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What are the side effects of enalapril: Enalapril (Vasotec) – Side Effects, Interactions, Uses, Dosage, Warnings

Содержание

Enalapril Maleate Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Dizziness, lightheadedness, or weakness may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).

Although enalapril may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking enalapril. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine.

This drug may rarely cause serious (possibly fatal) liver problems. Tell your doctor right away if you notice any of the following rare but serious side effects: yellowing eyes/skin, dark urine, severe stomach/abdominal pain, persistent nausea/vomiting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Enalapril (Vasotec, Epaned) in Children

Special Instructions

  • Give this medication only as directed, and do not stop unless directed to stop by your child’s doctor.
  • This medication can be taken with or without food.
  • Limit salt substitutes and other foods high in potassium. Do not use a salt substitute without the doctor’s advice.
  • Limit or avoid natural licorice, which can cause the body to retain sodium and water.
  • Do not use after the expiration date on the bottle / package.
  • Keep this medication out of the reach of children.
  • If too much medication is taken by accident, call the Drug and Poison Information Center (DPIC) at 513-636-5111 or 1-800-222-1222, or call your child’s doctor immediately.
  • If you become pregnant or think you may be pregnant, contact your doctor immediately.

If Your Child Misses a Dose

  • Give a missed dose as soon as possible.
  • If it is almost time for the next dose, skip the missed dose and return to your child’s regular schedule.
  • Do not give a double dose or extra doses.
  • Do not change dose or stop medicine. Talk with your healthcare provider.

For more medication information related to your child’s dosing schedule and / or missed doses, contact the healthcare provider who prescribed the medication.

Possible Side Effects of Medication

  • Trouble breathing or chest tightness
  • Lightheadedness or fainting
  • Excessive sweating, diarrhea or vomiting
  • Swelling of the lips, tongue or face
  • Swelling of the legs or belly
  • Dark urine or yellow skin or eyes
  • Significant weight gain

Call Your Child’s Doctor If:

Call if your child is having any side effects, especially:

  • Trouble breathing or swallowing
  • Swelling of the lips, tongue, throat, face, hands, feet or ankles
  • Vomiting, diarrhea, or other condition causing dehydration, since this may lower blood pressure
  • Excessive sweating
  • Persistent cough
  • Fainting
  • Yellowing of the skin or eyes
  • Fever, or other signs of infection

Enalaprilat, Vasotec (enalapril) dosing, indications, interactions, adverse effects, and more

  • aceclofenac

    Minor (1)aceclofenac decreases effects of enalapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • acemetacin

    Minor (1)acemetacin decreases effects of enalapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • agrimony

    Minor (1)agrimony increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • albiglutide

    Monitor Closely (1)enalapril increases effects of albiglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

  • aldesleukin

    Monitor Closely (1)aldesleukin increases effects of enalapril by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

  • alfuzosin

    Monitor Closely (1)enalapril, alfuzosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • aliskiren

    Contraindicated (2)enalapril, aliskiren.
    Either increases toxicity of the other by Mechanism: pharmacodynamic synergism. Contraindicated. Aliskiren use contraindicated with ACEIs in patients with diabetes; avoid coadministration with ACEIs if GFR

    enalapril decreases effects of aliskiren by Other (see comment). Contraindicated.
    Comment: Aliskiren use contraindicated with ACE-inhibitors in patients with diabetes; avoid coadministration with ACE-inhibitors if GFR. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of ACE-inhibitors with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.

  • allopurinol

    Serious – Use Alternative (1)enalapril, allopurinol. Mechanism: unknown. Avoid or Use Alternate Drug. Risk of anaphylaxis, Stevens Johnson syndrome.

  • aluminum hydroxide

    Monitor Closely (1)aluminum hydroxide decreases effects of enalapril by unspecified interaction mechanism. Use Caution/Monitor.

  • amifostine

    Monitor Closely (1)amifostine, enalapril.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

  • amiloride

    Monitor Closely (1)enalapril, amiloride. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.

  • apalutamide

    Monitor Closely (1)apalutamide will decrease the level or effect of enalapril by increasing elimination. Use Caution/Monitor. Apalutamide weakly induces OATP1B1 and may decrease systemic exposure of drugs that are OATP1B1 substrates.

  • asenapine

    Monitor Closely (1)enalapril, asenapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • aspirin

    Monitor Closely (1)enalapril, aspirin.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly with high dose aspirin, in elderly or volume depleted individuals.Serious – Use Alternative (1)aspirin, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • aspirin rectal

    Serious – Use Alternative (1)aspirin rectal, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • aspirin/citric acid/sodium bicarbonate

    Monitor Closely (2)enalapril, aspirin/citric acid/sodium bicarbonate.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    aspirin/citric acid/sodium bicarbonate decreases effects of enalapril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

  • avanafil

    Monitor Closely (1)avanafil increases effects of enalapril by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

  • azathioprine

    Monitor Closely (1)enalapril, azathioprine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of neutropenia.

  • azilsartan

    Serious – Use Alternative (1)azilsartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • bretylium

    Monitor Closely (1)enalapril, bretylium.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.

  • brimonidine

    Minor (1)brimonidine increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • bumetanide

    Monitor Closely (1)enalapril, bumetanide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

  • calcium carbonate

    Monitor Closely (1)calcium carbonate decreases effects of enalapril by unspecified interaction mechanism. Use Caution/Monitor.

  • canagliflozin

    Monitor Closely (1)enalapril and canagliflozin both increase serum potassium. Use Caution/Monitor.

  • candesartan

    Serious – Use Alternative (1)candesartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • capsicum

    Minor (1)capsicum, enalapril. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increase ACE inhibitor induced cough.

  • carbamazepine

    Monitor Closely (1)enalapril increases levels of carbamazepine by decreasing metabolism. Use Caution/Monitor.

  • carbidopa

    Monitor Closely (1)carbidopa increases effects of enalapril by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.

  • celecoxib

    Monitor Closely (1)enalapril, celecoxib.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)celecoxib, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • chlorpromazine

    Minor (1)chlorpromazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • chlorpropamide

    Monitor Closely (1)enalapril increases effects of chlorpropamide by pharmacodynamic synergism. Use Caution/Monitor.

  • choline magnesium trisalicylate

    Monitor Closely (1)enalapril, choline magnesium trisalicylate.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)choline magnesium trisalicylate, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • cornsilk

    Minor (1)cornsilk increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • creatine

    Minor (1)creatine, enalapril. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.

  • cyclosporine

    Minor (1)cyclosporine will increase the level or effect of enalapril by Other (see comment). Minor/Significance Unknown. may increase plasma concentrations of OATP substrates

  • dalteparin

    Monitor Closely (1)dalteparin increases toxicity of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia.

  • diclofenac

    Monitor Closely (1)enalapril, diclofenac.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)diclofenac, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • diflunisal

    Monitor Closely (1)enalapril, diflunisal.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)diflunisal, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • digoxin

    Monitor Closely (1)enalapril increases levels of digoxin by unspecified interaction mechanism. Use Caution/Monitor.

  • doxazosin

    Monitor Closely (1)enalapril, doxazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • drospirenone

    Monitor Closely (1)enalapril, drospirenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.

  • enoxaparin

    Monitor Closely (1)enoxaparin increases toxicity of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia.

  • entecavir

    Minor (1)enalapril, entecavir.
    Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.

  • eplerenone

    Monitor Closely (1)enalapril, eplerenone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.

  • eprosartan

    Serious – Use Alternative (1)eprosartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • ethacrynic acid

    Monitor Closely (1)enalapril, ethacrynic acid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

  • etodolac

    Monitor Closely (1)enalapril, etodolac.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)etodolac, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • everolimus

    Monitor Closely (1)enalapril, everolimus.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration increases risk of angioedema.

  • exenatide injectable solution

    Monitor Closely (1)enalapril increases effects of exenatide injectable solution by Other (see comment). Use Caution/Monitor.
    Comment: ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

  • exenatide injectable suspension

    Monitor Closely (1)enalapril increases effects of exenatide injectable suspension by Other (see comment). Use Caution/Monitor.
    Comment: ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor.

  • fenoprofen

    Monitor Closely (1)enalapril, fenoprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Serious – Use Alternative (1)fenoprofen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • ferric maltol

    Monitor Closely (1)enalapril, ferric maltol. Mechanism: unknown. Use Caution/Monitor. Risk of GI symptoms, hypotension.

  • ferrous gluconate

    Monitor Closely (1)enalapril, ferrous gluconate. Mechanism: unknown. Use Caution/Monitor. Risk of GI symptoms, hypotension.

  • finerenone

    Monitor Closely (1)enalapril and finerenone both increase serum potassium. Modify Therapy/Monitor Closely. Finerenone dose adjustment based on current serum potassium concentration. Monitor serum potassium and adjust finerenone dose as described in the prescribing information as necessary.

  • fluphenazine

    Minor (1)fluphenazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • flurbiprofen

    Monitor Closely (1)enalapril, flurbiprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)flurbiprofen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • fostemsavir

    Monitor Closely (1)fostemsavir will increase the level or effect of enalapril by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits OATP1B1/3 transporter. If possible, avoid coadministration or modify dose of OATP1B1/3 substrates coadministered with fostemsavir.

  • furosemide

    Monitor Closely (1)enalapril, furosemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

  • glecaprevir/pibrentasvir

    Monitor Closely (1)glecaprevir/pibrentasvir will increase the level or effect of enalapril by Other (see comment). Use Caution/Monitor. Coadministration with glecaprevir/pibrentasvir may increase plasma concentration of drugs that are substrates of OATP1B1 or OATP1B3

  • glimepiride

    Monitor Closely (1)enalapril increases effects of glimepiride by pharmacodynamic synergism. Use Caution/Monitor.

