GENERIC NAME: Enalapril Maleate

COMMON BRANDS: Epaned, Vasotec

Enalapril is an oral prescription drug, belongs to a class of drugs known as “angiotensin-converting enzyme (ACE) inhibitors.” It acts by hindering the activity of the enzyme ACE and decreases the production of angiotensin II (very potent vasoconstrictor that causes blood vessels to constrict, thereby narrowing the vessels. The narrowing of the blood vessels increases the pressure within the vessels causing high blood pressure). This drug dilates blood vessels, thereby decreasing blood pressure and makes it easier for the heart to pump blood and increase blood flow to kidneys.

Enalapril is available in both brand-name version and generic-name version. It is sold under the common brand name “Epaned.” The generic drugs usually cost less than the brand name version.

What is Enalapril used for?

Hypertension:

Enalapril is used to treat hypertension. Lowering high blood pressure prevents heart attacks, strokes and kidney problems. In addition to taking medicine, lifestyle changes will also help to control your blood pressure.

Heart failure:

It is used in the treatment of congestive heart failure in combination with diuretics and digitalis.

Left ventricular dysfunction after myocardial infarction:

It is used to improve the chances of survival after myocardial infarction in a clinically stable individual with left ventricular dysfunction manifested as an ejection fraction less than or equal to 40% and to decrease the rate of overt heart failure and subsequent hospitalizations for congestive heart failure in these patients.

Diabetic nephropathy:

It is also used to treat diabetic nephropathy (proteinuria >500 mg/day) in people with type I diabetes mellitus and retinopathy. This drug decreases the rate of progression of renal insufficiency and development of serious adverse clinical outcomes such as death or need for renal transplantation or dialysis.

How to use Enalapril?

Take this drug orally with or without food or as instructed by your doctor. The dose of the drug is based on your medical condition and response to treatment.

If you are using a liquid form of this drug, shake the oral suspension well just before you measure a dose. Measure the liquid dose with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup.

Store the liquid medication in the refrigerator, but do not freeze. Discard any left medicine liquid not used within 60 days.

If you are using tablet form swallow the whole tablet; do not split, chew, or crush them.

Take enalapril exactly as instructed. Do not alter your dosage or take it more frequently than prescribed by your doctor.

It controls hypertension but does not cure it. Do not discontinue using enalapril without consulting your doctor even if you feel better. Many people with hypertension do not feel sick.

To lower the risk of side effects, your doctor may advise you to start this medication at a low dose initially and gradually increase your dose. Follow your doctor’s guidance carefully.

Hypertension (high blood pressure) treatment may require about 2 to 4 weeks before you observe the full benefit of this medication. In case of heart failure, it may take weeks to months before you get the full benefit from this drug. Inform your doctor, if your condition remains same or if it gets worse (such as your blood pressure readings remain constant or increase).

What are the side effects of Enalapril?

The commonly observed side effects with the use of this drug include dizziness, skin rash, loss of taste and a persistent dry cough. Inform your doctor/pharmacist immediately If any of these side effects continue or worsen.

To minimize the risk of dizziness and lightheadedness get up slowly when rising from a sitting position or lying position.

Get medical assistance right away if you observe any severe side effects like fainting, symptoms of high potassium (like muscle weakness and slow or irregular heartbeat) signs of infection (such as fever, chills, persistent sore throat) and cloudy urine.

Although this drug is used to prevent kidney problems or treat people who have kidney problems, it may also rarely produce severe kidney problems or make them dangerous. Your doctor will test your kidney function while you are taking enalapril. Notify your doctor quickly if you experience any symptoms of kidney problems like a change in the amount of urine.

Enalapril may cause serious (possibly fatal) liver problems. Get medical assistance as soon as possible if you have any symptoms of the liver problem, like non-stop nausea/vomiting, dark urine, loss of appetite, stomach/abdominal pain or yellowing eyes/skin.

A severe allergic reaction to this drug is uncommon. However, get medical help quickly if you mark any symptoms of a severe allergic reaction such as rash, itching/swelling (particularly of the face/tongue/throat), trouble breathing or severe dizziness.

This record does not contain the full list of all possible side effects. If you mark other effects not listed above, contact your doctor/pharmacist.

What are the precautions while using Enalapril?

Inform your doctor/pharmacist before taking enalapril, if you are allergic to it; or if you have other allergies. This drug may also contain some inactive ingredients that can cause allergic reactions or other problems. Talk to your doctor/pharmacist for more information.

Inform your doctor/pharmacist about all the products you are using including prescription, non-prescription, vitamins, nutritional supplements, and herbal products.

Notify your doctor right away if you see any sign of infection (like a sore throat, fever), as it may be a sign of neutropenia (low level of neutrophils) or of progressive edema which might be related nephrotic syndrome.

Enalapril may cause dizziness, do not drive, use machinery, or do anything that needs sharpness until you can do it cautiously. Limit use of alcoholic beverages. Speak to your doctor if you are using marijuana.

Too much sweating, diarrhea or vomiting may lead to severe dehydration and fall in blood pressure because of reduction in fluid volume. Inform your doctor if you have prolonged diarrhea or vomiting. Make sure to take enough fluids to prevent dehydration unless your doctor directs you otherwise.

Before undergoing any surgery, notify your doctor or dentist that you are using Enalapril.

This product may increase potassium levels in your body, before using potassium supplements or salt substitutes that consist of potassium, seek advice from your doctor.

Older adults are susceptible to the side effects of this drug, mainly dizziness and increase in potassium level.

Some people on enalapril therapy for heart failure should be warned against rapid increases in physical activity.

This medication is not advised for use during pregnancy. It may harm an unborn baby. Ask your doctor for further details (See also Warning).

