Treatment and Prevention

Enalapril and Captopril: which is better?

ACE inhibitors are used in hypertension, heart failure and to prevent diseases of the cardiovascular system. Drugs such as enalapril or captopril inhibit a chemical that promotes vasoconstriction and increased pressure. Used as an independent tool in order to normalize blood pressure, as well as in conjunction with other medicines.

Characteristics of Enalapril

Enalapril reduces blood pressure, load on the myocardium, normalizes respiration and blood circulation in a small circle, promotes healthy blood circulation in the kidney vessels.

Enalapril or Captopril inhibit a chemical that promotes vasoconstriction and increased pressure

The main active ingredient is enalapril, which, after absorption, is hydrolyzed to enalaprilat, an ACE inhibiting peptide dipeptidase, which promotes the conversion of angiotensin. Due to the blocking of ACE, the formation of a vasoconstricting factor is reduced and the formation of kinins and prostacyclin, which have vasodilating properties, is activated. Enalapril differs diuretic effect associated with the suppression of aldosterone synthesis.

A noticeable decrease in the activity of ACE occurs 3 hours after taking the drug, the peak of the fall in blood pressure is observed after 5 hours. The duration of the effect is interrelated with the dosage, in most cases the effect of the drug is maintained throughout the day. Some patients require several weeks of therapy to achieve optimal blood pressure.

When it enters the body, the drug is rapidly absorbed in the gastrointestinal tract, after which the substance is hydrolyzed to form enalaprilat, which is largely excreted by the kidneys, as well as through the intestines.

Indications for use:

  • arterial hypertension;
  • clinically severe heart failure;
  • coronary heart disease;
  • bronchospastic conditions;
  • prevention of the development of clinically severe heart failure.

Enalapril reduces blood pressure and promotes healthy blood circulation in the kidney vessels.


  • individual intolerance to the components of the drug;
  • pregnancy, breastfeeding period;
  • aortic stenosis;
  • renal artery stenosis;
  • after kidney transplantation;
  • hyperkalemia;
  • combined use with Aliskiren in patients with diabetes, impaired renal function.

The drug is not prescribed to children under the age of 18 years.

With enalapril therapy, muscle spasms, nausea, headache, diarrhea, allergic skin reactions, orthostatic hypotension are possible.

Drug is taken orally, regardless of the use of food.

In hypertension, the standard single dose for adults - 0.01-0.02 g per s

ducks. The permissible daily dose is 0.04 g. Only the attending physician for each patient individually can choose the optimal dose. The duration of the therapeutic course depends on the effectiveness of the treatment.

Enalapril is used for heart failure.
Enalapril is used for hypertension.
Enalapril is used in bronchospastic condition.

Characteristics of Captopril

The ACE inhibitor lowers blood pressure and is used for hypertension, nephropathy of diabetic etiology, heart failure. It has a vasodilating effect, increases cardiac output and resistance to stress, without affecting lipid metabolism.

The main active ingredient is captopril, which is the first synthetic ACE inhibitor in medical practice. It blocks the conversion of angiotensin I to angiotensin II, helping to lower blood pressure, reduces the severity of left ventricular myocardial hypertrophy, prevents the development of heart failure, improves hemodynamics in the kidneys, and prevents the development of diabetic nephropathy.

Captopril is rapidly absorbed, metabolized in the liver, excreted to a greater extent by the kidneys. The half-life is about 120 minutes.

The maximum effect is recorded after 1-1.5 hours. The duration of action depends on the dose of the drug.

Captopril is advisable for such diseases:

  • arterial hypertension;
  • heart failure;
  • myocardial infarction;
  • diabetic nephropathy.

The main active ingredient is captopril, which is the first synthetic ACE inhibitor in medical practice.

The drug is used to prevent symptomatic heart failure in patients with asymptomatic left ventricular dysfunction in a clinically stable state.


  • hypersensitivity to the drug;
  • severe kidney disease;
  • hyperkalemia;
  • renal artery stenosis;
  • aortic stenosis and other changes that disrupt the normal outflow of blood from the left ventricle;
  • condition after kidney transplantation;
  • 2 and 3 trimesters of pregnancy;
  • breastfeeding period.

Not suitable for children under the age of 14.

As side effects while taking the drug, an allergic rash, a change in taste, impotence, leukopenia, proteinuria, agranulocytosis, convulsions, impaired coordination of movements are possible.