  • glipizide

    Monitor Closely (1)enalapril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

  • glyburide

    Monitor Closely (1)enalapril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

  • gold sodium thiomalate

    Monitor Closely (1)enalapril, gold sodium thiomalate. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Combo of ACE inhibitors and injectable gold has caused rare cases of nitritoid reaction (flushing, N/V, hypot’n).

  • heparin

    Monitor Closely (1)heparin increases toxicity of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia.

  • ibuprofen

    Monitor Closely (1)enalapril, ibuprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • ibuprofen IV

    Monitor Closely (1)enalapril, ibuprofen IV.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ibuprofen IV, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • icatibant

    Monitor Closely (1)icatibant decreases effects of enalapril by pharmacodynamic antagonism. Use Caution/Monitor. Icatibant has potential to have a pharmacodynamic interaction with ACE inhibitors where it may attenuate the antihypertensive effect of ACE inhibitors.

  • indomethacin

    Monitor Closely (1)enalapril, indomethacin.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)indomethacin, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • insulin aspart

    Monitor Closely (1)enalapril increases effects of insulin aspart by pharmacodynamic synergism. Use Caution/Monitor.

  • insulin degludec

    Monitor Closely (1)enalapril, insulin degludec.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

  • insulin degludec/insulin aspart

    Monitor Closely (1)enalapril, insulin degludec/insulin aspart.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

  • insulin detemir

    Monitor Closely (1)enalapril increases effects of insulin detemir by pharmacodynamic synergism. Use Caution/Monitor.

  • insulin glargine

    Monitor Closely (1)enalapril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • insulin glulisine

    Monitor Closely (1)enalapril increases effects of insulin glulisine by pharmacodynamic synergism. Use Caution/Monitor.

  • insulin inhaled

    Monitor Closely (1)enalapril, insulin inhaled.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

  • insulin lispro

    Monitor Closely (1)enalapril increases effects of insulin lispro by pharmacodynamic synergism. Use Caution/Monitor.

  • insulin NPH

    Monitor Closely (1)enalapril increases effects of insulin NPH by pharmacodynamic synergism. Use Caution/Monitor.

  • insulin regular human

    Monitor Closely (1)enalapril increases effects of insulin regular human by pharmacodynamic synergism. Use Caution/Monitor.

  • irbesartan

    Serious – Use Alternative (1)irbesartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • ketoprofen

    Monitor Closely (1)enalapril, ketoprofen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ketoprofen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • ketorolac

    Monitor Closely (1)enalapril, ketorolac.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ketorolac, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • ketorolac intranasal

    Monitor Closely (1)enalapril, ketorolac intranasal.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)ketorolac intranasal, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • lanthanum carbonate

    Monitor Closely (1)lanthanum carbonate decreases levels of enalapril by cation binding in GI tract. Use Caution/Monitor. Administer ACE inhibitor at least 2 hr before or after lanthanum.

  • letermovir

    Monitor Closely (1)letermovir increases levels of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Letermovir, an OATP1B1/3 inhibitor may increase plasma concentrations of coadministered OATP1B1/3 substrates.

  • levodopa

    Monitor Closely (1)levodopa increases effects of enalapril by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

  • liraglutide

    Monitor Closely (1)enalapril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

  • lithium

    Monitor Closely (1)enalapril increases toxicity of lithium by unknown mechanism. Use Caution/Monitor. ACE inhibitor induced Na+ depletion may increase reabsorption of lithium from renal tubule.

  • lofexidine

    Serious – Use Alternative (1)lofexidine, enalapril.
    Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

  • lornoxicam

    Minor (1)lornoxicam decreases effects of enalapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • losartan

    Serious – Use Alternative (1)losartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • lurasidone

    Monitor Closely (1)lurasidone increases effects of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

  • maitake

    Minor (1)maitake increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • maraviroc

    Monitor Closely (1)maraviroc, enalapril.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

  • meclofenamate

    Monitor Closely (1)enalapril, meclofenamate.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Serious – Use Alternative (1)meclofenamate, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • mefenamic acid

    Monitor Closely (1)enalapril, mefenamic acid.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)mefenamic acid, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • meloxicam

    Monitor Closely (1)enalapril, meloxicam.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • metformin

    Monitor Closely (1)enalapril increases toxicity of metformin by unspecified interaction mechanism. Use Caution/Monitor. Increases risk for hypoglycemia and lactic acidosis.

  • methylphenidate

    Monitor Closely (1)methylphenidate will decrease the level or effect of enalapril by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.

  • mipomersen

    Monitor Closely (1)mipomersen, enalapril.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

  • moxisylyte

    Monitor Closely (1)enalapril, moxisylyte. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • nabumetone

    Monitor Closely (1)enalapril, nabumetone.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)nabumetone, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • naproxen

    Monitor Closely (1)enalapril, naproxen.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)naproxen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • nesiritide

    Monitor Closely (1)nesiritide, enalapril.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.

  • nitroglycerin rectal

    Monitor Closely (1)nitroglycerin rectal, enalapril.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .

  • octacosanol

    Minor (1)octacosanol increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • olmesartan

    Serious – Use Alternative (1)olmesartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • oxaprozin

    Monitor Closely (1)enalapril, oxaprozin.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)oxaprozin, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • parecoxib

    Minor (1)parecoxib decreases effects of enalapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • perphenazine

    Minor (1)perphenazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • phenoxybenzamine

    Monitor Closely (1)enalapril, phenoxybenzamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • phentolamine

    Monitor Closely (1)enalapril, phentolamine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • piroxicam

    Monitor Closely (1)enalapril, piroxicam.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Serious – Use Alternative (1)piroxicam, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • potassium acid phosphate

    Monitor Closely (1)enalapril increases levels of potassium acid phosphate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.

  • potassium chloride

    Monitor Closely (1)enalapril increases levels of potassium chloride by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.

  • potassium citrate

    Monitor Closely (1)enalapril increases levels of potassium citrate by decreasing elimination. Use Caution/Monitor. Risk of hyperkalemia.

  • potassium citrate/citric acid

    Monitor Closely (1)enalapril and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

  • potassium iodide

    Monitor Closely (1)potassium iodide and enalapril both increase serum potassium. Use Caution/Monitor. Potassium salts may increase the hyperkalemic effects of ACE inhibitors; the effect may be the result of aldosterone suppression in patients receiving ACE inhibitors.

  • potassium phosphates, IV

    Serious – Use Alternative (1)enalapril and potassium phosphates, IV both increase serum potassium. Avoid or Use Alternate Drug.

  • prazosin

    Monitor Closely (1)enalapril, prazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • pregabalin

    Serious – Use Alternative (1)enalapril, pregabalin.
    Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Coadministration results in additive risk of developing angioedema of face, mouth, and neck. Angioedema may result in respiratory compromise.

  • probenecid

    Minor (1)probenecid increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • prochlorperazine

    Minor (1)prochlorperazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • promazine

    Minor (1)promazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • promethazine

    Minor (1)promethazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • protein a column

    Contraindicated (1)enalapril, protein a column. Other (see comment). Contraindicated.
    Comment: Risk of anaphylactic reaction. Mechanism: buildup of bradykinin d/t deactivation of kininase by ACE inhibitors. D/C ACE inhibitor 72h prior to use of protein A column.

  • reishi

    Minor (1)reishi increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • rifampin

    Minor (1)rifampin decreases levels of enalapril by increasing metabolism. Minor/Significance Unknown.

  • rose hips

    Monitor Closely (1)enalapril, rose hips. Mechanism: unknown. Use Caution/Monitor. Risk of GI symptoms, hypotension.

  • sacubitril/valsartan

    Contraindicated (1)sacubitril/valsartan, enalapril.
    Either increases toxicity of the other by Other (see comment). Contraindicated.
    Comment: Coadministration of neprilysin inhibitors (eg, sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hr of switching to or from sacubitril/valsartan.Serious – Use Alternative (1)sacubitril/valsartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • salicylates (non-asa)

    Minor (1)salicylates (non-asa) decreases effects of enalapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • salsalate

    Monitor Closely (1)enalapril, salsalate.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)salsalate, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • shepherd’s purse

    Minor (1)shepherd’s purse, enalapril. Other (see comment). Minor/Significance Unknown.
    Comment: Theoretically, shepherd’s purse may interfere with BP control.

  • silodosin

    Monitor Closely (1)enalapril, silodosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • sirolimus

    Monitor Closely (1)enalapril, sirolimus.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration increases risk of angioedema.

  • sodium bicarbonate

    Monitor Closely (1)sodium bicarbonate decreases effects of enalapril by unspecified interaction mechanism. Use Caution/Monitor.

  • sodium citrate/citric acid

    Monitor Closely (1)sodium citrate/citric acid decreases effects of enalapril by unspecified interaction mechanism. Use Caution/Monitor.

  • sodium sulfate/?magnesium sulfate/potassium chloride

    Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate

    Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sofosbuvir/velpatasvir

    Monitor Closely (1)sofosbuvir/velpatasvir increases levels of enalapril by Other (see comment). Use Caution/Monitor.
    Comment: Velpatasvir inhibits OATP1B1, OATP1B3, and OATP2B1 transporters. .

  • spironolactone

    Monitor Closely (1)enalapril, spironolactone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.

  • sulfasalazine

    Monitor Closely (2)enalapril, sulfasalazine.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

    sulfasalazine decreases effects of enalapril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

  • sulindac

    Monitor Closely (1)enalapril, sulindac.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)sulindac, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • synthetic human angiotensin II

    Monitor Closely (1)enalapril increases effects of synthetic human angiotensin II by unspecified interaction mechanism. Use Caution/Monitor.

  • tadalafil

    Monitor Closely (1)tadalafil increases effects of enalapril by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

  • telmisartan

    Serious – Use Alternative (1)telmisartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • temsirolimus

    Monitor Closely (1)enalapril, temsirolimus.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration increases risk of angioedema.