There is no information whether or not this medication passes into breast milk. Ask your doctor before breastfeeding.

What are the drug Interactions of Enalapril?

Enalapril may interact with other medications, herbs, or vitamins you may be using. A drug interaction is when a substance changes the way a drug works which can be harmful or block the drug from working well.

Do not start, stop, or alter the dose of the drug without consulting your doctor because your doctor may be monitoring you for all possible drug interactions.

Taking enalapril along with sacubitril, which is used with valsartan to treat high blood pressure and heart failure, may raise your risk of angioedema (severe swelling). Avoid using enalapril within 36 hours of using sacubitril.

Double blockade of the renin-angiotensin system with angiotensin receptor blockers, ACE inhibitors, or aliskiren may develop hyperkalemia, hypotension, and changes in renal function (acute renal failure) compared to monotherapy. Regularly monitor blood pressure, renal function and electrolytes in people using enalapril and other drugs that affect the RAS.

Taking potassium-sparing diuretics like spironolactone, amiloride, triamterene along with enalapril may lead to high blood potassium in your body.

Enalapril interacts with some medicines like everolimus, sirolimus that decrease the immune system/increase the risk of infection.

Some products may contain ingredients that could raise your blood pressure or increase the risk of heart failure. Tell your doctor/pharmacist what products you are using, and ask how to use them safely (particularly cough-and-cold products, NSAIDs such as ibuprofen/naproxen, diet aids).

A reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) along with enalapril. Make sure all your doctors know about medicines you are using.

WARNINGS:

Pregnancy warning:

Do not take this drug during pregnancy because enalapril can harm the unborn baby or end your pregnancy. Discuss with your doctor about other ways to lower your blood pressure if you plan to get pregnant. If you get pregnant while taking enalapril, tell your doctor right away.

Swelling warning:

This drug can cause severe, sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines. This swelling can be fatal. Stop this medicine right away and inform your doctor right away if you have swelling or have stomach pain.

Low blood pressure warning:

This drug can cause low blood pressure, mainly at the start of treatment. Tell your doctor if you feel lightheaded or faint.

Infections warning:

This drug may decrease white blood cell counts. This can increase your risk of infections. Inform your doctor promptly if you notice any signs of infection, like a fever or a sore throat.

What are the forms and strengths of Enalapril?

Generic: Enalapril
Form: Oral tablet
Strengths: 2.5mg, 5mg, 10mg, and 20mg

Brand: Vasotec
Form: Oral tablet
Strengths: 2.5mg, 5mg, 10mg, and 20mg

What is the dosage of Enalapril?

For high blood pressure:

Adult (18 years and above):

The starting dose is 5mg taken by orally once per day. Your doctor may increase your dose based on your condition. The usual dosage range is 10 to 40mg per day. The maximum dose is 40mg per day. Your doctor may prescribe this drug once or twice per day. If you are using enalapril with diuretics, your starting dose could be 2.5mg taken by orally once per day.

Children (1 month to 17 years):

The starting dose is 0.08mg/kg taken orally once per day (up to 5mg once per day). Your doctor may increase your dose based on your blood pressure. The maximum dose is 0.58mg/kg taken orally once per day (40mg once per day).

Senior dosage (65 years and above):

Older adults are susceptible to the side effects of this drug due to slow kidney and liver function. To avoid this, your doctor may initiate your treatment on a low dose.

Special considerations:

For people with renal impairment:

Normal or mild kidney problems: 5mg taken once per day
Moderate to severe kidney problems: 2.5mg taken once per day.
People on dialysis: 2.5mg taken once per day on dialysis.

For heart failure:

Adult (18 years and older):

The starting dose is 2.5mg taken orally twice per day. The usual dose is 2.5–20mg taken orally twice per day. Your doctor may increase your dose after a few days or weeks. The maximum dose is 40mg per day taken in divided doses.

Children (0–17 years):

Dosage is not established in children younger than 18 years.

Senior dosage (65 years and older):

Older adults are susceptible to the side effects of this drug due to slow kidney and liver function. To avoid this, your doctor may initiate your treatment on a low dose.

Special dose considerations:

Renal impairment: If your blood serum creatinine level is greater than 1.6mg/dL, the starting dose is 2.5mg, taken once a day. Your doctor may increase the dose to 2.5mg twice daily, and then to 5mg twice a day or higher as needed. The changes will likely be made at 4 days interval or more. The maximum dose is 40mg per day.

Low sodium: If your blood sodium level is less than 130 mEq/L, the starting dose is 2.5mg, taken once a day. Your doctor may increase your dose up to 2.5mg twice daily, and then to 5mg twice a day or higher as needed. The changes will likely be made at 4 days intervals or more. The maximum dose is 40mg per day.

For asymptomatic left ventricular dysfunction:

Adult (18 years and older):

The starting dose is 2.5mg taken twice a day orally. Your doctor could increase your dose up to a maximum of 10mg taken twice per day based on your condition.

Children (0–17 years):

Dosage is not established in children younger than 18 years.

Senior dosage (65 years and older):

Older adults are susceptible to the side effects of this drug due to slow kidney and liver function. To avoid this, your doctor may initiate your treatment on a low dose.

Most common questions asked about Enalapril / Q&A’s:

What are the serious side effects of Enalapril?

Some of the serious side effects of enalapril may include swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness, difficulty in breathing or swallowing, yellowing of the skin or eyes, fever, sore throat, chills, and other signs of infection, lightheadedness, fainting. Seek a medical emergency as soon as possible if you notice any of these side effects.

What are the symptoms of Enalapril overdose?

Symptoms of enalapril overdose include lightheadedness, fainting. Seek a medical emergency as soon as possible if you notice any of these symptoms.

Disclaimer
TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.