Enalapril is indicated in-
- All grades of essential hypertension and renovascular hypertension either alone or in combination with other antihypertensive agents especially thiazide diuretics.
- Prevention of symptomatic heart failure.
- Treatment of congestive heart failure (adjunct), usually in combination with diuretics and digitalis.
- Prevention of coronary ischaemic events in patients with left ventricular dysfunction.
Enalapril is also used either alone or as an adjunct in the treatment of angina, diabetic nephropathy and Raynaud’s disease.
Dosage & Administration
Hypertension: Initially 5 mg once daily if used alone or 2.5 mg daily if used in addition to diuretic, in elderly patients or in patients with renal impairment. Usual maintenance dose is 10-20 mg once daily. However, in severe hypertension it may be increased to a maximum of 40 mg once daily.
Heart failure (adjunct) and asymptomatic left ventricular dysfunction: Initially 2.5 mg under close medical supervision. Usual maintenance dose is 20 mg daily in 1-2 divided doses
Dizziness and headache are more commonly reported side effects. Fatigue and asthenia were reported in 2-3% of patients. Other side effects occurred in less than 2% of patients and included hypotension, orthostatic hypotension, syncope, nausea, diarrhoea, muscle cramps, rash and cough.
Less frequently renal dysfunction, renal failure and oliguria have been reported. Angioedema, hyperkalemia and hyponatremia have also been reported rarely
Pregnancy & Lactation
Precautions & Warnings
Use in Special Populations
- Lightheadedness, dizziness, or fainting
- Decrease in urine output
- Drowsiness, headache, or back pain
- Slow or irregular heartbeat.
- Fluids through an intravenous line (IV)
- Medications to increase blood pressure
- Other treatments based on complications that occur
- Closely monitoring the heart and lungs.