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Medications and Drugs

Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: enalapril

BRAND NAME: Vasotec

DRUG CLASS AND MECHANISM: Enalapril is a drug that is used for treating high blood pressure. It is in a class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE is an enzyme in the body that causes the formation of angiotensin II. Angiotensin II causes the arteries in the body to narrow, thereby elevating blood pressure. ACE inhibitors, such as enalapril, lower blood pressure by preventing the formation of angiotensin II thereby relaxing the arteries. ACE inhibitors also improve the effectiveness of the heart in patients with heart failure by reducing the blood pressure that the heart must maintain. Enalapril was approved by the FDA in December, 1985.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 2.5, 5, 10, and 20 mg. Injection: 1.25 mg/mL STORAGE: Store below 30°C (86°F).

PRESCRIBED FOR: Enalapril is used alone or in combination with other drugs to treat high blood pressure or congestive heart failure. After a heart attack, enalapril has been found to be effective in improving function of the damaged heart and in reducing symptoms and hospitalizations related to heart failure.

DOSING: The usual oral dose for treating high blood pressure is 2.5-40 mg once daily. It may also be administered twice daily. The dose for treating heart failure is 2.5-20 mg given twice daily. The usual intravenous dose is 1.25 mg every 6 hours.

DRUG INTERACTIONS: Enalapril may increase potassium levels (hyperkalemia) in blood. Therefore, there is an increased risk of hyperkalemia when enalapril is given with potassium supplements or drugs that increase potassium levels (e.g., spironolactone).

Nitritoid reactions (symptoms includie facial flushing, nausea, vomiting and hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including enalapril.

PREGNANCY: ACE inhibitors, including enalapril, can be harmful to the fetus and should not be taken by pregnant women.

NURSING MOTHERS: ACE inhibitors, including enalapril, should be avoided in nursing mothers.

SIDE EFFECTS: Enalapril is generally well tolerated, and side effects usually are mild and transient. A dry, persistent cough has been reported with the use of ACE inhibitors. Coughing resolves after discontinuing the medication. Other side effects include abdominal pain, diarrhea, dizziness, fatigue, headache, loss of appetite, nausea and vomiting, chest pain, dizziness or fainting, numbness or tingling in the hands or feet, rash, and a sore or swollen throat. In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors. In susceptible individuals ACE inhibitors may reduce kidney function.

Reference: FDA Prescribing Information


Last Editorial Review: 12/13/2005




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Suggested Reading by Our Doctors
MedicineNet Doctors
  • ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
  • Kidney Failure - Learn about kidney failure, in which the body has fluid retention, risen blood pressure, toxin build up and lack of red blood cells. Symptoms include fatigue, nausea, and apetite loss.
  • Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.

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What is a heart attack?

A heart attack (also known as a myocardial infarction) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen,causing injury to the heart muscle. Injury to the heart muscle causes chest pain and chest pressure sensation. If blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is "complete." The dead heart muscle is eventually replaced by scar tissue.

Approximately one million Americans suffer a heart attack each year. Four hundred thousand of them die as a result of their heart attack.

What causes a heart att...

Read the Heart Attack article »











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