. . . . . . . "004.005" . . . . "Kalium \u0161et\u0159\u00EDc\u00ED diuretika nebo drasl\u00EDkov\u00E9 suplementy\nInhibitory ACE zm\u00EDr\u0148uj\u00ED diuretiky navozenou ztr\u00E1tu drasl\u00EDku. Drasl\u00EDk \u0161et\u0159\u00EDc\u00ED diuretika (nap\u0159.\u00A0spironolakton, eplerenon, triamteren nebo amilorid), drasl\u00EDkov\u00E9 suplementy nebo n\u00E1hra\u017Eky sol\u00ED obsahuj\u00EDc\u00EDch drasl\u00EDk mohou v\u00E9st k v\u00FDznamn\u00E9mu zv\u00FD\u0161en\u00ED hladin drasl\u00EDku v s\u00E9ru. Je-li kv\u016Fli prok\u00E1zan\u00E9 hypokal\u00E9mii indikov\u00E1no jejich sou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED, je t\u0159eba je u\u017E\u00EDvat s opatrnost\u00ED a za \u010Dast\u00E9ho monitorov\u00E1n\u00ED hladin drasl\u00EDku v s\u00E9ru (viz\u00A0bod 4.4).\nDiuretika (thiazidov\u00E1 nebo kli\u010Dkov\u00E1 diuretika)\nP\u0159edchoz\u00ED l\u00E9\u010Dba vysok\u00FDmi d\u00E1vkami diuretik m\u016F\u017Ee m\u00EDt p\u0159i zahajov\u00E1n\u00ED terapie enalaprilem za n\u00E1sledek objemovou depleci a riziko hypotenze (viz bod 4.4). Hypotenzn\u00ED \u00FA\u010Dinky lze omezit vysazen\u00EDm diuretika, zv\u00FD\u0161en\u00EDm objemu nebo p\u0159\u00EDjmu soli nebo zah\u00E1jen\u00EDm terapie n\u00EDzkou d\u00E1vkou enalaprilu.\nOstatn\u00ED hypertenziva\nSou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED t\u011Bchto l\u00E1tek m\u016F\u017Ee zes\u00EDlit hypotenzn\u00ED \u00FA\u010Dinky enalaprilu. Sou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED nitroglycerinu a dal\u0161\u00EDch nitr\u00E1t\u016F nebo dal\u0161\u00EDch vazodialatanci\u00ED m\u016F\u017Ee krevn\u00ED tlak d\u00E1le sn\u00ED\u017Eit.\nLithium\nP\u0159i sou\u010Dasn\u00E9m pod\u00E1v\u00E1n\u00ED lithia a inhibitor\u016F ACE bylo pops\u00E1no reverzibiln\u00ED zv\u00FD\u0161en\u00ED s\u00E9rov\u00FDch koncentrac\u00ED lithia a toxicita. Sou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED thiazidov\u00FDch diuretik a inhibitor\u016F ACE m\u016F\u017Ee d\u00E1le zv\u00FD\u0161it hladiny lithia a\u00A0zv\u00FD\u0161it riziko toxicity lithia. U\u017E\u00EDv\u00E1n\u00ED enalaprilu spolu s lithiem se nedoporu\u010Duje, pokud se v\u0161ak takov\u00E1 kombinace uk\u00E1\u017Ee jako nezbytn\u00E1, je nutno pe\u010Dliv\u011B monitorovat hladiny lithia v s\u00E9ru (viz bod 4.4).\nTricyklick\u00E1 antidepresiva/antipsychotika/anestetika/narkotika\nSou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED n\u011Bkter\u00FDch anestetick\u00FDch produkt\u016F, tricyklick\u00FDch antidepresiv a antipsychotik spolu s inhibitory ACE m\u016F\u017Ee v\u00E9st k dal\u0161\u00EDmu poklesu krevn\u00EDho tlaku (viz bod 4.4).\nNesteroidn\u00ED antiflogistika (NSAID)\nDlouhodob\u00E9 pod\u00E1v\u00E1n\u00ED NSAID m\u016F\u017Ee sn\u00ED\u017Eit antihypertenzn\u00ED \u00FA\u010Dinek inhibitoru ACE. NSAID a inhibitory ACE maj\u00ED p\u0159\u00EDdatn\u00FD \u00FA\u010Dinek na zvy\u0161ov\u00E1n\u00ED s\u00E9rov\u00FDch koncentrac\u00ED drasl\u00EDku, a mohou v\u00E9st ke zhor\u0161en\u00ED ren\u00E1ln\u00ED funkce. Tyto \u00FA\u010Dinky jsou obvykle reverzibiln\u00ED. Vz\u00E1cn\u011B m\u016F\u017Ee doj\u00EDt k rozvoji akutn\u00EDho ren\u00E1ln\u00EDho selh\u00E1n\u00ED, zvl\u00E1\u0161t\u011B u pacient\u016F s ohro\u017Eenou ren\u00E1ln\u00ED funkc\u00ED jako jsou star\u0161\u00ED jedinci nebo dehydratovan\u00E9 osoby.\nZlato \nU pacient\u016F l\u00E9\u010Den\u00FDch injek\u010Dn\u00EDmi slou\u010Deninami zlata (natrium-aurothiomal\u00E1t) sou\u010Dasn\u011B s\u00A0inhibitory ACE v\u010Detn\u011B enalaprilu byly vz\u00E1cn\u011B uv\u00E1d\u011Bny nitritoidn\u00ED reakce (symptomy zahrnuj\u00ED zrudnut\u00ED tv\u00E1\u0159e, nevolnost, zvracen\u00ED a hypotenzi).\nSympatomimetika\nSympatomimetika mohou sn\u00ED\u017Eit antihypertenzn\u00ED \u00FA\u010Dinek inhibitor\u016F ACE.\nAntidiabetika\nNa z\u00E1klad\u011B epidemiologick\u00FDch studi\u00ED se lze domn\u00EDvat, \u017Ee sou\u010Dasn\u00E9 pod\u00E1v\u00E1n\u00ED inhibitor\u016F ACE a antidiabetik (inzulin\u016F, peror\u00E1ln\u00ED hypoglykemik) m\u016F\u017Ee m\u00EDt za n\u00E1sledek zv\u00FD\u0161en\u00FD \u00FA\u010Dinek na sni\u017Eov\u00E1n\u00ED hladin cukru v krvi spolu s rizikem hypoglyk\u00E9mie. Zd\u00E1 se, \u017Ee tento jev se \u010Dast\u011Bji vyskytuje v prvn\u00EDch t\u00FDdnech kombina\u010Dn\u00ED terapie a u pacient\u016F s poruchou ren\u00E1ln\u00ED funkce.\nAlkohol\nAlkohol potencuje hypotenzn\u00ED \u00FA\u010Dinek inhibitor\u016F ACE.\nKyselina acetylsalicylov\u00E1, trombolytika a betablok\u00E1tory\nEnalapril lze bez obav pod\u00E1vat sou\u010Dasn\u011B s kyselinou acetylsalicylovou (v kardiologick\u00FDch d\u00E1vk\u00E1ch), trombolytiky a betablok\u00E1tory.\n"@cs . . "4.5. Interakce s jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky a jin\u00E9 formy interakce"@cs . . . . . . . . .