ENALAPRIL oral

Therapeutic action

• Angiotensin converting enzyme inhibitor (ACE)

Indications

• Hypertension
• Chronic heart failure

Forms and strengths

• 5 mg and 20 mg tablets

Dosage

Hypertension

• Adult: start with 5 mg once daily, then increase the dose gradually every 1 to 2 weeks, according to blood pressure, up to 10 to 20 mg once daily (max. 40 mg daily)
• In elderly patients, patients taking a diuretic or patients with renal impairment: start with 2.5 mg once daily then adapt dose according to renal function.
   

Chronic heart failure

• Adult:

Week 1: 2.5 mg once daily for 3 days then 5 mg once daily 
Week 2: 10 mg once daily for 3 days then 20 mg once daily
The usual dose is 10 to 20 mg once daily or 5 to 10 mg 2 times daily depending on tolerance (max. 40 mg daily). 
Reduce dosage in patients with renal impairment.

Duration

• According to clinical response

Contra-indications, adverse effects, precautions

• Do not administer to patients with history of enalapril-related angioedema.
• May cause:
  • hypotension, dizziness, headache, gastrointestinal disturbances, dry cough, renal impairment, hyperkalaemia, hyponatraemia;
  • allergic reactions, angioedema; hypoglycaemia, haematological disorders. 
• Avoid or monitor combination with: potassium-sparing diuretics and/or potassium chloride (risk of hyperkalaemia); non steroidal anti-inflammatory drugs and/or diuretics (risk of renal impairment).
• Monitor combination with: 
  • other antihypertensive drugs (risk of hypotension);
  • drugs that provoke hypotension (e.g. haloperidol, amitriptyline);
  • oral antidiabetics and insulin (risk of hypoglycaemia).
• Pregnancy: CONTRA-INDICATED
• Breast-feeding: no contra-indication at recommended doses

Storage