Enalapril5mg

• Hypertension: All grades of essential hypertension and renovascular hypertension.
• Heart Failure: Enalapril Maleate should be used as an adjunctive therapy with non-potassium-sparing diuretics and, where appropriate, digitalis. In severe heart failure, treatment should always be initiated in hospital under close medical supervision. When used as an adjunct to conventional therapy in these patients, Enalapril Maleate improves symptoms, and reduces mortality and hospitalization. In mild to moderate heart failure, treatment should always be initiated under close medical supervision.
• Prevention of heart attack and stroke.

Adult Dose:

• Hypertension: Initial: 2.5-5 mg PO qDay. Maintenance: 10-40 mg/day PO qDay or divided q12hr.
• Left Ventricular Dysfunction: Initial: 2.5 mg PO q12hr. May titrate up to 20 mg/day.
• Congestive Heart Failure: Initial: 2.5 mg PO qDay or q12hr. Maintenance: 5-40 mg/Day PO divided q12hr; titrate slowly q2Weeks.
• Hepatic impairment: No dosage adjustment required.

Child Dose (1 month to 16 years): Hypertension: Initial: 0.08 mg/kg/day PO or divided q12hr; not to exceed 5 mg/day. May increase PRN q2Weeks according to blood pressure not to exceed 0.58 mg/kg/day (or 40 mg/day).

Renal Dose: CrCl <30 mL/min: (PO) Initiate 2.5 mg; titrate to response; not to exceed 40 mg. Dialysis: 2.5 mg PO on day of dialysis; adjust dose on nondialysis days according to BP.

Elderly (over 65 years): Starting dose should be 2.5 mg. Enalapril is effective in the treatment of hypertension in the elderly. Some elderly patients may be more responsive to Enalapril than younger patients. The dose should be titrated according to need for the control of blood pressure. Maximum daily dose: 40 mg.

Common Side Effects: Decreased blood pressure, cough, increased potassium level in blood, fatigue, weakness, dizziness.

Other Side Effects: Severe hypotension and renal failure. Dizziness, headache, fatigue, asthenia, orthostatic hypotension, syncope, nausea, diarrhoea, muscle cramps, rash, cough.

Less Frequently: Renal dysfunction, renal failure, oliguria.

Rare: Myocardial infarction, chest pain, palpitations, rhythm disturbances, angina pectoris, pancreatitis, hepatitis, jaundice, abdominal pain, vomiting, dyspepsia, constipation, anorexia, stomatitis, depression, confusion, somnolence, insomnia, nervousness, paraesthesiae, vertigo, bronchospasm, asthma, dyspnoea, rhinorrhoea, sore throat and hoarseness, diaphoresis, erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pruritus, urticaria, alopecia, impotence, flushing, taste alteration, tinnitus, glossitis, blurred vision, etc. Angioneurotic oedema has been reported rarely.

Precautions: Enalapril Maleate may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur. It should be taken with or without food, preferably at the same time each day. Enalapril Maleate can make you feel dizzy for the first few days, so rise slowly if you have been sitting or lying down. You can also prefer taking it at bedtime to avoid dizziness throughout the day. Let your doctor know about any cough, or throat irritation that does not go away. It may increase the level of potassium in blood. Avoid taking potassium supplements and potassium-rich foods such as banana and broccoli.

Important Warnings: Pretreatment assessment of renal function: Assessment of renal function prior to initiation of therapy, and during treatment where appropriate. Symptomatic hypotension was seen rarely in uncomplicated hypertensive patients. It has been reported mainly in patients with severe heart failure and who have been volume-depleted by diuretic therapy. By initiating therapy with a small dose (2.5 mg Enalapril) the duration of any hypotensive effect may be lessened. Similar considerations in terms of initiating therapy with a small dose may apply also to patients with ischaemic heart or cerebrovascular disease in whom severe hypotension could result in a myocardial infarct or cerebrovascular accident. Enalapril should be used with caution in patients with renal insufficiency as they may require reduced or less frequent doses. A high incidence of anaphylactoid reactions have been reported in patients dialyzed with high flux membranes (e.g., AN 69) and treated concomitantly with an ACE inhibitor. This combination should therefore be avoided. Cough has been reported with the use of ACE inhibitors. Characteristically, the cough is non-productive, persistent and resolves after discontinuation of therapy. In patients undergoing major surgery or during anaesthesia with agents that produce hypotension, Enalapril blocks angiotensin II formation secondary to compensatory renin release. This may lead to hypotension which can be corrected by volume expansion. Enalapril should not be used in patients with aortic stenosis or outflow obstruction.