What is enalapril?
Enalapril is a second-generation ACE inhibitor and has been used for treating high blood pressure and heart failure since the 1980s. As a prodrug, it is converted into active enalaprilate in the body.
It is available as a monopreparation and in combination with hydrochlorothiazide (Enalapril-ratiopharm® comp.) or Lercanidipine (Enalapril/Lercanidipine-ratiopharm). Enalapril is usually taken twice a day.
Active Ingredients & Mechanism of Action
Active ingredient: Enalapril
Enalapril acts like all ACE inhibitors via inhibition of angiotensin converting enzyme:
Active mechanism:
- is converted into enalaprilate (active form) in the body
- inhibits the conversion of angiotensin I to angiotensin II
- Angiotensin II is a strong vascular constrictor
- The vessels expand, blood pressure drops
Special features:
- Prodrug with active metabolism in the liver
- Effect after 1 hour
- duration of action 12-24 hours
- Protects heart and kidneys from reconstruction
Additional effects:
- Reduction of the load at the heart
- Improving heart performance in heart failure
- Reduction of protein excretion via kidneys
Who is it suitable for?
Enalapril is suitable for:
- Adults with high blood pressure
- Patients with heart failure
- Prevention of symptomatic heart failure
Advantages:
- Long-standing experience and good study situation
- Also approved for heart failure
- Conveniently available as a generic
Not suitable:
- Pregnancy and breastfeeding
- Angioedema in History
- Side-side kidney arterial stenosis
- Children (except for special indication)
Available Dosages
High blood pressure:
- start dose: 5 mg once a day
- usual maintenance dose: 10-20 mg daily (one or two)
- Maximum dose: 40 mg daily
Sufficiency:
- start dose: 2.5 mg once a day
- Slow increase
- Target dose: 20 mg daily (divided on two doses)
Available starches:
- 2.5 mg, 5 mg, 10 mg, 20 mg tablets
Combination preparations:
- Enalapril + Hydrochlorothiazid (Enalapril comp.)
- Enalapril + Lercanidipine
How to Take
Intake:
- One to twice a day, always at the same time
- Independent meals
- With sufficient water
**
- Take the first dose in the evening (blood pressure drop)
- Slow dose increase over weeks
- Regular blood pressure and laboratory controls
- Do not drop abruptly
For forgotten dose:
- Over a few hours
- Otherwise next dose at the usual time
- Never take double dose
Contraindications
**Enalapril must not be taken at:* *
- hypersensitivity to Enalapril or other ACE inhibitors
- Angioedema in History
- Side-sided kidney arterial stenosis
- Pregnancy (especially 2nd and 3rd trimester)
- Still time
Preview at:
- Restricted kidney function
- Liver malfunction
- Increased potassium level
- Simultaneous diuretics therapy
- Aortenstenose
pregnant: Contraindicated. Can cause severe damage to the unborn. In case of child request, change to a safe preparation in time.
Possible Side Effects
Acid (1-10%):
- Dry stimulus cough
- Squeeze
- Headaches
- Weakness
- Hidden vision
** Occasionally (0,1-1%):* *
- Blood pressure drop (orthostatic)
- nausea, diarrhea
- Muscle cramps
- Skin rash
- Increased potassium values
Selten:
- Angioedema (sofort emergency doctor call!)
- Severe kidney function disorder
- Liver malfunction
- Blood-image changes
** The dry cough occurs in about 5-10% of patients and is the most common reason for a drug change.
Interactions
Enhanced blood pressure reduction:
- Other antihypertensive agents
- Diuretics
- Nitrate
Calium increase:
- Potassium-saving diuretics
- potassium supplements
- Trimethoprim
Reduced effect:
- NSAR (Ibuprofen, Diclofenac)
- High salt feed
More interactions:
- Lithium (increased mirrors)
- Antidiabetics (increased blood sugar reduction)
- Allopurinol (increased allergy risk)
Frequently Asked Questions
Similar Medications
Is enalapril right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.