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- Angiotensin converting enzyme inhibitor (ACE)
- 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
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