ENALAPRIL

Enalapril (Envas)  is an angiotensin converting enzyme (ACE) inhibitor used in the treatment of hypertension and some types of chronic heart failure. ACE converts the peptide hormone angiotensin I to angiotensin II. One of the actions of angiotensin II is the vasoconstriction of blood vessels resulting in an increase in blood pressure. ACE inhibitors such as enalapril prevent this effect. Enalapril has been shown to lower the death rate in systolic heart failure. Enalapril was the first member of the group known as the dicarboxylate-containing ACE inhibitors.

Enalapril is an ACE inhibitor. ACE stands for angiotensin converting enzyme.

Enalapril is used to treat high blood pressure (hypertension) and congestive heart failure.

Enalapril is also used to treat a disorder of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart). This disorder can decrease the heart's ability to pump blood to the bod

chemically described as (S)-1-[N-[1-(ethoxycarbonyl)-3-phenylpropyl]-L-alanyl]-L-proline, (Z)-2-butenedioate salt (1:1). Its empirical formula is C20H28N2O5•C4H4O4, and its structural formula is:

Enalapril Dosing Information

Usual Adult Dose for Diabetic Nephropathy:
Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally per day in 1 to 2 divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Hypertension:
Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally per day in 1 to 2 divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Hypertensive Emergency:
Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally per day in 1 to 2 divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Congestive Heart Failure:
Initial dose (oral): 2.5 mg orally once a day.
Maintenance dose (oral): 2.5 to 20 mg orally twice a day.
Doses should be titrated upward, as tolerated, over a period of a few days or weeks.
The maximum daily dose is 40 mg in divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Left Ventricular Dysfunction:
Initial dose (oral): 2.5 mg orally twice a day.
Maintenance dose (oral): 20 mg orally in divided doses.
If possible, the dose of any concomitant diuretic should be reduced which may diminish the likelihood of hypotension.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Pediatric Dose for Hypertension:
Hypertension:
Oral:
Children 1 month to 17 years: Initial: 0.08 mg/kg/day (up to 5 mg) in 1 to 2 divided doses. Adjust dosage based on patient response.
Doses greater than 0.58 mg/kg (40 mg) have not been evaluated in pediatric patients



IMPORTANT INFORMATION 

Do not use enalapril if you are pregnant. Stop using and tell your doctor right away if you become pregnant.

You should not use enalapril if you have ever had angioedema.

If you have diabetes or kidney disease, you may not be able to take enalapril if you are taking medication that contains aliskiren. Tell your doctor about all medicines you use.

Enalapril can cause kidney problems. Call your doctor at once if you have swelling, rapid weight gain, little or no urinating, or if you feel short of breath.

Enalapril can affect your heart or your electrolyte levels. Call your doctor if you have chest pain, pounding heartbeats or fluttering in your chest, a slow heart rate or weak pulse, a tingly feeling, muscle weakness, or muscle tightness or contraction.



Before taking enalapril

You should not use enalapril if you have ever had angioedema, or if you are allergic to enalapril or to any other ACE inhibitor (benazepril, captopril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril).

To make sure enalapril is safe for you, tell your doctor if you have:

kidney disease (or if you are on dialysis);
liver disease;
heart disease or congestive heart failure (unless you are taking enalapril for this condition);
diabetes; or
a history of blood clot or stroke (including "mini-stroke").
FDA pregnancy category D. Do not use enalapril if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Enalapril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking this medication.