What is Ebrantil (Urapidil)?
Ebrantil® (active ingredient Urapidil) is an antihypertensive with a unique dual mechanism of action: it blocks peripheral alpha-1 receptors and simultaneously stimulates central serotonin-5-HT1A receptors. This combination lowers blood pressure without the reflexive heart rate increase, which frequently occurs in other vasodilators.
Urapidil is used with severe high blood pressure, which does not respond sufficiently to other drugs. As an injection solution, it is one of the standard drugs for hypertensive emergency cases in emergency intake. Oral is available as Ebrantil® Retard capsules.
Unlike most high blood pressure drugs, Urapidil has no negative influence on metabolism (blood sugar, blood fats) and can even improve insulin sensitivity.
Active Ingredients & Mechanism of Action
Active ingredient: Urapidil
Urapidil has a dual mechanism of action:
Peripheral alpha-1 blockade:* *
- Blocks alpha-1 receptors on blood vessels
- Arteries and veins expand
- Peripheral vascular resistance drops
- Blood pressure falls
**2. Central serotonin action (5-HT1A agonism):* *
- Stimulates central 5-HT1A receptors in the brain stem
- Maintains the sympathy tone
- Prevents the reflector heart rate increase
- Uniform blood pressure reduction without heart turf
Advantages of the dual mechanism:
- No reflective tachycardia (in contrast to pure alpha blockers)
- No sodium retention
- Metabolic neutral (no negative influence on blood sugar/blood fats)
- Can improve insulin sensitivity
Initiation of action: Retard capsules: after 30-60 minutes. Intravenous: within 5 minutes. Working time of the retard form: 10-14 hours.
Who is it suitable for?
Ebrantil® (Urapidil) is suitable for:
- Moderate to severe hypertension
- Treatment-resistant high blood pressure (as an additional medication)
- Hypertensive crises and emergencies
- Perioperative blood pressure control
Especially suitable for:
- High blood pressure with metabolic syndrome
- Diabetes with high blood pressure (substantially neutral)
- Patients in which reflextachycardia is undesirable
- Hypertensive derailment as emergency therapy
Not suitable:
- Aortenstenose
- Arteriovenous shunts (except hemodynamically inactive)
- Simultaneous intake of MAO inhibitors
- Pregnancy and breastfeeding
Available Dosages
High blood pressure (oral, retard capsules):
- start dose: 30 mg twice a day
- usual dose: 30-60 mg twice a day
- Maximum dose: 180 mg daily (divided to 2 administrations)
Hypertensive emergency (intravenous):
- 25 mg slow i.v. (over 20 seconds)
- With insufficient effect: repeat after 5 minutes
- Maintenance infusion: 9-30 mg/hour
Available starches:
- 30 mg, 60 mg, 90 mg retard capsules (Ebrantil®)
- 25 mg/5 ml, 50 mg/10 ml injection solution
How to Take
Intake (retard capsules):
- twice a day (morning and evening)
- Swallow capsules with water
- Do not open or chew
- Independent meals
**
- Regular blood pressure and pulse controls
- Slowly move up (orthostatic hypotension possible)
- Pay attention to dizziness especially in the first days
- Do not drop abruptly (slip slowly)
In case of emergency (i.v.): Only by medical professionals monitoring blood pressure and EKG.
Contraindications
**Ebrantil® must not be taken at:* *
- hypersensitivity to Urapidil
- Heavy aortic stenosis
- Simultaneously with MAO inhibitors
- Pregnancy and breastfeeding (inappropriate data)
Preview at:
- Liver insufficiency (reduced degradation)
- Kidney failure (possibly dose adjustment)
- Older patients (increased sensitivity)
- Heart failure
- hypovolaemia (blood pressure decrease increased)
pregnant: Not recommended. No sufficient data for safety in pregnancy.
Possible Side Effects
Acid (1-10%):
- Squeeze
- Headaches
- nausea
- fatigue
- Heart palpitations (despite rarer than other vasodilators)
** Occasionally (0,1-1%):* *
- Orthostatic hypotension (especially at the beginning)
- Gastrointestinal complaints
- Mouth dryness
- Nose blockage
- Sleep disorders
- Skin rash
Selten:
- Priapism (Permanent Action – Emergency!)
- thrombocytopenia
- Angioedema
- Heavy blood pressure drop
Advantage: Compared to other alpha blockers (e.g. doxazosin), Urapidil causes less reflextachycardia and orthostatic hypotension thanks to the central serotonin action.
Interactions
Contraint with:
- MAO inhibitor → heavy hypotension
Preview at:
- Other blood pressure counter → increased hypotension
- Alpha Blocker (Doxazosin, Tamsulosin) → additive hypotension
- PDE-5-Hemmer (Sildenafil, Tadalafil) → increased blood pressure reduction
- Alcohol → increased hypotension
- Cimetidine → increased Urapidil level
Combinable with:
- Betablockers
- ACE inhibitors and sartans
- calcium channel blockers
- Diuretics
** Urapidil has a relatively favorable interaction profile and can be combined well with other antihypertensive agents.
Frequently Asked Questions
Similar Medications
Is Ebrantil (Urapidil) right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.