| name | Enalaprilat |
| classification | ACE Inhibitor |
| pharmacokinetics | | absorption | IV administration only; rapidly absorbed and distributed. Bioavailability is not applicable. | | distribution | Extensive distribution throughout the body, including the kidneys. Volume of distribution is relatively high. | | metabolism | Minimal hepatic metabolism. Primarily excreted by the kidneys, unchanged. | | excretion | Renal excretion is the primary route of elimination; the half-life is short (approximately 1-2 hours). This is relevant as doses must be frequent and/or continuous infusion. |
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| suggested dosage | | note | Dosage must be carefully titrated based on patient response and renal function. Consult with a prescribing healthcare professional. The dosage below represents a starting point and must be individualized based on the patient's response. | | range mg kg day | Not available as a mg/kg/day dosing as it's frequently administered as a continuous infusion tailored to specific blood pressure needs. | | typical initial infusion rate | 0.5 - 1.0 mcg/kg/min, gradually titrated to achieve desired blood pressure. |
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| indications | | 1 | Management of hypertensive emergencies, including malignant hypertension. | | 2 | Acute heart failure in patients with reduced ejection fraction. | | 3 | Short-term therapy in situations where oral ACE inhibitors are not feasible or not quickly effective. |
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| Safety in pregnancy | Category D: Use during pregnancy only if the potential benefit outweighs the potential risk to the fetus. ACE inhibitors, including enalaprilat, are contraindicated in the second and third trimesters and should be avoided during pregnancy. |
| Safety in breastfeeding | May be present in breast milk. Consult with a healthcare professional before use. |
| side effects | | 1 | Hypotension (most common and potentially serious) | | 2 | Renal dysfunction (especially in patients with pre-existing renal impairment) | | 3 | Angioedema (swelling of the face, lips, tongue, or throat) | | 4 | Cough | | 5 | Dizziness | | 6 | Headache | | 7 | Fatigue | | 8 | Taste disturbances | | 9 | Gastrointestinal upset (nausea, vomiting, diarrhea) | | 10 | Rash or other allergic reactions |
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| alternatives | |
| contraindications | | 1 | History of angioedema | | 2 | Severe renal impairment | | 3 | Bilateral renal artery stenosis | | 4 | Pregnancy (second and third trimesters) | | 5 | Hypersensitivity to ACE inhibitors. |
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| interactions | | 1 | Diuretics (may increase risk of hypotension) | | 2 | Potassium-sparing diuretics (may increase risk of hyperkalemia) | | 3 | NSAIDs (may reduce the effectiveness of ACE inhibitors) | | 4 | Lithium (may increase lithium levels, causing toxicity) | | 5 | Other medications affecting renal function (monitor closely for kidney issues) |
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| warnings and precautions | | 1 | Closely monitor blood pressure, renal function, and electrolyte levels, particularly potassium. | | 2 | Use caution in patients with heart failure or reduced cardiac output. | | 3 | Administer IV enalaprilat slowly and monitor for hypotension. | | 4 | Assess the patient's baseline renal function before and during treatment. | | 5 | Assess patient hydration status | | 6 | Potential for first dose hypotension |
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| additional informations | | 1 | Enalaprilat is a short-acting prodrug that is rapidly converted to enalapril in the body. Enalapril is then an active drug in its own right. Rapid action makes this an important consideration in the management of hypertensive emergencies | | 2 | This information is intended for educational purposes only and should not be considered medical advice. Always consult with a healthcare professional for diagnosis and treatment. | | 3 | The patient's age and weight are considered but will not dictate the dosing regiment. Dosing is dependent on the clinical situation (e.g. severity of hypertension) and patient response. A prescribing healthcare professional should make any treatment decisions |
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| patient profile | |