  • terazosin

    Monitor Closely (1)enalapril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • thioridazine

    Minor (1)thioridazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • tizanidine

    Minor (1)tizanidine increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

  • tolazamide

    Monitor Closely (1)enalapril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.

  • tolbutamide

    Monitor Closely (1)enalapril increases effects of tolbutamide by pharmacodynamic synergism. Use Caution/Monitor.

  • tolfenamic acid

    Minor (1)tolfenamic acid decreases effects of enalapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

  • tolmetin

    Monitor Closely (1)enalapril, tolmetin.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)tolmetin, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

  • torsemide

    Monitor Closely (1)enalapril, torsemide. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypotension, renal insufficiency.

  • treprostinil

    Minor (1)treprostinil increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

  • triamterene

    Monitor Closely (1)enalapril, triamterene. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hyperkalemia.

  • trifluoperazine

    Minor (1)trifluoperazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

  • trimethoprim

    Monitor Closely (1)trimethoprim and enalapril both increase serum potassium. Use Caution/Monitor. Trimethoprim decreases urinary potassium excretion. May cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia.

  • valsartan

    Serious – Use Alternative (1)valsartan, enalapril.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment.

  • voclosporin

    Monitor Closely (2)voclosporin and enalapril both increase serum potassium. Use Caution/Monitor.

    voclosporin, enalapril.
    Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.Minor (1)voclosporin will increase the level or effect of enalapril by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.

  • xipamide

    Monitor Closely (1)xipamide increases effects of enalapril by pharmacodynamic synergism. Use Caution/Monitor.

  • zotepine

    Monitor Closely (1)enalapril, zotepine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

  • ACT Enalapril – Uses, Side Effects, Interactions

    How does this medication work? What will it do for me?

    Enalapril belongs to the class of medications called angiotensin converting enzyme (ACE) inhibitors. It is used to treat high blood pressure and congestive heart failure.

    This medication works by relaxing blood vessels and by making the heart pump more efficiently. The injectable form is used to lower high blood pressure when the oral form cannot be used.

    This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

    Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

    Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

    What form(s) does this medication come in?

    2.5 mg
    Each white-to-off-white, oval-shaped, biconvex tablet with “EL | 25” on one side and a symbol on the other contains 2.5 mg of enalapril maleate. Nonmedicinal ingredients: lactose monohydrate, maize starch, magnesium stearate (vegetable grade), pregelatinized maize starch, and sodium bicarbonate.

    5 mg
    Each white-to-off-white, rounded triangle-shaped, biconvex tablet with “EL | 5” on one side and a symbol on the other contains 5 mg of enalapril maleate. Nonmedicinal ingredients: lactose monohydrate, maize starch, magnesium stearate (vegetable grade), pregelatinized maize starch, and sodium bicarbonate.

    10 mg
    Each peach, rounded, triangle-shaped, biconvex tablet with “EL | 10” on one side and a symbol on the other contains 10 mg of enalapril maleate. Nonmedicinal ingredients: iron oxide red, lactose monohydrate, maize starch, magnesium stearate (vegetable grade), pregelatinized maize starch, and sodium bicarbonate.

    20 mg
    Each salmon, rounded, triangular-shaped, biconvex tablet with “EL | 20” on one side and a symbol on the other side, contains 20 mg of enalapril maleate. Nonmedicinal ingredients: iron oxide yellow and iron oxide red, lactose monohydrate, maize starch, magnesium stearate (vegetable grade), pregelatinized maize starch, and sodium bicarbonate.

    How should I use this medication?

    The recommended starting dose for high blood pressure is 2.5 mg to 5 mg taken once a day. The usual treatment dose ranges from 2.5 mg once daily to 20 mg twice daily, depending on the needs and circumstances of the person using the medication. The dose may need to be adjusted according to how well the kidneys are functioning and the effectiveness of the medication.

    The starting dose for children less than 16 years of age is based on body weight and will be calculated by your child’s doctor.

    The recommended starting dose to treat congestive heart failure is 2.5 mg taken once a day. The dose may be increased gradually to a maximum of 40 mg daily, depending on the effectiveness of the medication.

    Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

    It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, and it is within 6 hours of your regularly scheduled time, administer it as soon as possible and continue with your regular schedule. If more than 6 hours has passed, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

    Store this medication at room temperature, protect it from moisture and keep out of reach of children.

    Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

    Who should NOT take this medication?

    Do not take this medication if you:

    • are allergic to enalapril or any ingredients of the medication
    • are pregnant or planning to get pregnant
    • have been diagnosed with hereditary angioedema
    • have had angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any other ACE inhibitors (e.g., captopril, enalapril, ramipril)
    • have diabetes or kidney disease and are taking aliskiren

    What side effects are possible with this medication?

    Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

    The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

    The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

    Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

    • abdominal pain
    • cough (dry, persistent)
    • diarrhea
    • fatigue
    • headache
    • loss of appetite
    • nausea
    • rash
    • sore throat
    • vomiting

    Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

    Check with your doctor as soon as possible if any of the following side effects occur:

    • chest pain
    • dizziness, lightheadedness, or fainting (signs of low blood pressure)
    • flu-like symptoms (sudden lack of energy, fever, cough, sore throat)
    • shortness of breath
    • signs of  liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
    • signs of too much potassium in the body (e.g., confusion; irregular heartbeat; nervousness; numbness or tingling in the hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness of legs)
    • symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heart beat, weakness

    Stop taking the medication and seek immediate medical attention if any of the following occur:

    • signs of angioedema (e.g., swelling of face, mouth, hands, or feet)

    Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

    Are there any other precautions or warnings for this medication?

    HEALTH CANADA ADVISORY

    February 4, 2014

    Health Canada has issued new restrictions concerning the use of enalapril. To read the full Health Canada Advisory, visit Health Canada’s web site at www.hc-sc.gc.ca.

    Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

    Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ACE inhibitors, including enalapril, although uncommonly. If you experience swelling of the face, tongue, or throat, you should stop taking this medication at once and get immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving an ACE inhibitor such as enalapril.

    Cough: People taking enalapril may develop a dry, persistent cough that usually disappears only after stopping or lowering the enalapril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.

    Diabetes: Enalapril may cause a loss of blood glucose control, and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

    Kidney function: Changes in kidney function have been seen in certain people taking this medication. The use of diuretics (water pills) or aliskiren may further increase the risk of kidney problems for those already at risk for this problem. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

    Liver function: Changes in liver function have occurred in people with or without preexisting liver problems during treatment with this medication. In most cases, the changes were reversed when the medication was stopped. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

    Low blood pressure: Occasionally, blood pressure drops too low after taking enalapril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur in those who take aliskiren, are on dialysis, are experiencing diarrhea or vomiting, are sweating excessively and not drinking enough fluids, have a salt-restricted diet, or are taking water pills. People with these conditions should be monitored closely by their doctor for the first weeks of treatment and whenever the dose of the medication is increased. To reduce the risk of dizziness, get up slowly from a lying down or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

    Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.

    Potassium levels: Increases in blood levels of potassium occur for a small percentage of people taking enalapril. This rarely causes problems, but potassium levels should be monitored by your doctor. Avoid using salt substitutes that contain potassium while you are taking enalapril.

    Pregnancy: ACE inhibitors such as enalapril may cause severe harm or death to the developing fetus if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

    Breast-feeding: This medication passes into breast milk in small amounts. If you are a breast-feeding mother and are taking enalapril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

    Children: The safety and effectiveness of this medication have not been established for infants and children with decreased kidney function.

    Seniors: Seniors have an increased risk of experiencing side effects when taking enalalpril due to reduced kidney function. Lower doses may be necessary to minimize side effects.

    What other drugs could interact with this medication?

    There may be an interaction between enalapril and any of the following:

    • acetylsalicylic acid (ASA)
    • aldesleukin
    • aliskiren
    • allopurinol
    • alpha blockers (e.g., alfuzosin, doxazosin, tamsulosin)
    • alpha agonists (e.g., clonidine, methyldopa)
    • amifostine
    • amiodarone
    • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
    • angiotensin II receptor blockers (ARBs; e.g., candesartan, losartan)
    • antidiabetes medications (e.g., insulin, metformin, glyburide)
    • atypical anti-psychotics (e.g., clozapine, olanzapine, quetiapine, risperidone)
    • azathioprine
    • barbiturates (e.g., butalbital, pentobarbital phenobarbital)
    • beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
    • brimonidine
    • bromocriptine
    • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
    • canagliflozin
    • ciprofloxacin
    • conivaptan
    • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
    • drospirenone
    • duloxetine
    • eplerenone
    • everolimus
    • “gliptin” diabetes medications (e.g., linagliptin, saxagliptin, sitagliptin)
    • grass pollen allergen extract
    • guanfacine
    • heparin
    • iron dextran complex
    • iron gluconate
    • levodopa
    • lithium
    • low-molecular-weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
    • medications that increase potassium levels (e.g., potassium supplements, spironolactone, amiloride, and salt substitutes containing potassium)
    • metformin
    • methylphenidate
    • minoxidil
    • nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
    • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
    • other angiotensin-converting-enzyme inhibitors (ACEIs; e.g., captopril,  ramipril)
    • pentoxifylline
    • phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
    • pregabalin
    • quinine
    • ropinirole
    • sacubitril
    • selegiline
    • sirolimus
    • sodium phosphates
    • temsirolimus
    • tizanidine
    • tolcapone
    • tolvaptan
    • trimethoprim
    • yohimbine

    If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

    • stop taking one of the medications,
    • change one of the medications to another,
    • change how you are taking one or both of the medications, or
    • leave everything as is.

    An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

    Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

    All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/ACT-Enalapril

    Enalapril | 1800PetMeds

    What is Enalapril?

