Enalapril (Vasotec, Epaned) Uses, Side Effects & Dosage (original) (raw)

• What is enalapril, and how does it work (mechanism of action)?
• What are the side effects of enalapril?
• What is the dosage for enalapril?
• Which drugs or supplements interact with enalapril?
• Is enalapril safe to take if I'm pregnant or breastfeeding?
• What else should I know about enalapril?

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?

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:

• abdominal pain,
• diarrhea,
• dizziness,
• fatigue,
• headache,
• loss of appetite,
• nausea and vomiting,
• chest pain,
• 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. Enalapril may cause hypersensitivity (allergic) reactions and angioedema (swelling of face, lips, tongue, throat).

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.

SLIDESHOW How to Lower Blood Pressure: Exercise and Tips See Slideshow

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).

Health News

Summary

Enalapril (Vasotec, Epaned) is a drug that belongs to the drug class of Ace inhibitors. Enalapril is prescribed for the treatment of high blood pressure. Side effects, drug interactions, warnings and precautions, and use during pregnancy should be reviewed prior to taking any medication.

Multimedia: Slideshows, Images & Quizzes

• What Is High Blood Pressure (Hypertension)? Symptoms, Treatments What causes high blood pressure (hypertension)? What is normal blood pressure? Know the warning signs and symptoms of high blood...
• High Blood Pressure (Hypertension) Quiz: Symptoms, Signs & Causes Take this quiz and test your IQ of high blood pressure (hypertension), the cardiovascular disease that causes most strokes and...
• Picture of Hypertension High blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140...

Related Disease Conditions

• High Blood Pressure (Hypertension) High blood pressure (hypertension) occurs due to the tightening or stiffness of very small arteries called arterioles. As a result, the heart pumps harder through the stiff or narrow arterioles, leading to elevated pressure inside the vessels. Hypertension is known as 'the silent killer' because it often goes unnoticed and may cause serious complications such as kidney diseases, heart diseases, heart failure, and stroke.
• Kidney Failure Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post-renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
• Diabetes Mellitus (Type 1 and Type 2) Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue.
• Congestive Heart Failure (CHF) Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema.
• Heart Attack A heart attack (myocardial infarction) occurs when the sudden blockage of a coronary artery, usually because of blood clot, causes damage and death to heart muscle. Symptoms of a heart attack may include chest discomfort often described as a pain, pressure or tightness associated with shortness of breath, sweating and nausea.
• Chronic Cough Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
• Pulmonary Edema Pulmonary edema, or fluid in the lungs, can cause symptoms such as shortness of breath. Learn about causes, diagnosis complications, treatment, and prevention.
• Things to Know About High Blood Pressure Treatment High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
• Diabetes Treatment: Medication, Diet, and Insulin The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
• Febrile Seizures Febrile seizures, or convulsions caused by fever, can be frightening in small children or infants. However, in general, febrile seizures are harmless. Febrile seizure is not epilepsy. It is estimated that one in every 25 children will have at least one febrile seizure. It is important to know what to do to help your child if he/she has a febrile seizure. Some of the features of a febrile seizure include losing consciousness, shaking, moving limbs on both sides of the body, and lasts 1-2 minutes. Less commonly, a febrile seizure may only affect one side of the body.

Treatment & Diagnosis

Medications & Supplements

Prevention & Wellness

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References

Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine

REFERENCE:

FDA Prescribing Information