| name | Enalapril |
| classification | ACE Inhibitors |
| pharmacokinetics | Enalapril is a prodrug metabolized in the liver to enalaprilat, the active form. Enalaprilat is primarily excreted by the kidneys. Renal function significantly affects its clearance. |
| suggested dosage | | adult male 25 70kg | | initial dose | 10 mg once daily | | typical dose | 10-40 mg once daily or divided doses, titrated to response | | maximum dose | 40 mg daily | | notes | Adjust dosage based on patient response and blood pressure control. Dosage should be individualized. |
| | dosage considerations | Dosage adjustments may be necessary based on individual patient characteristics, including renal function and concomitant medications. |
|
| indications | | 1 | Essential hypertension | | 2 | Heart failure | | 3 | Diabetic nephropathy | | 4 | Left ventricular dysfunction after myocardial infarction | | 5 | Prevention of cardiovascular events |
|
| safety in pregnancy | Contraindicated. Use with extreme caution in pregnant women with hypertension requiring an antihypertensive; a less risky alternative should be prioritized. May cause fetal harm if used during pregnancy, especially in the second and third trimesters. |
| safety in breastfeeding | Use with caution. Limited data on excretion in breast milk. Consult a healthcare professional for individualized advice. |
| side effects | | 1 | Dizziness | | 2 | Headache | | 3 | Cough (persistent dry cough) | | 4 | Hypotension | | 5 | Rash | | 6 | Angioedema (swelling of face, lips, tongue, throat) | | 7 | Kidney problems | | 8 | Taste disturbances | | 9 | Fatigue | | 10 | Gastrointestinal upset | | 11 | Hyperkalemia (elevated potassium levels) | | 12 | Loss of taste |
|
| alternatives | |
| contraindications | | 1 | History of angioedema related to ACE inhibitors | | 2 | Severe renal artery stenosis | | 3 | Bilateral renal artery stenosis | | 4 | Hypersensitivity to ACE inhibitors | | 5 | Pregnancy (especially 2nd and 3rd trimester) | | 6 | Severe liver disease | | 7 | Known hypersensitivity to any component of the drug |
|
| interactions | | 1 | Diuretics (may increase risk of hypotension) | | 2 | Potassium-sparing diuretics (may increase risk of hyperkalemia) | | 3 | NSAIDs (may reduce antihypertensive effect) | | 4 | Lithium (may increase lithium levels) | | 5 | Other ACE inhibitors | | 6 | Other antihypertensives | | 7 | Potassium supplements | | 8 | Certain medications affecting kidney function |
|
| warnings and precautions | | 1 | Monitor blood pressure closely during initial therapy and dose adjustments. | | 2 | Monitor renal function (especially in patients with pre-existing renal impairment). | | 3 | Monitor electrolytes (especially potassium levels), particularly in patients with renal impairment or taking potassium supplements. | | 4 | Avoid abrupt discontinuation of the medication. | | 5 | Assess for angioedema (swelling of face, lips, tongue, throat). | | 6 | Increased risk of developing cough. Stop the medication if persistent cough develops. | | 7 | Patients with renal artery stenosis may develop worsening renal function. | | 8 | Consult a doctor about potential risk factors for side effects | | 9 | Inform doctor of all other medications being taken |
|
| additional information | ACE inhibitors can cause a persistent dry cough, which often resolves when the medication is discontinued. This should be considered when evaluating a patient with a chronic cough. |
| additional notes | This information is for educational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. |
