| name | Enalapril |
| classification | ACE Inhibitor |
| pharmacokinetics | | absorption | Well absorbed orally, bioavailability is approximately 60%. | | distribution | Distributed widely throughout the body, crossing the placenta. | | metabolism | Metabolized primarily to enalaprilat, the active metabolite, in the liver. | | excretion | Excreted primarily by the kidneys. Enalaprilat has a longer half-life than enalapril. |
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| suggested dosage | | initial | 5-10 mg once daily; may increase by 5-10 mg increments every 1-2 weeks. | | maintenance | 10-40 mg once daily, titrated to response. | | note | Dosage adjustments may be necessary based on individual patient response, renal function, and other factors. |
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| indications | | 1 | Essential hypertension | | 2 | Congestive heart failure | | 3 | Diabetic nephropathy in patients with type 2 diabetes | | 4 | Post-myocardial infarction (in selected cases) |
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| safety in pregnancy | | category d | Avoid use during pregnancy. Potential for fetal injury. | | discussion | Enalapril is teratogenic and may cause injury to the developing kidney and cause death in the fetus. ACE inhibitors are contraindicated during pregnancy, unless other medications aren't feasible. |
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| safety in breastfeeding | | potential for transfer | Possible transfer to breast milk. | | discussion | Consult with a healthcare professional regarding the use of enalapril during breastfeeding. Alternative therapies should be considered whenever possible due to potential risks. |
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| side effects | | 1 | Dizziness | | 2 | Headache | | 3 | Fatigue | | 4 | Cough (dry, persistent) | | 5 | Hypotension (low blood pressure) | | 6 | Rash | | 7 | Renal dysfunction | | 8 | Angioedema (swelling of the face, lips, tongue, throat) | | 9 | Hyperkalemia (high potassium levels) |
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| alternatives | |
| contraindications | | 1 | History of angioedema | | 2 | Severe renal impairment | | 3 | Bilateral renal artery stenosis | | 4 | Pregnancy (Category D) |
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| interactions | | 1 | | drug | Potassium-sparing diuretics | | interaction | Increased risk of hyperkalemia | | discussion | Avoid concurrent use or use with caution. Monitor potassium levels closely. |
| | 2 | | drug | NSAIDs | | interaction | Reduced antihypertensive effect of enalapril | | discussion | May decrease efficacy. Monitor blood pressure closely. |
| | 3 | | drug | Lithium | | interaction | Increased lithium levels and toxicity | | discussion | Avoid concomitant use. Monitor lithium levels closely if unavoidable. |
| | 4 | | drug | Diuretics | | interaction | Possible hypotension and electrolyte imbalances. | | discussion | Monitor blood pressure and electrolytes closely. |
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| warnings and precautions | | 1 | Monitor renal function, especially in patients with pre-existing renal impairment | | 2 | Monitor blood pressure closely during initiation of therapy and dosage adjustments. | | 3 | Monitor serum potassium levels, especially in patients taking potassium-sparing diuretics or with renal impairment. | | 4 | Assess for signs and symptoms of angioedema | | 5 | Avoid use in patients with bilateral renal artery stenosis |
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| additional information | Consult with a healthcare professional for personalized dosing and monitoring. Enalapril should be used in conjunction with a comprehensive treatment plan to manage hypertension or other associated conditions. |