    Enalapril is used to treat mild, moderate, or severe heart failure and high blood pressure, and is usually used in combination with other medications. Enalapril requires a prescription from your veterinarian, and is sold by the tablet.

    For:

    Cats and Dogs

    Benefits:

    • Helps the heart beat more efficiently
    • Prevents fluid buildup in the lungs
    • Lowers blood pressure
    • Improves ability to tolerate exercise

    How it Works:

    Enalapril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking an enzyme in the body that is needed to produce a substance that causes blood vessels to tighten. As a result, the blood vessels relax. This lowers blood pressure and increases the supply of blood and oxygen to the heart.

    Cautions:

    Do not give your pet potassium supplements unless directed to by your veterinarian. Enalapril may cause birth defects. Do not give to pregnant animals.

    Brand Name:

    Enacard (Merial), Vasotec (Merck)

    Generic Name:

    Enalapril

    What is Enalapril:

    Enalapril belongs to a group of drugs called angiotensin converting enzyme (ACE) inhibitors. Enalapril is used in dogs to treat congestive heart failure and high blood pressure. Enalapril may also be used for purposes other than those listed in this guide.

    What should I discuss with my veterinarian before giving Enalapril to my pet:

    Tell your veterinarian if your pet has ever had an allergic reaction to enalapril or any other ACE inhibitor such as lisinopril (Prinivil, Zestril), captopril (Capoten), or benazopril (Lotensin) or any other medications. Tell your veterinarian if your pet has kidney or liver disease; heart disease or congestive heart failure; diabetes; lupus, or rheumatoid arthritis. Tell your veterinarian if your pet is pregnant, lactating, or if you intend to breed your pet. Enalapril may cause birth defects or harm a nursing pup.

    What is the most important information I should know about Enalapril:

    Enalapril is FDA approved for use in dogs only; however, it is a commonly accepted practice to use Enalapril in cats as well. Enalapril is available by prescription as 2.5mg, 5mg, 10mg and 20mg tablets. The usual dose in dogs is 0.25mg per pound once a day. The usual dose in cats is 0.1 to 0.25mg per pound once a day. The dose of Enalapril may require adjustment based on the animal’s response to treatment. Enalapril is usually administered with furosemide and digoxin. Tell your veterinarian if your pet is pregnant or if you plan on breeding your pet. Enalapril could cause birth defects. Allow plenty of water for the pet to drink. If the pet becomes dehydrated, this can lead to very low blood pressure, electrolyte disorders, or kidney failure.

    How should this medication be given:

    Give Enalapril exactly as directed by your veterinarian. Do not give this medication in larger amounts, or take for longer than recommended by your veterinarian. Follow the directions on the prescription label. If you do not understand these directions, ask your pharmacist or veterinarian to explain them to you. Allow plenty of water for the pet to drink. Enalapril may be given with or without food. Periodic liver and kidney function testing may be required by your veterinarian. Store Enalapril at room temperature away from moisture and heat.

    What should I avoid while giving Enalapril:

    Do not give potassium supplements to your pet unless directed to by your veterinarian.

    What are the possible side effects of Enalapril:

    If any of the following serious side effects occur, stop using this Enalapril and seek emergency veterinary medical attention; an allergic reaction (swelling of the lips, face, or tongue; difficulty breathing; closing of the throat; or hives). Call your veterinarian if your pet develops any of these serious side effects; fainting; urinating more or less than usual, or not at all; fever, chills; easy bruising, or bleeding; swelling, rapid weight gain. Less serious side effects may be more likely to occur. Continue to use Enalapril, but speak to your veterinarian if your pet experiences; cough; loss of appetite; dizziness, drowsiness; sleep problems; dry mouth; nausea, vomiting, diarrhea; mild itching or skin rash. Side effects other than those listed here may also occur. Talk to your veterinarian about any side effect that seems unusual or bothersome to the animal.

    What other drugs will affect Enalapril:

    Tell your veterinarian if your pet is being given; a potassium supplement; aspirin or other NSAIDs such as etodolac (EtoGesic), carprofen (Rimadyl), deracoxib (Deramaxx), and others; a diuretic. Talk to your veterinarian or pharmacist before giving any prescription or over the counter medications, including vitamins, minerals, and herbal products.

    Epaned, Vasotec (enalapril) Uses, Side Effects, Dosage & Interactions

    000930026_PB

    oval, yellow, imprinted with 93 26

    000930027_PB

    oval, white, imprinted with 93 27

    000930028_PB

    oval, pink, imprinted with 93 28

    000930029_PB

    oval, peach, imprinted with 93 29

    001870141_PB

    triangular, white, imprinted with VASO 5

    001870142_PB

    triangular, red, imprinted with VASO 10

    001870143_PB

    triangular, peach, imprinted with VASO 20

    516724037_PB

    round, yellow, imprinted with T 2

    516724038_PB

    round, yellow, imprinted with T 5

    516724039_PB

    round, pink, imprinted with T 10

    516724040_PB

    round, orange, imprinted with T 20

    604290183_PB

    round, yellow, imprinted with T 2

    604290184_PB

    round, yellow, imprinted with T 5

    604290185_PB

    round, pink, imprinted with T 10

    604290186_PB

    round, orange, imprinted with T 20

    646790923_PB

    round, white, imprinted with W 923

    646790924_PB

    round, white, imprinted with W 924

    646790925_PB

    round, orange, imprinted with W 925

    646790926_PB

    round, beige, imprinted with W 926

    Enalapril 10 mg-APO

    round, red, imprinted with APO 051

    Enalapril 10 mg-EON

    round, pink, imprinted with E 147

    Enalapril 10 mg-GEN

    round, pink, imprinted with GG 483

    Enalapril 10 mg-MYL

    round, blue, imprinted with M E17

    Enalapril 10 mg-SAN

    round, pink, imprinted with ELP 10

    Enalapril 10 mg-SCH

    round, pink, imprinted with SCHN, 2727

    Enalapril 10 mg-TAR

    round, pink, imprinted with T 10

    Enalapril 10 mg-WAT

    round, pink/white specks, imprinted with WATSON 670

    Enalapril 2.5 mg-APO

    round, yellow, imprinted with APO 049

    Enalapril 2.5 mg-EON

    round, yellow, imprinted with E 114

    Enalapril 2.5 mg-MYL

    round, white, imprinted with M E15

    Enalapril 2.5 mg-PAR

    round, white, imprinted with EN 25, G

    Enalapril 2.5 mg-SAN

    round, yellow, imprinted with ELP 2 1/2

    Enalapril 2.5 mg-SCH

    round, white, imprinted with SCHN, 26 98

    Enalapril 2.5 mg-TAR

    round, yellow, imprinted with T 2

    Enalapril 2.5 mg-WAT

    round, white, imprinted with WATSON 668

    Enalapril 20 mg-APO

    rectangular, orange, imprinted with APO 052

    Enalapril 20 mg-EON

    round, pink, imprinted with E 214

    Enalapril 20 mg-MYL

    round, blue, imprinted with M E18

    Enalapril 20 mg-PAR

    oval, peach, imprinted with G, EN 20

    Enalapril 20 mg-SAN

    round, gray, imprinted with ELP 20

    Enalapril 20 mg-SCH

    round, pink, imprinted with SCHN, 2734

    Enalapril 20 mg-TAR

    round, orange, imprinted with T 20

    Enalapril 20 mg-WAT

    round, peach/white specks, imprinted with WATSON 671

    Enalapril 5 mg-APO

    round, white, imprinted with APO 050

    Enalapril 5 mg-GEN

    round, white, imprinted with GG 482

    Enalapril 5 mg-MYL

    round, white, imprinted with M E16

    Enalapril 5 mg-SAN

    round, pink, imprinted with ELP 5

    Enalapril 5 mg-SCH

    round, white, imprinted with SCHN, 27 01

    Enalapril 5 mg-TAR

    round, yellow, imprinted with T 5

    Enalapril 5 mg-WAT

    round, white, imprinted with WATSON 669

    Vasotec 10 mg

    shield, pink, imprinted with VASOTEC, MSD 713

    Vasotec 10 mg-BTA

    triangular, orange, imprinted with VASO 10

    Vasotec 2.5 mg

    shield, yellow, imprinted with VASOTEC, MSD 14

    Vasotec 2.5 mg-BTA

    oval, white, imprinted with VASO 2.5

    Vasotec 20 mg

    shield, beige, imprinted with VASOTEC, MSD 714

    Vasotec 20 mg-BTA

    triangular, yellow, imprinted with VASO 20

    Vasotec 5 mg

    shield, white, imprinted with VASOTEC, MSD 712

    Vasotec 5 mg-BTA

    triangular, white, imprinted with VASO 5

    Memorial Sloan Kettering Cancer Center

    This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

    Brand Names: US

    Epaned; Vasotec

    Brand Names: Canada

    ACT Enalapril; APO-Enalapril; JAMP Enalapril; MAR-Enalapril; MYLAN-Enalapril [DSC]; NOVO-Enalapril; PRO-Enalapril-10; PRO-Enalapril-2.5; PRO-Enalapril-20; PRO-Enalapril-5; RAN-Enalapril; RIVA-Enalapril [DSC]; SANDOZ Enalapril; TARO-Enalapril; TEVA-Enalapril [DSC]; Vasotec

    Warning

    • Do not take if you are pregnant. Use during pregnancy may cause birth defects or loss of the unborn baby. If you get pregnant or plan on getting pregnant while taking this drug, call your doctor right away.

    What is this drug used for?

