Dosage and Frequency: The typical starting dose of enalapril for hypertension in adults is 5 mg once daily, with adjustments made by the healthcare provider based on individual response. The maximum recommended dose is 40 mg per day. For heart failure, the initial dose may be lower, typically 2.5 mg once or twice daily, again with adjustments as necessary.
Route of Administration (ROA): Enalapril is administered orally, usually in the form of tablets or liquid suspension.
Mechanism of Action (MOA): Enalapril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This action leads to vasodilation and decreased secretion of aldosterone, resulting in reduced blood pressure.
Pharmacokinetics (PK): Enalapril is rapidly absorbed after oral administration, reaching peak plasma concentrations within about one hour. It undergoes conversion to its active metabolite, enalaprilat, primarily in the liver. The elimination half-life of enalaprilat is approximately 11 hours.
Pharmacodynamics (PD): Enalapril lowers blood pressure by inhibiting the action of ACE, thereby reducing the production of angiotensin II and decreasing peripheral vascular resistance.
Pathophysiology: Enalapril helps manage hypertension and heart failure by counteracting the effects of the renin-angiotensin-aldosterone system, leading to vasodilation and improved cardiac function.
Indications: Enalapril is indicated for the treatment of hypertension and symptomatic heart failure.
Contraindications: Contraindications to enalapril include hypersensitivity to ACE inhibitors, a history of angioedema related to previous ACE inhibitor use, and pregnancy.
Drug Interactions: Enalapril may interact with other medications that affect blood pressure, potassium levels, or renal function. Concurrent use with potassium-sparing diuretics, potassium supplements, or nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of hyperkalemia.
Precautions: Special precautions should be taken in patients with renal impairment, as enalapril can cause further deterioration of renal function. Close monitoring of renal function and electrolytes is recommended, especially during initiation of therapy and dose adjustments.
Monitoring and Laboratory Tests: Monitoring of blood pressure, renal function (serum creatinine and potassium levels), and signs of angioedema is important during enalapril therapy. Regular follow-up appointments with healthcare providers are recommended to assess treatment response and monitor for adverse effects.
Medication Information and Guidelines
Purpose: Enalapril is primarily used to treat hypertension (high blood pressure) and heart failure. It helps to lower blood pressure and improve heart function.
Usage Instructions: Take enalapril exactly as prescribed by your healthcare provider. Typically, it is taken orally once daily for hypertension and may be taken once or twice daily for heart failure. Follow your doctor’s instructions carefully.
Other Uses: Enalapril may also be used to manage certain kidney conditions, such as diabetic nephropathy, to slow the progression of kidney damage.
Specific Precautions: Be cautious if you have a history of angioedema, as enalapril can rarely cause swelling of the face, lips, tongue, or throat, which can be life-threatening. Inform your doctor about any allergies or kidney problems before starting enalapril.
Dietary Changes: While taking enalapril, you may need to avoid excessive salt intake, as it can increase blood pressure. Your doctor may also advise monitoring your potassium intake, especially if you have kidney problems, as enalapril can affect potassium levels.
Missed Dose: If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Possible Side Effects: Common side effects of enalapril include dizziness, headache, cough, and low blood pressure. Less common but more serious side effects may include kidney problems, allergic reactions, and angioedema.
Storage and Disposal: Store enalapril at room temperature away from moisture and heat. Keep it out of reach of children and pets. Dispose of any unused medication properly, following local regulations or guidelines.
Emergency Situations: In case of an overdose, seek immediate medical attention or contact a poison control center. Symptoms of overdose may include severe dizziness, fainting, or difficulty breathing. If you experience signs of angioedema, such as swelling of the face, lips, tongue, or throat, seek emergency medical help.