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Prilenal Tablets contain the drug enalapril which is classed as an ACE inhibitor. Prilenal acts to counter some of the effects of congestive heart failure, usually caused by valve problems or a weakened and stretched heart muscle wall. Blood pressure and the total workload on the heart are reduced through this effect. An improvement in clinical signs and extension of life expectancy can be expected. Prilenal is normally given once daily and is often combined with a diuretic or other medication. Regular veterinary checks are important to ensure effective treatment.
Prilenal® tablets for dogs are presented as brown spotted, white round tablets, for oral administration containing 1, 2.5, 5, 10 and 20 mg of enalapril maleate.
For the treatment of mild, moderate or severe congestive heart failure, caused by mitral regurgitation or dilated cardiomyopathy, as an adjunctive therapy with diuretics (furosemide, whether associated or not with digoxin).
Prilenal® tablets for dogs should be administered orally at the recommended dose of 0.5 mg/kg of enalapril maleate per day (i.e. 0.38 mg/kg of enalapril base per day). Individual doses should be administered based on body weight using the most appropriate tablet size or combination of tablets. The dosage can be adapted according to the clinical response of the treated animal. In the absence of expected clinical response within 2 weeks following initiation of the therapy, the dose of 0.5 mg/kg of enalapril maleate can be administered twice a day. The increase in dose can be more rapid if the signs of heart failure require it. Dogs should be observed closely for 48 hours following initial dosing or an increase in dose.
Do not use in pregnant and lactating bitches.
Do not use in breeding dogs.
Do not use in cases of hypersensitivity to enalapril or any of the excipients.
Do not use in dogs with evidence of cardiac output failure (e.g. aortic stenosis, mitral stenosis, obstructive cardiomyopathy).
Special warnings for each target species
Pre-renal azotemia generally results from hypotension due to cardio-vascular insufficiency. Substances that deplete blood volume, such as diuretics, or with a vasodilator effect, such as ACE inhibitors, may contribute to lowering systemic blood pressure. This may create a hypotensive state or exacerbate an existing hypotensive situation and result in pre-renal azotemia.
Dogs with no detectable renal disease may develop mild and transient increases in blood urea nitrogen or serum creatinine when the product is administered concomitantly with a diuretic.
The diuretic and/or enalapril dose should be reduced if clinical signs of hypotension or azotemia appear or if the blood concentration of urea nitrogen and/or creatinine increases significantly above the values observed before treatment. Should clinical signs of overdose occur (azotemia) after the dose is increased from once daily to twice daily, the dose should be decreased to once daily.
Special precautions for use
In case of hypokalaemia, potassium supplements can be administered concomitantly with the product. Plasma potassium should be assessed prior to treatment and periodic monitoring should be continued.
In humans, in case of renal impairment, the concomitant use of enalapril with aldosterone-antagonists can lead to hyperkalaemia. Therefore, both the renal function and plasma potassium are closely monitored in such patients. In absence of data in dogs, such recommendations should be followed in the target species. Therapy with diuretics should be started at least 1 day prior to initiating treatment with enalapril. Renal function should be assessed prior to, and for 2-7 days after starting treatment. Periodic monitoring of renal function should be continued.
Normal dogs dosed at 15 mg/kg/day for up to 1 year showed no adverse effects. This means that overdose symptoms generally appear at more than 30 times (at 0.5 mg/kg) or 15 times (at 1 mg/kg) the recommended dosage during one year.
Clinical signs reported include hypotension, azotemia, and increased concentration of urea and/or creatinine. Treat symptomatically.
Hypotension and its consequences (e.g. azotemia) can occur at the start of the therapy (in less than 2 % of the treated dogs). Diarrhoea, vomiting, lethargy, dizziness, disorientation and in-coordination can also occur.
Interaction with other medicinal products
Sodium chloride may decrease the hypotensive effect of enalapril.
Concurrent use with NSAIDs may increase the risk of renal toxicity.
Special precautions to be taken by the person administering the medicinal product to animals
Wash hands after use.
In case of accidental ingestion, seek medical advice showing the label to the doctor or medical practitioner.
For animal treatment only. Keep out of reach and sight of children.
No special precautions for storage.
Any unused product or waste materials should be disposed of in accordance with local requirements.
Box containing 4 blisters of 7 tablets
Box containing 12 blisters of 7 tablets
Box containing 24 blisters of 7 tablets
Not all pack sizes may be marketed
Prilenal 2.5 mg:
Prilenal 5 mg:
Prilenal 10 mg:
Prilenal 20 mg:
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