    • It is used to treat high blood pressure.
    • It is used to treat heart failure (weak heart).
    • It is used in certain patients with heart failure to lower the chance of having to go to the hospital for heart failure that gets worse.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    For all patients taking this drug:

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have kidney disease.
    • If you have ever had a very bad or life-threatening reaction called angioedema. Signs may be swelling of the hands, face, lips, eyes, tongue, or throat; trouble breathing; trouble swallowing; unusual hoarseness.
    • If you are taking a drug that has aliskiren in it and you also have diabetes or kidney problems.
    • If you have taken a drug that has sacubitril in it in the last 36 hours.
    • If you are breast-feeding. Do not breast-feed while you take this drug.

    Children:

    • If your child is younger than 1 month of age. Do not give this drug to an infant younger than 1 month of age.
    • If your child was born premature and has not reached the corrected age of 44 weeks.

    This is not a list of all drugs or health problems that interact with this drug.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
    • Check your blood pressure as you have been told.
    • Have blood work checked as you have been told by the doctor. Talk with the doctor.
    • If you are taking a salt substitute that has potassium in it, a potassium-sparing diuretic, or a potassium product, talk with your doctor.
    • If you are on a low-salt or salt-free diet, talk with your doctor.
    • Low white blood cell counts have happened with captopril, a drug like this one. This may lead to more chance of getting an infection. Most of the time, this has happened in people with kidney problems, mainly if they have certain other health problems. Call your doctor right away if you have signs of infection like fever, chills, or sore throat.
    • If you are taking this drug and have high blood pressure, talk with your doctor before using OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and some natural products or aids.
    • Talk with your doctor before you drink alcohol.
    • Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss.
    • Tell your doctor if you have too much sweat, fluid loss, throwing up, or loose stools. This may lead to low blood pressure.
    • This drug may not work as well to lower blood pressure in Black patients. Sometimes another drug may need to be given with this drug. If you have any questions, talk with the doctor.
    • A severe and sometimes deadly reaction called angioedema has happened. The chance of angioedema may be higher in Black patients.

    What are some side effects that I need to call my doctor about right away?

    WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
    • Signs of high potassium levels like a heartbeat that does not feel normal; feeling confused; feeling weak, lightheaded, or dizzy; feeling like passing out; numbness or tingling; or shortness of breath.
    • Very bad dizziness or passing out.
    • Cough that does not go away.
    • Chest pain or pressure.
    • Liver problems have happened with drugs like this one. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

    What are some other side effects of this drug?

    All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

    You may report side effects to your national health agency.

    You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Take this drug at the same time of day.
    • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
    • Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.

    Tablets:

    • A liquid (suspension) can be made if you cannot swallow pills. Talk with your doctor or pharmacist.
    • If a liquid (suspension) is made, shake well before use.

    All liquid products:

    • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    All products:

    • Store at room temperature. Do not freeze.
    • Protect from heat.
    • Store in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    Tablets:

    • If a liquid (suspension) is made, store in a refrigerator. Do not freeze. Throw away any part not used after 30 days.

    Liquid (solution):

    • Throw away any part not used after 60 days. If this drug was mixed from a powder, throw away any unused part 60 days after this drug was mixed. Talk with your pharmacist if you have questions about this.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else’s drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
    • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

    Consumer Information Use and Disclaimer

    This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

    Last Reviewed Date

    2021-03-23

    Copyright

    © 2021 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

    Enalapril instructions for use: indications, contraindications, side effects – description of Enalapril tab. 10 mg: 10, 20, 30, 40, 50, 60, 80, 100, 200, 400, 600, 800 or 1000 pcs. (6410)

    When used simultaneously with immunosuppressants, cytostatics, the risk of developing leukopenia increases.

    With the simultaneous use of potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements containing potassium, hyperkalemia may develop (especially in patients with impaired renal function), i.e.because ACE inhibitors reduce the content of aldosterone, which leads to a retention of potassium in the body against the background of limiting the excretion of potassium or its additional intake into the body.

    With the simultaneous use of opioid analgesics and anesthetics, the antihypertensive effect of enalapril is enhanced.

    With the simultaneous use of “loop” diuretics, thiazide diuretics, the antihypertensive effect is enhanced. There is a risk of developing hypokalemia. Increased risk of impaired renal function.

    With simultaneous use with azathioprine, anemia may develop, which is due to inhibition of the activity of erythropoietin under the influence of ACE inhibitors and azathioprine.

    A case of the development of anaphylactic reaction and myocardial infarction with the use of allopurinol in a patient receiving enalapril is described.

    Acetylsalicylic acid in high doses can reduce the antihypertensive effect of enalapril.

    It has not been definitively established whether acetylsalicylic acid reduces the therapeutic efficacy of ACE inhibitors in patients with coronary artery disease and heart failure.The nature of this interaction depends on the course of the disease.

    Acetylsalicylic acid, by inhibiting COX and prostaglandin synthesis, can cause vasoconstriction, which leads to a decrease in cardiac output and worsening of the condition of patients with heart failure receiving ACE inhibitors.

    With the simultaneous use of beta-blockers, methyldopa, nitrates, calcium channel blockers, hydralazine, prazosin, an increase in the antihypertensive effect is possible.

    When used simultaneously with NSAIDs (incl.including indomethacin) decreases the antihypertensive effect of enalapril, apparently due to the inhibition of the synthesis of prostaglandins under the influence of NSAIDs (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors). The risk of developing impaired renal function increases; hyperkalemia is rarely observed.

    With the simultaneous use of insulin, hypoglycemic agents, sulfonylurea derivatives, hypoglycemia may develop.

    With the simultaneous use of ACE inhibitors and interleukin-3, there is a risk of developing arterial hypotension.

    With simultaneous use with clozapine, there are reports of the development of syncope.

    With simultaneous use with clomipramine, an increase in the action of clomipramine and the development of toxic effects have been reported.

    With simultaneous use with co-trimoxazole, cases of hyperkalemia have been described.

    With simultaneous use with lithium carbonate, the concentration of lithium in the blood serum increases, which is accompanied by symptoms of lithium intoxication.

    When used simultaneously with orlistat, the antihypertensive effect of enalapril decreases, which can lead to a significant increase in blood pressure, the development of a hypertensive crisis.

    It is believed that the simultaneous use of procainamide may increase the risk of developing leukopenia.

    With simultaneous use with enalapril, the effect of drugs containing theophylline decreases.

    There are reports of the development of acute renal failure in patients after kidney transplantation with simultaneous use with cyclosporine.

    With simultaneous use with cimetidine, Tmax 1/2 of enalapril increases and its concentration in blood plasma increases.

    It is believed that it is possible to reduce the effectiveness of antihypertensive drugs when used simultaneously with erythropoietins.

    With simultaneous use with ethanol, the risk of arterial hypotension increases.

    Arpimed

    Driving and operating machinery

    Before operating machinery that requires special attention, determine how you react to the reception of Enalapril-N. Taking the first dose or increasing the dose may be accompanied by dizziness, lightheadedness, or fainting.

    How to take Enalapril-N

    Enalapril-N is not intended for initial therapy. First, before prescribing this combination drug, you need to select the correct doses of the active ingredients by taking it as monotherapy (enalapril and hydrochlorothiazide). If the dosage of each component selected by monotherapy corresponds to the dosage of Enalapril-N, then your doctor may already prescribe Enalapril-N once a day (instead of monotherapy with each component).

    It is recommended to take the dose every day at about the same time, exactly as prescribed.

    Enalapril-N can be taken with or without food. If Enalapril-N is causing a digestive upset, take it with food or milk.

    Adult dose

    The maximum daily dose should not exceed two tablets of Enalapril-N 10 mg / 25 mg.

    If you took more Enalapril-N than you recommended

    If you think you have taken too many Enalapril-N tablets, contact your doctor, nurse, pharmacist, hospital emergency department, or regional poison control center immediately, even if you do not have any symptoms.

    If you forget to take Enalapril-N

    Don’t worry. If you forget to take a tablet, skip this dose. Take your next dose at the right time. Do not take a double dose of the drug to make up for the missed dose.

    If you stop taking Enalapril-N

    Do not stop taking Enalapril-N without first consulting your doctor.

    If you have any further questions about treatment, ask your doctor or pharmacist.

    Sugar intolerance

    If your doctor has told you that you have an intolerance to some sugars, please contact your doctor before taking this medication as it contains lactose.

    Possible side effects

    Like any other medicines, Enalapril-N can cause side effects, but they do not occur in all patients.

    Side effects include:

    • Vertigo,
    • Drowsiness, fatigue, weakness,
    • Cough,
    • Rash,
    • Headache,
    • Abdominal pain, indigestion, loss of appetite, constipation,
    • Muscle pain,
    • Sore throat,
    • Impotence,
    • Skin tingling.

    Enalapril-N may lead to misinterpretation of blood test results. Your doctor will decide when blood tests are needed and analyze the results.

    SERIOUS SIDE EFFECTS, HOW OFTEN HAPPEN AND WHAT TO DO WITH THEM

    Symptoms / Effects

    Tell your PCP, pharmacist or nurse

    Stop use and call a doctor immediately

    Only in severe cases

    In any case

    Often

    Low blood pressure: dizziness, fainting, lightheadedness when moving from a lying position to a standing position or after exercise and / or in hot weather, when you lose a lot of fluid due to sweating.

    Increase or decrease in the level of potassium in the blood: irregular heartbeat, muscle weakness, general poor health.

    Pain in the chest area.

    Difficulty breathing, shortness of breath.

    Uncommon

    Allergic reactions / Angioedema: rash / itching, hives, swelling of the face, eyes, lips, tongue or throat, hands or feet, difficulty swallowing or breathing.

    Renal dysfunction: decreased urination, nausea, vomiting, swelling of the extremities, fatigue.

    Liver dysfunction: yellowing of the skin or eyes (jaundice), darkening of urine, abdominal pain, nausea, vomiting, loss of appetite.

    Elevated blood glucose: frequent urination, thirst and hunger.

