enalapril, Vasotec, Epaned

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is enalapril, and how does it work (mechanism of action)?

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.

What brand names are available for enalapril?

Vasotec, Epaned

Is enalapril available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for enalapril?

Yes

What are the side effects of enalapril?

Enalapril is generally well tolerated, and side effects usually are mild and transient. A dry, persistent cough has been reported commonly with the use of ACE inhibitors. Coughing resolves after discontinuing the medication.

Other important side effects include:

In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors. In susceptible individuals ACE inhibitors may reduce kidney function. Enalapril may cause hypersensitivity (allergic) reactions and angioedema (swelling of face, lips, tongue, throat).

Quick GuideHow to Lower Blood Pressure: Exercise Tips

How to Lower Blood Pressure: Exercise Tips

What is the dosage for enalapril?

The usual oral dose for treating high blood pressure is 2.5-40 mg once daily. It may also be administered twice daily in two divided doses. The dose for treating heart failure is 2.5-20 mg given twice daily. The usual starting intravenous dose is 1.25 mg administered over a 5 minute period every 6 hours. If a patient is receiving diuretic therapy the initial intravenous dose is 0.625 mg every 6 hours.

Which drugs or supplements interact with enalapril?

Patients receiving diuretics may experience excessive reduction in blood pressure when enalapril is started. Stopping the diuretic or increasing salt intake prior to taking enalapril may prevent excessive blood pressure reduction. Close supervision for at least 2 hours after the start of enalapril and until blood pressure is stable is recommended if the diuretic cannot be stopped.

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 (for example, spironolactone [Aldactone]).

There have been reports of increased lithium (Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The reason for this interaction is not known, but the increased levels may lead to toxicity from lithium. There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable gold (sodium aurothiomalate [Myochrysine]), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including enalapril.

Is enalapril safe to take if I'm pregnant or breastfeeding?

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

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

What else should I know about enalapril?

What preparations of enalapril are available?

  • Tablets: 2.5, 5, 10, and 20 mg.
  • Injection: 1.25 mg/mL
  • STORAGE: Tablets should be stored at room temperature between 15 C - 30 C (59 F - 86 F). The injectable formulation should be stored at 20 C to 25 C (68 F to 77 F).

Reference: FDA Prescribing Information

Quick GuideHow to Lower Blood Pressure: Exercise Tips

How to Lower Blood Pressure: Exercise Tips

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See more info: enalapril on RxList
Reviewed on 1/29/2015
References
Reference: FDA Prescribing Information

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