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Administration
May be taken with or without food.
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Contraindications
History of angioedema related to previous treatment with ACE inhibitor, idiopathic or hereditary angioedema. Concomitant use with aliskiren in patient with diabetes mellitus. Coadministration with or within 36 hours of switching to or from a neprilysin inhibitor (e.g. sacubitril). Pregnancy.
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Special Precautions
Patient with diabetes mellitus, volume depletion, renal artery stenosis, severe aortic stenosis; ascites due to cirrhosis or refractory ascites; ischaemic heart disease or cerebrovascular disease; collagen vascular disease; hypertrophic cardiomyopathy and outflow tract obstruction; pre-existing renal insufficiency. Black race. Renal and hepatic impairment. Children and elderly. Lactation. Patient Counselling This drug may cause occasional dizziness or weariness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, baseline serum creatinine and K; reassess serum creatinine and K within 1-2 weeks after initiation and periodically thereafter in patient treated for heart failure.
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Adverse Reactions
Significant: Cough, haematologic effects (e.g. neutropenia, agranulocytosis, anaemia, thrombocytopenia), hyperkalaemia, hypersensitivity reactions (e.g. anaphylactic/anaphylactoid reactions), hypotension, syncope, renal function deterioration, increased serum creatinine. Rarely, cholestatic jaundice.
Cardiac disorders: Chest pain, rhythm disturbances, angina pectoris, orthostatic hypotension, dyspnoea, tachycardia.
Eye disorders: Blurred vision.
Gastrointestinal disorders: Abdominal pain, anorexia, constipation, diarrhoea, dysgeusia, nausea, vomiting, taste alteration.
General disorders and administration site conditions: Weakness, asthenia, fatigue.
Nervous system disorders: Dizziness, headache.
Psychiatric disorders: Depression.
Respiratory, thoracic and mediastinal disorders: Bronchitis.
Skin and subcutaneous tissue disorders: Rash.
Potentially Fatal: Angioedema. Rarely, fulminant hepatic necrosis. |
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Drug Interactions
May potentiate hypotensive action with diuretics, other antihypertensives, TCAs, vasodilating agents (e.g. nitrates) or anaesthetics. May increase lithium serum concentration and enhance risk of lithium toxicity. May increase risk of hypoglycaemia with oral antidiabetic agents or insulin. May increase risk of hyperkalaemia with K-sparing diuretics (e.g. spironolactone, triamterene, amiloride), K-containing supplements or salt substitutes. May increase risk of renal impairment with NSAIDs (e.g. aspirin, ibuprofen) including COX-2 inhibitors. Rarely, may cause nitritoid reactions with injectable gold (Na aurothiomalate).
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CIMS Class
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ATC Classification
C09AA02 - enalapril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.
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