    Electrolyte imbalance: weakness, drowsiness, muscle pain or cramps, irregular heartbeat.

    Rarely

    Decreased white blood cell count: infections, fatigue, fever, pain and flu-like symptoms (malaise, muscle aches, rash, itching, abdominal pain, nausea, vomiting, diarrhea, jaundice or lack of appetite).

    Decreased platelet count: bruising, bleeding, fatigue and weakness.

    Very rare

    Toxic epidermal necrolysis: severe scaling of the skin, especially around the mouth and eyes.

    Frequency unknown

    Visual impairment:

    – Nearsightedness: sudden nearsightedness or blurred vision.

    – glaucoma: increased intraocular pressure, eye pain.

    Anemia: fatigue, loss of energy, weakness, shortness of breath.

    Inflammation of the pancreas: abdominal pain that continues and gets worse when you lie down, nausea and vomiting.

    Reporting side effects

    If you notice any side effects, tell your doctor, pharmacist or pharmacist about it, including any side effects not listed in this leaflet.You can also report side effects to Arpimed LLC by going to the website www.arpimed.com and filling out the appropriate form “Report side effects or drug ineffectiveness” and to the Scientific Center for the Expertise of Drugs and Medical Technologies named after Academician E. Gabrielyan by going to the website www.pharm.am in the section “Report side effects of the drug” and fill out the form “Card of messages about side effects of the drug”. Scientific center hotline: +37410237665; +37498773368 By reporting side effects you are helping to gather more information on the safety of this medicine.

    How to store Enalapril – N

    • The drug should be stored out of the reach of children, protected from moisture and light, at a temperature of 15 90 578 0 90 579 C -25 90 578 0 90 579 C.
    • Shelf life – 3 years. Do not take Enalapril-N after the expiration date indicated on the drug packaging. The expiry date refers to the last day of the specified month.
    • If tablets change color or show other signs of deterioration, do not take the drug.
    • Do not empty medicines into waste water or sewage systems. Ask your pharmacist how to dispose of a drug you no longer need. These measures are aimed at protecting the environment.

    Contents of the box and additional information

    What Enalapril contains – N

    One Enalapril-N tablet contains:

    active substance: enalapril maleate – 10 mg, hydrochlorothiazide – 25 mg;

    excipients: microcrystalline cellulose, monohydrate lactose, corn starch, povidone, sodium starch glycolate, magnesium stearate, calcium hydrogen phosphate.

    What Enalapril-N looks like and contents of the pack

    White round biconvex tablets with a score on one side; without smell.

    Packaging description

    Cardboard package containing 20 tablets together with an enclosed leaflet: 2 blisters of 10 tablets each.

    Vacation conditions

    Available by prescription.

    Memorial Sloan Kettering Cancer Center

    This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects, and when you should contact your healthcare provider.

    Trade names: USA

    Epaned; Vasotec

    Trade names: Canada

    ACT Enalapril; APO-Enalapril; JAMP Enalapril; MAR-Enalapril; MYLAN-Enalapril [DSC]; NOVO-Enalapril; PRO-Enalapril-10; PRO-Enalapril-2.5; PRO-Enalapril-20; PRO-Enalapril-5; RAN-Enalapril; RIVA-Enalapril [DSC]; SANDOZ Enalapril; TARO-Enalapril; TEVA-Enalapril [DSC]; Vasotec

    Warning

    • Not for use by pregnant women. The use of the drug during pregnancy can cause birth defects or intrauterine death of the child.If you become pregnant or plan to become pregnant while taking this drug, call your doctor right away.

    What is this drug used for?

    • Used to treat high blood pressure.
    • Used to treat heart failure (weakened heart).
    • It is used in some patients with heart failure to reduce the risk of hospitalization if heart failure worsens.
    • This medicinal product may be used for other indications. Consult your doctor.

    What should I tell my doctor BEFORE taking this drug?

    For all patients taking this drug:

    • If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
    • If you have kidney disease.
    • If you have ever had a serious allergic reaction called angioedema (angioedema). Symptoms include swelling of the hands, face, lips, tongue, or throat; breathing disorder; swallowing disorder; uncharacteristically hoarse voice.
    • If you are taking a drug containing aliskiren if you have diabetes or kidney disease.
    • If you have taken a preparation containing sacubitrile in the past 36 hours.
    • If you are breastfeeding.Do not breast-feed while taking this drug.

    Children:

    • If your child is less than 1 month old. Do not give this drug to babies younger than 1 month old.
    • If your baby was born prematurely and has not reached the prematurity-adjusted age of 44 weeks.

    This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

    Tell your doctor and pharmacist about all medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical condition and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

    What do I need to know or do while taking this drug?

    • Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
    • Avoid driving or other activities that require special attention until you can see how this drug is affecting you.
    • To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position.Use caution when going up and down stairs.
    • Check blood pressure as directed.
    • Perform blood tests as directed by your healthcare practitioner. Please consult your doctor.
    • If you are using a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium supplement, consult your doctor.
    • Consult your doctor if you are on a salt-free or low-salt diet.
    • Low leukocyte counts have been reported with captopril (a drug similar to this drug). This can lead to an increased risk of infection. Most of the time, this has happened in people with kidney problems, mostly with some other health problem. See your doctor right away if you have symptoms of an infection such as high fever, chills, or sore throat.
    • If you are taking this drug and have high blood pressure, talk to your doctor before taking any over-the-counter drugs that can raise blood pressure.These drugs include medicines for coughs and colds, diet pills, stimulants, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, and some naturally occurring drugs.
    • Consult a physician before drinking alcohol.
    • Exercise caution in hot weather and during vigorous activity. Drink plenty of fluids to prevent dehydration.
    • Tell your doctor if you experience excessive sweating, fluid loss, vomiting, or loose stools.This can lead to a drop in blood pressure.
    • The ability of this drug to lower blood pressure may be less pronounced in Blacks. In some cases, you may need to take another drug at the same time in addition to this drug. If you have any questions, please consult your doctor.
    • A serious and sometimes fatal reaction called angioedema has occurred. The risk of developing angioedema may be increased in the Negroid race.

    What side effects should I report to my doctor immediately?

    WARNING. In rare cases, some people with this drug can have serious and sometimes deadly side effects. Call your doctor or get medical help right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

    • Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
    • Signs of kidney problems, including lack of urination, change in urine volume, blood in the urine, or rapid weight gain.
    • Signs of elevated potassium levels, such as a feeling of a disturbed heartbeat, confusion, feeling weak or dizzy, feeling light-headed, feeling numb or tingling, or shortness of breath.
    • Severe dizziness or fainting.
    • Persistent cough.
    • Pain or pressure in the chest.
    • Liver dysfunction has been reported while taking drugs of this kind. Sometimes these cases were fatal. Call your doctor right away if you have signs of liver dysfunction, such as dark urine, tired feeling, lack of appetite, nausea or abdominal pain, light colored stools, vomiting, yellow skin or eyes.

    What are some other side effects of this drug?

    Any medicine can have side effects.However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

    • Dizziness.
    • Cough.

    This list of potential side effects is not comprehensive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

    You can report side effects to the National Health Office.

    You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

    What is the best way to take this drug?

    Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

    All forms of issue:

    • Take this drug at about the same time of the day.
    • Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.
    • Drink plenty of decaffeinated fluids, unless your doctor tells you to drink less fluids.

    Tablets:

    • If you cannot swallow the tablets, a liquid form of the drug (suspension) can be made.Ask your doctor or pharmacist for advice.
    • Shake the solution (suspension) well before use.

    All liquid preparations:

    • Doses of liquid preparation should be measured with caution. Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for a dosing product for this drug.

    What should I do if a dose of a drug is missed?

    • Take the missed dose as soon as you can.
    • If it is time for your next dose, do not take the missed dose and then return to your normal dose.
    • Do not take 2 doses at the same time or an additional dose.

    How do I store and / or discard this drug?

    All forms of issue:

    • Store at room temperature. Do not freeze.
    • Protect from heat.
    • Store in a dry place. Do not store in the bathroom.
    • Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
    • Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

    Tablets:

    • When using the liquid form of the drug (suspension), store it in the refrigerator. Do not freeze. All unused leftovers must be thrown away after 30 days.

    Liquid (solution):

    • Throw away all unused portions of the drug after 60 days. Throw away all unused portions of the drug after 60 days after reconstitution if the drug was obtained by reconstituting powder.If you have any questions, please consult your pharmacist.

    General information about medicines

    • If your health does not improve or even worsens, see your doctor.
    • Do not give your medicine to anyone or take other people’s medicines.
    • Some medicines may come with other patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
    • Some medicines may come with other patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
    • If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

    Use of information by the consumer and limitation of liability

    This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a guide to treatment and does not replace the information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug.Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

    Copyright

    © UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

    90,000 What are the side effects of enalapril?

    Side effects of enalapril include cough, diarrhea, dizziness. Drowsiness, vomiting, and dry mouth may also occur.In addition, the person taking the medication may experience headaches, nausea, loss of appetite, and a rash. Severe side effects include an allergic reaction, body pain, difficulty breathing or swallowing, and loss of consciousness. Other serious side effects of enalapril include increased or decreased urination, infection, dizziness, and swelling; in some cases, kidney or liver problems may occur.

    When a person experiences serious side effects, he or she should see a doctor immediately.This is also the case when side effects, which are not usually considered serious, become persistent or worsen over time. Some of the side effects of enalapril, such as diarrhea and vomiting, can dehydrate a person. Heavy sweating can also cause dehydration. Lack of drinking water to alleviate this problem can lead to lightheadedness and fainting, which can then lead to low blood pressure or kidney failure

    It is important that the doctor is advised of pre-existing medical conditions, other medications and lifestyle choices before taking enalapril.Enalapril side effects can be affected by any of these factors. For example, side effects can be increased by alcohol consumption. Since alcohol can also contribute to further lowering blood pressure, it is recommended that the person taking enalapril not drink it. In addition, since enalapril may be prescribed for use alone or in combination with other drugs, a person may experience slight differences in side effects.

