuretic effect, thereby preventing fluid retention in the body;
- eliminates left ventricular hypotrophy;
- prevents the process of thrombosis.
The use of Lisinopril in the early rehabilitation period after an acute heart attack reduces the risk of death
The pharmacological properties of Lisinopril include direct inhibition of aldosterone production and an increase in the synthesis of prostaglandins. The drug has a similar effect on the body of a hypertensive patient as Enalapril, since all the effects are due to the effect on the renin-angiotensin-aldosterone system. However, there is a difference between drugs in the mechanism of evacuation from the body, since the drugs belong to different classes of ACE inhibitors. Thus, Enalapril is a lipophilic prodrug in which the elimination of breakdown products occurs mainly through the kidneys, and to a lesser extent, through the liver.
Lisinopril belongs to the hydrophilic group of medications that are not amenable to metabolic processes in the body. The active components are evacuated in unchanged form, mainly by the kidneys.
It follows from this that the distinguishing feature of Enalapril from Lisinopril is their distribution in the body after consuming the tablet. So Enalapril undergoes a process of biotransformation into the active metabolite - enalaprilat.
The transformation of the structural components of Enalapril occurs in the liver, which exposes it to additional functional load. Therefore, in hypertensive patients with liver dysfunction, a significant decrease in the conversion of active components may be observed, that is, a decrease in the therapeutic effectiveness of the drug.
Perindopril, Noliprel, Prestarium or Lisinopril: which is better?
Perindopril is the active ingredient in perindopril erbumine . It is also an ACE inhibitor , like lisinopril . But it began to be used back in the 70s of the last century. Of course, this is a good drug and copes well with high blood pressure and helps avoid heart failure. But more modern drugs, such as Lisinopril , are better because they represent an improved formula - these are safer and more effective tablets.
Prestarium is the active ingredient perindopril . The difference is in the name because it is a different manufacturer. Also, Noliprel is a combination drug that contains “perindopril” (ACE inhibitor) and indapamide (a diuretic that is part of the sulfonamide group). Therefore, it is the same as perindopril, but with a diuretic effect. Prescribed to patients who have kidney problems.
Which medicine is better according to the method of administration?
Before choosing the best antihypertensive drug, patients have a question: what is the difference between drugs that are similar in almost all respects? One of the significant differences between Lisinopril and Enalapril is the dosage of the active substance and the dosage regimen, which, although they have minor differences, do affect the therapeutic effect.
Due to its prolonged action, Enalapril is more effective when taken in the morning
The duration of the hypotensive effect of Enalapril is on average 18 hours. To maintain normal blood pressure, it is recommended to take the drug 2 times a day, regardless of meal times. The medicine has a long period of evacuation from the body, so it is prescribed once or twice a day. However, the drug has one main drawback: it enters the body in an inactive state, which means it requires activation of the active substance in the liver. The drug's chemicals can accumulate in fatty tissue, reducing its effectiveness in overweight patients. Therefore, patients with a history of hypertension and type 2 diabetes should take the pills with caution.
A stable hypotensive effect when taking Lisinopril is observed after 1-2 months, which should be taken into account when increasing the dose
Lisinopril compares favorably with its analogue, since the hydrophilic class of the drug is well suited for the treatment of arterial hypertension. The duration of action is 24 hours, providing mild stabilization of blood pressure. It is enough to take the tablets once a day.
During treatment with both drugs, the following recommendations should be followed:
- monitor blood pressure levels throughout the day;
- monitor indicators of the state of the circulatory and excretory systems using laboratory tests;
- monitor the functional state of the heart and kidneys;
- Do not increase the dose of the drug yourself;
- It is recommended to take the minimum doses that maintain the hypotensive effect;
- Do not combine products with drinking alcohol.
Comparison of ease of use of Lisinopril and Enalapril
This includes dose selection taking into account various conditions and frequency of doses. At the same time, it is important not to forget about the release form of the drug; it is also important to take it into account when making an assessment.
The ease of use of Lisinopril is approximately the same as Enalapril. However, they are not convenient enough to use.
The drug ratings were compiled by experienced pharmacists who studied international research. The report is generated automatically.
Last update date: 2020-12-04 13:42:31
Which drug is better in the treatment of hypertension?
Lisinopril has been used for the treatment of hypertension for many years, and at this time there is a lot of practical evidence proving the good effectiveness of the drug compared to other analogues.
In the treatment of arterial hypertension, both drugs showed good tolerance by the body.
A direct comparison of the therapeutic effectiveness of Lisinopril and Enalapril was carried out by monitoring blood pressure levels in patients undergoing antihypertensive treatment. For qualitative control, it was customary to use the target blood pressure level (140/90 mm Hg), the dosage of the active substance was selected until the stated indicators were achieved. Both medications reduced blood pressure to an optimal level, but the therapeutic effect of taking Lisinopril was more pronounced.
As a result of the study, it was revealed that with the same dosage and dosage regimen, Lisinopril has a longer duration of action.
Thus, both drugs have shown in practice high effectiveness and safety in the treatment of hypertension. The most advantageous feature of Lisinopril is its broader indications for use, so it can be prescribed to patients with obesity, viral hepatitis, and a history of acute heart attack.
Patient reviews
Dmitry, 65 years old, Orel: “A few months ago I suffered a stroke. The doctor prescribed Lisinopril for the treatment of hypertension. My blood pressure quickly returned to normal, but I have difficulty coping with such a side effect as a dry cough, which bothers me both day and night.”
Alena, 33 years old, Samara: “Many years ago they gave me a disability because... I suffer from severe asthma. Recently my blood pressure began to rise even more. I tried all sorts of medications, but only Enalapril helped. Thanks to him, my blood pressure normalized and it became much easier to breathe.”
In patients taking Lisinopril, blood pressure quickly returns to normal, so the drug is more effective.
