GENERIC NAME: enalapril

BRAND NAME: Vasotec

DRUG CLASS AND MECHANISM: Enalapril is an ACE (angiotensin converting enzyme) inhibitor. ACE is an enzyme in the body which is important for the formation of angiotensin II. Angiotensin II causes constriction of arteries in the body, thereby elevating blood pressure. ACE inhibitors , such as enalapril, lower blood pressure by inhibiting the formation of angiotensin II, thus relaxing the arteries. Relaxing the arteries not only lowers blood pressure, but also improves the pumping efficiency of a failing heart and improves cardiac output in patients with heart failure.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: tablets: 2.5 mg, 5 mg, 10 mg, 20 mg.

STORAGE: Tablets should be stored at room temperature in a tightly closed container.

PRESCRIBED FOR: Enalapril can be used alone in treating high blood pressure. Its blood pressure lowering effect can be further enhanced by the addition of a diuretic medication. Vaseretic is an example of a medication that combines the effect of enalapril with a thiazide-type diuretic (water pill) to reduce blood pressure. By reducing resistance in the arteries, enalapril can be useful in the treatment of congestive heart failure. In treating heart failure, enalapril usually supplements conventional treatment, including a diuretic and digoxin (Lanoxin). After a heart attack, enalapril has been found to be effective in improving functioning of the damaged heart, and in reducing symptoms and hospitalizations related to heart failure.

PROPER USE: Should be taken on an empty stomach one hour before meals.

PRECAUTIONS: Enalapril should not be taken by people with a known allergy to ACE inhibitors. Swelling of the facial tissues and even the upper airways has been reported with ACE inhibitors on very rare occasions, and can lead to serious breathing difficulties. Enalapril can interact with diuretics (water pills) and other blood pressure medicines to cause an excessive drop in blood pressure, which can cause symptoms of weakness, dizziness, and lightheadedness. Impairment of kidney function has been reported with ACE inhibitors, especially in patients with severe heart failure or pre-existing kidney disease.

Combining enalapril with potassium supplements, potassium containing salt substitutes, and potassium-conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium.

In rare instances, low white blood cell counts have been reported with the use of captopril , another ACE inhibitor. Low white blood cells increase the patient's risk of infections. When taken with lithium , enalapril can increase lithium to toxic levels in the blood. Safe use in children is not established. It is not habit forming.

PREGNANCY: ACE inhibitors, including enalapril, can be harmful to the fetus and should not be taken by pregnant women.

NURSING MOTHERS: ACE inhibitors, including enalapril, should be avoided in nursing mothers.

SIDE EFFECTS: Enalapril is generally well tolerated and side effects are usually mild and transient. A dry, persistent cough has been reported with the use of ACE inhibitors. Coughing resolves after discontinuing the medication. Other side effects are rare and include abdominal pain, diarrhea, dizziness, fatigue, headache, loss of appetite, nausea and vomiting, chest pain, severe dizziness or fainting, numbness or tingling in the hands or feet, rash, and a sore or swollen throat. In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors.

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