    Pregnant or breastfeeding women should not take enalapril. The drug may cause birth defects or additional harm to the unborn baby. Enalapril can also harm a nursing baby because the drug can pass through breast milk. While taking the medication, it is important that the woman is using an effective form of birth control to prevent pregnancy. If she becomes pregnant, she should immediately stop taking the medication and see a doctor.

    Despite the side effects, enalapril is prescribed for a reason. It is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure, congestive heart failure, and diabetic kidney disease. In addition, it can also be prescribed after a heart attack. ACE inhibitors work by relaxing and dilating blood vessels to provide better blood flow. This lowers blood pressure and makes the heart more efficient at pumping blood.

    OTHER LANGUAGES

    90,000 30 reviews, instructions for use

    When used simultaneously with immunosuppressants, cytostatics, the risk of developing leukopenia increases.

    With the simultaneous use of potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium preparations, salt substitutes and dietary supplements containing potassium, hyperkalemia may develop (especially in patients with impaired renal function), i.e.because ACE inhibitors reduce the content of aldosterone, which leads to a retention of potassium in the body against the background of limiting the excretion of potassium or its additional intake into the body.

    With the simultaneous use of opioid analgesics and anesthetics, the antihypertensive effect of enalapril is enhanced.

    With the simultaneous use of “loop” diuretics, thiazide diuretics, the antihypertensive effect is enhanced. There is a risk of developing hypokalemia. Increased risk of impaired renal function.

    With simultaneous use with azathioprine, anemia may develop, which is due to inhibition of the activity of erythropoietin under the influence of ACE inhibitors and azathioprine.

    A case of the development of anaphylactic reaction and myocardial infarction with the use of allopurinol in a patient receiving enalapril is described.

    Acetylsalicylic acid in high doses can reduce the antihypertensive effect of enalapril.

    It has not been definitively established whether acetylsalicylic acid reduces the therapeutic efficacy of ACE inhibitors in patients with coronary artery disease and heart failure.The nature of this interaction depends on the course of the disease.

    Acetylsalicylic acid, by inhibiting COX and prostaglandin synthesis, can cause vasoconstriction, which leads to a decrease in cardiac output and worsening of the condition of patients with heart failure receiving ACE inhibitors.

    With the simultaneous use of beta-blockers, methyldopa, nitrates, calcium channel blockers, hydralazine, prazosin, an increase in the antihypertensive effect is possible.

    When used simultaneously with NSAIDs (incl.including indomethacin) decreases the antihypertensive effect of enalapril, apparently due to the inhibition of the synthesis of prostaglandins under the influence of NSAIDs (which are believed to play a role in the development of the hypotensive effect of ACE inhibitors). The risk of developing impaired renal function increases; hyperkalemia is rarely observed.

    With the simultaneous use of insulin, hypoglycemic agents, sulfonylurea derivatives, hypoglycemia may develop.

    With the simultaneous use of ACE inhibitors and interleukin-3, there is a risk of developing arterial hypotension.

    With simultaneous use with clozapine, there are reports of the development of syncope.

    With simultaneous use with clomipramine, an increase in the action of clomipramine and the development of toxic effects have been reported.

    With simultaneous use with co-trimoxazole, cases of hyperkalemia have been described.

    With simultaneous use with lithium carbonate, the concentration of lithium in the blood serum increases, which is accompanied by symptoms of lithium intoxication.

    When used simultaneously with orlistat, the antihypertensive effect of enalapril decreases, which can lead to a significant increase in blood pressure, the development of a hypertensive crisis.

    It is believed that the simultaneous use of procainamide may increase the risk of developing leukopenia.

    With simultaneous use with enalapril, the effect of drugs containing theophylline decreases.

    There are reports of the development of acute renal failure in patients after kidney transplantation with simultaneous use with cyclosporine.

    With simultaneous use with cimetidine, Tmax 1/2 of enalapril increases and its concentration in blood plasma increases.

    It is believed that it is possible to reduce the effectiveness of antihypertensive drugs when used simultaneously with erythropoietins.

    With simultaneous use with ethanol, the risk of arterial hypotension increases.

    Enalapril Hexal® | Sandoz in Russia

    Symptomatic hypotension

    Symptomatic hypotension is rarely observed in patients with uncomplicated hypertension. In patients with hypertension taking enalapril, there is a possibility of developing symptomatic hypotension if the volume of intercellular fluid decreases, for example, while taking diuretics, restricting salt intake, dialysis, diarrhea or vomiting (see.sections “Interaction with other medicinal products” and “Side effects”). In patients with heart failure with or without renal failure, the development of symptomatic hypotension was observed. Its likelihood increases as the severity of heart failure increases due to high doses of loop diuretics, hyponatremia, or renal impairment. It is necessary to carefully monitor the condition of such patients at the stage of starting treatment and adjusting the dose of enalapril and / or diuretics.The same precautions should be taken when prescribing the drug to patients with coronary heart disease and cerebrovascular accident, in whom an excessive decrease in blood pressure can lead to the development of myocardial infarction or stroke. If hypotension develops, the patient should be laid on his back, if necessary, an intravenous infusion of saline should be given. A transient hypotensive reaction is not a contraindication to the continuation of drug treatment, which is allowed to be carried out as usual, provided that blood pressure increases after the volume of intercellular fluid in the body is restored.

    In some patients with heart failure with normal or low blood pressure during treatment with enalapril, a decrease in systemic blood pressure may be observed. This effect of the drug is suspected and, as a rule, does not require discontinuation of treatment. If symptomatic hypotension occurs, it may be necessary to reduce the dose of the diuretic and / or enalapril or discontinue treatment.

    Aortic or mitral valve stenosis / hypertrophic cardiomyopathy

    ACE inhibitors should be used with caution in patients with obstructed left ventricular valves and outflow tract.ACE inhibitors are contraindicated in cardiogenic shock and hemodynamically significant obstruction.

    Impaired renal function

    In case of impaired renal function (creatinine clearance <80 ml / min.), The initial dose of enalapril should be adjusted depending on the creatinine clearance value in the patient (see section "Dosage and Administration"), and then according to the patient's response to treatment. It is standard medical practice to regularly monitor potassium and creatinine levels in these patients.

    While taking enalapril, there were cases of renal failure, mainly in patients with severe heart failure or primary kidney disease, incl. renal artery stenosis. With timely diagnosis and appropriate treatment, renal failure that occurs during treatment with enalapril is usually reversible. In some patients who do not suffer from severe pre-existing kidney disease, an increase in the level of urea and creatinine in the blood was observed against the background of the simultaneous use of enalapril and diuretics.In such cases, it may be necessary to reduce the dose of enalapril and / or to stop taking diuretics. The likelihood of developing this condition is high on the background of stenosis of the renal arteries
    (see section “Renovascular hypertension”).

    In patients with severe renal impairment (GFR <30 ml / min.), The use of ACE inhibitors, incl. enalapril, or ARA II with aliskiren is contraindicated (see section "Interaction with other medicinal products").

    Renovascular hypertension

    In the presence of bilateral stenosis of the renal arteries or stenosis of an artery supplying one functioning kidney, during treatment with ACE inhibitors, the risk of hypotension and renal failure increases.Cessation of renal function may occur with minor changes in serum creatinine levels. In such cases, treatment should be started with low doses with careful monitoring of the patient’s condition, caution in dose selection and monitoring of renal function.

    Kidney transplant

    There is no experience with the use of enalapril in patients who have recently undergone kidney transplantation. Thus, the use of enalapril in this category of patients is not recommended.

    Liver failure

    In rare cases, taking ACE inhibitors is accompanied by the development of a syndrome that begins in the form of cholestatic jaundice or hepatitis with progression to fulminant liver necrosis (in some cases) with a fatal outcome. The mechanism of this syndrome has not been studied. If jaundice appears or a significant increase in liver enzyme levels while taking ACE inhibitors, drug treatment should be canceled and appropriate medical supervision should be prescribed.

    Neutropenia / agranulocytosis

    Neutropenia, agranulocytosis, thrombocytopenia, and anemia were observed in patients treated with ACE inhibitors. In patients without renal impairment or other complicating factors, neutropenia is rare. Enalapril should be used with extreme caution in patients with connective tissue disease, during treatment with immunosuppressants, allopurinol or procainamide, or a combination of these complicating factors, especially in the presence of preexisting renal dysfunction.Some of these patients developed serious infectious diseases, which in several cases did not respond to intensive antibiotic therapy. When using enalapril in such patients, it is recommended to periodically measure the level of leukocytes and notify patients of the need to report any signs of infection.

    Hypersensitivity / angioedema

    In patients treated with angiotensin-converting enzyme inhibitors, incl.including enalapril, there were cases of angioedema of the face, limbs, lips, tongue, glottis and / or larynx. These phenomena can occur at any stage of treatment. If they develop, you should immediately stop taking enalapril and continue monitoring the patient’s condition until the symptoms are completely resolved and the patient is discharged from the hospital.

    Even in cases where there is only swelling of the tongue, not accompanied by respiratory depression, long-term observation may be required, since treatment with antihistamines and corticosteroids may not be sufficient.

    Very rarely, cases of angioedema accompanied by laryngeal edema or tongue edema have been fatal. Patients with swelling of the tongue, glottis, or larynx are more likely to develop airway obstruction, especially after undergoing airway surgery.

    In case of swelling of the tongue, glottis or larynx, which can lead to airway obstruction, immediate emergency treatment should be carried out, which may include subcutaneous administration of 1: 1000 epinephrine solution (in a volume of 0.3 to 0.5 ml) and / or manipulations aimed at maintaining the patient’s airway.

