Enalapril – Information, Uses, Side Effects and Dosage

Drug Trade Name: Vasotec

Category: Angiotensin-converting enzyme (ACE) inhibitor

Generic Name: enalapril maleate                                                            

Introduction and Quick Information:

Enalapril is a prodrug, which is converted to an active drug, enalaprilat in the liver. This active compound blocks the angiotensin-converting (ACE) enzyme, which plays a central role in regulating the volume of fluids in the body, thus maintaining a normal blood pressure. It does so by converting Angiotensin-I to Angiotensin-II, which is a potent vasoconstrictor i.e., it constricts the blood vessels and raises blood pressure.

In certain cardiovascular and renal conditions, Enalapril blocks the ACE enzyme, thus preventing the formation of Angiotensin-II and lowering the raised blood pressure.

Is Enalapril Approved by FDA?

Yes, the U.S FDA (Food and Drug Administration) has approved Enalapril for medical use.

Usage and Benefits of Enalapril:

Enalapril is used to treat hypertension (high blood pressure), congestive cardiac failure and kidney complications arising due to diabetes. Its use is described below.

• High Blood Pressure (Hypertension): Enalapril has the ability to lower diastolic and systolic blood pressure. However, it does not cure hypertension.
• Congestive Heart Failure: For those who are suffering from congestive heart failure, Enalapril can reduce the blood pressure, which further makes your heart more efficient, thereby improving the blood flow to the organs. These effects can also reduce the symptoms of congestive heart failure including fatigue, shortness of breath, and swelling.
• Left Ventricular Dysfunction: A heart attack can damage the heart’s chamber, thereby reducing the efficiency of heart to pump blood. This is known as left ventricular dysfunction. For those people who are suffering from left ventricular dysfunction, using Enalapril can minimize the risk of developing CHF symptoms and reduce the hospitalization rate in such patients.
• Diabetic Nephropathy: Nephropathy, in simpler terms kidney damage, is a major complication of diabetes. If left untreated, it can progress to kidney failure. However, enalapril lowers the blood pressure and improves the blood flow to kidneys, thus slowing down the progression of nephropathy and preventing theDrug onset of kidney failure.

Side Effects of Enalapril:

Enalapril can cause some side-effects, which are enlisted below.

• Dizziness, light-headedness or fainting on getting up after prolonged sitting or lying down 
• confusion
• chills
• fever
• sweating
• a cough with mucus
• chest pain
• chest tightness
• a sore throat
• a headache
• nausea
• body aches
• loss of taste sensation
• sleep problems (insomnia)
• dry mouth
• diarrhea
• vomiting
• mild skin rash or itching

Call your doctor urgently if you experience any of the aforementioned side effects.

General Recommended Dosages of Enalapril:

You must consume Enalapril in the dose prescribed by your doctor. Also, follow the directions mentioned on the prescription label.

Occasionally, your doctor may change the Enalapril dosage to make sure that you get desirable results.

You can take Enalapril without or with food. Take every dose with one complete glass of water.

Vomiting, heavy sweating or diarrhea can lead to dehydration. This can further result in electrolyte disorders, low blood pressure or kidney failure during the treatment of Enalapril. Maintain adequate hydration.

Consult your doctor prior to making any amendments to your dosage regimen. Inform your doctor about your drug history before undergoing any surgery.

In Case I Miss the Dose?

You can take your missed dose the moment you remember it. However, if it is about time for the next dosage, then you need not take the missed dose instead, take your scheduled dose.

In Case I Take Overdose?

Some common symptoms of Enalapril overdose involve feeling extremely light-headed or dizzy, or fainting. Seek emergency medical help in case of overdose.

Drug Interactions of Enalapril:

There are certain drugs, which when taken with Enalapril can cause serious side-effects. These drugs are listed below.

• lithium (Eskalith, Lithobid)
• gold injections for the treatment of arthritis
• salt substitutes which include potassium
• potassium supplement like Klor-Con, K-Dur
• aspirin or several other NSAIDs (non-steroidal anti-inflammatory drugs) like diclofenac (Voltaren), ibuprofen (Advil, Motrin), indomethacin (Indocin), etodolac (Lodine), naproxen (Naprosyn, Aleve), ketoprofen (Orudis), etc
• diuretic (water pill)

Besides the drugs listed above, there are many more drugs which can interact with Enalapril. Hence, inform your healthcare provider about the drugs you are consuming, including vitamin, potassium and mineral supplements.

Lifestyle and Food Habits You Must Follow When on Enalapril:

Refrain from consuming alcohol when on Enalapril. It can further reduce your blood pressure and can predispose you to the side-effects of Enalapril. A healthy lifestyle is inevitable to potentiate the action of Enalapril.

Don’t consume the drug if you are allergic to Enalapril or any other ACE inhibitor. Also, inform your doctor if you have:

• liver disease
• kidney disease
• diabetes
• congestive heart failure or heart disease
• Connective tissue disorders like Sjogren’s syndrome, Marfan syndrome, scleroderma, lupus, or rheumatoid arthritis.

In case you have any of the aforesaid conditions, you might require special tests or dose adjustment to safely use Enalapril.

How Safe Is Enalapril for Pregnant Women or Nursing Mothers?

Enalapril is usually contraindicated in pregnancy as it poses a risk to the developing fetus. It should be given in pregnancy only if it is absolutely indicated or if the benefit outweighs the risk to the fetus.

Enalapril should not be consumed by lactating mothers in first few weeks of delivery or if the baby is a preterm infant. However, if absolutely required by mother, the doctor may prescribe this drug.

Therefore, inform your doctor in advance, if you are pregnant, planning to get pregnant or is breastfeeding. 

Complications and Conditions Possible Due to Prolonged Use of Enalapril:

According to several studies, prolonged or extended use of any drug can cause several severe health complications. However, in case of Enalapril, there is no evidence suggesting its addiction liability.

However, consult your doctor before stopping the medication and abrupt cessation of treatment without a prior consultation is not recommended. 

Availability of Enalapril:                   

Due to its major side-effects, Enalapril is available on a doctor’s prescription only and is not usually available as an over-the-counter drug.