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    Prescription under medical supervision


    Therapeutic action

    • Angiotensin converting enzyme inhibitor (ACE)


    • Hypertension
    • Chronic heart failure

    Forms and strengths

    • 5 mg and 20 mg tablets



    • 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.


    • 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



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