The optimal dose of Captopril is determined by an expert individually and varies from 0.025 g to 0.15 g per day. In the case of a rapid and sharp rise in blood pressure, it is recommended to take the minimum dose by dissolving the pill under the tongue. When treating children, the optimal dose is calculated taking into account body weight, the recommended ratio is 0.001-0.002 g per 1 kg.

Contraindications to the use of Captopril are aortic stenosis.
Contraindications to the use of Captopril are children under 14 years of age.
Contraindications to the use of Captopril are severe kidney disease.
Contraindication to the use of captopril is breastfeeding.
Contraindication to the use of Captopril is pregnancy 2 and 3 trimester.

Comparison of drugs


The drugs are included in the group of ACE inhibitors, have a similar mechanism of action and are used to treat high blood pressure and diseases of the cardiovascular system. They have almost identical contraindications. The therapeutic effect is dose dependent.

What is the difference

The main difference is in the composition. Both drugs are made on the basis of the amino acid derivative Proline. But Enalapril differs from its analogue by a complex chemical structure: when it enters the body, the main active substance is hydrolyzed to enalaprilat, which inhibits ACE.

Different drugs and the recommended frequency of administration. For mild hypertension, enalapril is taken 1 time per day. Captopril has a less lasting effect, for the maintenance of which it is necessary to take the drug several times a day.

Captopril is better combined with diuretics. During therapy with its analogue, it is recommended to reduce the dosage of diuretic drugs or temporarily abandon them.

What's cheaper

Medicines have a low price and are available to consumers. The average cost is 60-130 rubles.

What is better enalapril or captopril

Enalapril is best suited for long-term use when it is necessary to maintain blood pressure within the desired limits, but is not used as an ambulance. Captopril is effective for occasional adjustment of dramatically increased pressure. The drug also has a beneficial effect on the heart, increases endurance at regular loads, which makes its reception expedient in the presence of pathologies of the cardiovascular system.

How to switch from Captopril to Enalapril

The drugs belong to the same pharmacological group and are characterized by a pronounced negative interaction, which is dangerous to health and can cause a sharp decrease in blood pressure. In the treatment of hypertension, drugs are dosed individually. To switch from one drug to another, you should consult a specialist who will select the optimal dose, form of release and treatment regimen, taking into account the history of the disease, age and other personal characteristics of the patient.

Patient Reviews

Marianna P .: “The pressure rises from time to time, but I try to avoid taking pills to reduce the drug burden. A year ago I was in the hospital due to frequent trips and climate change. The complex of medical measures could not reduce the pressure, even the injection did not improve the condition I remembered that once a friend recommended Captopril. I put 2 tablets under my tongue, and after almost 30 minutes the pressure began to decrease. The next day I completely normalized. Now I always keep this drug in my bag. "

Vika A.: “I don’t consider Captopril as an ambulance medication. My mother-in-law’s blood pressure soared, she put 2 pieces under her tongue, after a few hours - another 3, closer to the morning - again 2. And only in the morning there were changes for the better. slow down. If the drug is marketed as an ambulance, the effect of the drug should be fast. The pressure in the mother-in-law returned to normal only after the doctor injected some kind of diuretic drug. "

Elena R .: “At discharge from the hospital, mothers were prescribed Enalapril. Immediately she paid attention to a cough that had not existed before. I read the instructions for the drug, it turns out that it is not suitable for everyone. It should be taken with caution, and it is better to find a replacement.”

Different drugs and the recommended frequency of administration.

Reviews of doctors about Enalapril and Captopril

A. Tsukanova, a therapist with 5 years of experience: “The only advantage of Enalapril is an affordable price. In small doses it is practically useless, many people drink it in the maximum acceptable dosage. It often causes a side reaction in the form of dry cough, therefore it is not suitable for asthmatics. Not I recommend this drug to patients, there are more effective and modern drugs. "

V. Zafiraki, a cardiologist with 17 years of experience, PhD: "Many patients in old age who complain about the lack of effect or its weak severity buy Captopril, not knowing the difference between Capoten and Captopril. They have the same acting substance, but the first drug was developed by the company producing it, and the second is a replicated copy of the original version and is made by different companies. I recommend to buy both products and compare which one is stronger. "

Watch the video: How do ACE inhibitors work? (January 2020).