Enalapril

GENERIC NAME: enalapril

DRUG CLASS AND MECHANISM
Enalapril is a drug that is used for treating high blood pressure. It is in a class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE is an enzyme in the body that causes the formation of angiotensin II. Angiotensin II causes the arteries in the body to narrow, thereby elevating blood pressure. ACE inhibitors, such as enalapril, lower blood pressure by preventing the formation of angiotensin II thereby relaxing the arteries. ACE inhibitors also improve the effectiveness of the heart in patients with heart failure by reducing the blood pressure that the heart must maintain. Enalapril was approved by the FDA in December, 1985.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 2.5, 5, 10, and 20 mg. Injection: 1.25 mg/mL STORAGE: Store below 30°C (86°F).

PRESCRIBED FOR
Enalapril is used alone or in combination with other drugs to treat high blood pressure or congestive heart failure. After a heart attack, enalapril has been found to be effective in improving function of the damaged heart and in reducing symptoms and hospitalizations related to heart failure.

DOSING
The usual oral dose for treating high blood pressure is 2.5-40 mg once daily. It may also be administered twice daily. The dose for treating heart failure is 2.5-20 mg given twice daily. The usual intravenous dose is 1.25 mg every 6 hours.

DRUG INTERACTIONS
Enalapril may increase potassium levels (hyperkalemia) in blood. Therefore, there is an increased risk of hyperkalemia when enalapril is given with potassium supplements or drugs that increase potassium levels (e.g., spironolactone).

Nitritoid reactions (symptoms includie facial flushing, nausea, vomiting and hypotension) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including enalapril.

USES
This drug belongs to a group of medications called ACE inhibitors. It is used to treat high blood pressure (hypertension) in adults and children. It works by relaxing blood vessels, causing them to widen. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems. This medication is also used with other drugs (e.g., "water pills"/diuretics, digoxin) to treat congestive heart failure.

OTHER USES
This medication may also be used to help protect the kidneys from damage due to diabetes.

HOW TO USE
Take this medication by mouth, usually once or twice a day; or as directed by your doctor. You may take this drug with or without food. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day. If you are taking this drug in the liquid suspension form, shake the bottle well before each use. Measure the dose out carefully. Do not take potassium supplements or salt substitutes containing potassium without talking to your doctor or pharmacist first. This medicine can raise your potassium levels, which rarely can cause serious side effects such as muscle weakness or very slow heartbeats. Tell your doctor immediately if these effects occur. The dosage is based on your medical condition and response to therapy. For the treatment of high blood pressure, it may take several weeks before the full benefit of this drug occurs or several weeks to months when used for congestive heart failure. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

SIDE EFFECTS
Enalapril is generally well tolerated, and side effects usually are 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 include abdominal pain, diarrhea, dizziness, fatigue, headache, loss of appetite, nausea and vomiting, chest pain, 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. In susceptible individuals ACE inhibitors may reduce kidney function.

PRECAUTIONS
Before taking enalapril, tell your doctor or pharmacist if you are allergic to it; or to other ACE inhibitors (e.g., benazepril, captopril); or if you have any other allergies (including allergies to bee or wasp stings, or exposure to certain membranes used for blood filtering). This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: history of an allergic reaction which included swelling of the face/lips/tongue/throat (angioedema). Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, high blood levels of potassium, heart problems, severe dehydration (and loss of electrolytes such as sodium), diabetes (poorly controlled), strokes, blood vessel disease (e.g., collagen vascular diseases such as lupus, scleroderma). This drug may make you dizzy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. To minimize dizziness and light-headedness due to lowering of your blood pressure, get up slowly when rising from a seated or lying position. Serious loss of body fluids can also lower your blood pressure and worsen dizziness. Drink adequate fluids to prevent from becoming dehydrated. If you are on restricted fluid intake, consult your doctor for further instructions. Be careful not to become too overheated during exercise which can lead to excessive sweating. Consult your doctor if you experience severe vomiting or diarrhea. Before having surgery, tell your doctor or dentist that you are taking this medication. Caution is advised when using this drug in the elderly because they may be more sensitive its effects, especially dizziness. Caution is advised when using this drug in children because they may be more sensitive to its effects. This medication should be used only when clearly needed during the first 3 months of pregnancy. It is not recommended for use during the last 6 months of pregnancy due to the risk for fetal harm. Discuss the risks and benefits with your doctor. See also Warning section. This drug passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

OVERDOSE
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: unusually fast or slow heartbeat, severe dizziness, or fainting.

MISSED DOSE
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE
Store tablets at room temperature below 86 degrees F (30 degrees C) away from light and moisture. Do not store in the bathroom. Refrigerate the liquid suspension between 36-46 degrees F (2-8 degrees C). Discard any unused suspension after 30 days. Keep all medicines away from children and pets.

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited, medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.