    In black patients, the incidence of angioedema while taking ACE inhibitors is higher than in other patients.

    Patients with a history of angioedema not associated with an ACE inhibitor may be at a higher risk of angioedema while receiving an ACE inhibitor (see also section “Contraindications”).

    Co-administration of ACE inhibitors and sacubitril / valsartan is contraindicated due to the increased risk of angioedema.

    Treatment with sacubitril / valsartan should not be started earlier than 36 hours after the last dose of enalapril. Treatment with enalapril should not be started earlier than 36 hours after the last dose of sacubitril / valsartan (see section “Contraindications” and “Interaction with other medicinal products”).

    Concomitant use of an ACE inhibitor and mTOR (mammalian target of rapamycin) inhibitors (eg temsirolimus, sirolimus, everolimus), racecadotril and vildagliptin increases the risk of angioedema (eg, airway or tongue edema, or without impairment) (cm.section “Interaction with other medicinal products”). Patients taking ACE inhibitors should be careful when starting racecadotril, mTOR inhibitors (eg, sirolimus, everolimus, temsirolimus), and vildagliptin.

    In patients treated with ACE inhibitors, cases of intestinal angioedema were observed, which manifested itself as abdominal pain with or without nausea and vomiting, in some cases angioedema of the face was also observed simultaneously.When a patient develops the above symptoms during treatment with ACE inhibitors, the possibility of developing intestinal angioedema should also be considered during the differential diagnosis.

    Anaphylactoid reactions against the background of desensitization therapy with Hymenoptera poison

    In rare cases, during treatment with ACE inhibitors against the background of desensitization therapy with Hymenoptera poison, life-threatening anaphylactoid reactions occur. In order to prevent anaphylactoid reactions, ACE inhibitors are temporarily suspended before desensitization therapy.

    Anaphylactoid reactions during low-density lipoprotein (LDL) apheresis

    In rare cases, life-threatening anaphylactic reactions have occurred in patients treated with ACE inhibitors during low-density lipoprotein (LDL) apheresis with dextran sulfate. Such reactions were prevented by temporarily discontinuing the ACE inhibitor prior to each apheresis procedure.

    Patients on hemodialysis

    Cases of anaphylactoid reactions have been reported in patients on hemodialysis using high permeability membranes (for example, AN 69 ® ) and simultaneously receiving treatment with an ACE inhibitor.In such patients, the advisability of using a different type of dialysis membrane or an antihypertensive drug of a different class should be considered.

    Hypoglycemia

    In diabetic patients taking oral antidiabetic drugs or receiving insulin, at the stage of initiation of treatment with an ACE inhibitor, close glycemic control should be carried out, especially during the first month of combination treatment (see the section “Interaction with drugs”) …

    Cough

    While taking ACE inhibitors, there have been cases of coughing. As a rule, the cough is not productive, persistent, and stops after treatment is discontinued. A cough triggered by an ACE inhibitor should be considered when making a differential diagnosis of cough.

    Performing surgery / anesthesia

    When performing major surgery or receiving anesthetics that can induce hypotension, enalapril blocks the production of angiotensin II against the background of compensatory renin release.When hypotension occurs under the action of this mechanism, an increase in the volume of intercellular fluid in the body is carried out.

    Hyperkalemia

    In patients treated with ACE inhibitors, incl. enalapril, an increase in serum potassium was observed. Risk factors for hyperkalemia include renal failure, decreased renal function, age (> 70 years), diabetes mellitus, recurrent events such as dehydration, acute heart failure, metabolic acidosis, and concomitant use of potassium-sparing diuretics (eg, spironolactone, eplerenone, triamterene or amiloride), potassium supplements or potassium salt substitutes, or other drugs that cause high serum potassium (eg, heparin, co-trimoxazole, also called trimethoprim / sulfamethoxazole).Taking potassium supplements, potassium-sparing diuretics or potassium-containing salt substitutes, especially in patients with impaired renal function, can lead to a significant increase in serum potassium levels. Hyperkalemia can cause serious arrhythmias, in some cases fatal. If the simultaneous use of enalapril and these drugs is advisable, it is recommended to be careful and regularly monitor the level of potassium in the blood serum (see.section “Interaction with other medicinal products”).

    Lithium preparations

    As a rule, it is not recommended to prescribe enalapril in combination with lithium preparations (see the section “Interaction with other medicinal products”).

    Double blockade of the renin-angiotensin-aldosterone system (RAAS)

    ACE inhibitors, incl. enalapril, in combination with other drugs that block the RAAS, for example, ARA II or aliskiren, should be prescribed with caution (see.section 4.5 “Interaction with other medicinal products”).

    Differences by race

    Like other ACE inhibitors, enalapril may be less effective in lowering blood pressure in black patients than in others. This may be due to the fact that patients of the Negroid race with hypertension have a higher prevalence of conditions accompanied by a low level of renin.

    Use in elderly patients

    Clinical studies of the efficacy and safety of enalapril were similar in elderly and younger patients with hypertension.

    90,000 what is the difference or is it the same

    Arterial hypertension is a disease that affects an increasing number of people. In an effort to help patients, doctors prescribe various drugs that reduce blood pressure. These drugs are Enap and Enalapril. Both drugs belong to the group of inhibitors (blockers) of the angiotensin-converting enzyme, which leads to an increase in blood pressure. Both help in the production of health-promoting substances. Taking them regularly improves breathing and reduces cardiac stress.Enap and Enalapril what is the difference?

    Indications for use and action of drugs

    To consider the differences between drugs, we list their indications.

    Both drugs are prescribed:

    • at high pressure;
    • chronic heart failure;
    • in case of impaired activity of the left ventricle;
    • for intermittent angina pectoris;
    • ischemia;
    • for the prevention of myocarditis;
    • for the prevention of heart attack and arrhythmia.

    After taking Enap and Enalapril are rapidly absorbed. The body decays the main component to enalaprilat. The maximum volume of the active substance in the blood is concentrated after three to four hours.

    The angiotensin-converting enzyme in the body converts the hormone angiotensin-1 into angiotensin-2, which, in turn, causes vasospasm. In addition, there is a slowdown in the breakdown of bradykinin, which stimulates vascular expansion. The level of aldosterone in the blood decreases.

    Similar drugs have been used in cardiology for over 40 years. They have a clear vasodilator effect, due to which the pressure decreases. Moreover, the pressure drop is not performed abruptly, but gradually. Enap and Enalapril reduce the stress on the heart and prevent many serious cardiac pathologies.

    Drugs are prescribed for diabetic nephropathy, they reduce the progression of the disease.

    The doctor should prescribe the medicine and determine the dosage depending on the information received about the patient’s health.

    Contraindications, side effects and reception features

    Both drugs have contraindications:

    • individual intolerance to medicinal components;
    • angioedema;
    • porphyria – violation of hemoglobin metabolism;
    • time of pregnancy and lactation.

    Both drugs can cause side effects, which include:

    • hypotension;
    • fatigue;
    • dizziness.

    These signs are characteristic of the initial stage of therapy.

    With further treatment, the following are possible:

    1. Cardiovascular disorders: angina pectoris, tachycardia, heart attack.
    2. Respiratory system: cough, rhinorrhea (discharge of mucus from the nose), pharyngitis.
    3. Gastrointestinal organs: nausea, stool disorders, pancreatitis, abdominal pain, liver dysfunction, appetite changes.
    4. Nervous system: headache, depression, insomnia, paresthesia (numbness, tingling sensations).
    5. Laboratory tests: an increase in the amount of potassium and bilirubin, protein in the urine, a drop in the amount of hemoglobin, leukocytes, glucose.
    6. Allergic manifestations: skin rash, itching.
    7. General side effects: decreased potency, profuse sweating, agranulocytosis (a decrease in the number of leukocytes), vasculitis (vascular inflammation), pain in muscles and joints.

    Instructions for use for both Enap and Enalapril prescribes to take the medicine, regardless of food, once a day.The therapeutic dose is determined by the doctor. The minimum dose is prescribed first. Medicines can be taken for a long time.

    If diuretic therapy was preceded by taking the tablets, it should be discontinued 2-3 days before the administration of ACE inhibitors.

    During therapy, it is necessary to monitor the state of the kidneys and the volume of potassium in the blood. Doctors advise eating a low potassium diet during treatment. This is associated with the risk of hyperkalemia – an excess amount of potassium in the body.It happens that doctors additionally prescribe non-potassium-sparing diuretics – diuretics that actively remove potassium from the body. The combination of these two groups of drugs provides the necessary balance of potassium.

    All disturbing symptoms while taking medications must be reported to the doctor, who can change the dosage or cancel the pills.

    What’s the Difference?

    Enap is the trade name of the drug, and Enalapril is the active ingredient.Both drugs have the same active ingredient, which helps to lower blood pressure. Their mechanism of action is identical.

    The only difference is the country that makes the pills. Enap is produced by KRKA in Slovenia. Enalapril is manufactured in Russia, Germany and India. Enalapril is also available under the names Berlipril, Renipril, Renitek, Enam, Enafarm, Envas. Additional components in the composition of the tablets may differ.

    The price of Enap is significantly higher than Enalapril due to the good reputation of the pharmaceutical plant that produces it.The Slovenian company KRKA guarantees high protection of medicines against counterfeiting and has gained popularity due to the highest quality of the products produced.

    Generics (analogs for the active substance) Enap are much cheaper. The doctor should prescribe this or that medicine, taking into account his experience.

    According to ongoing clinical studies, no difference was found in the therapeutic effect of the drugs. Enap and Enalapril have similar hypotensive effects.However, like their numerous counterparts.

    What is the difference between Enap and Enalapril, patients cannot say, since both drugs have the same effect. These tablets differ by the manufacturer and the price.

    .