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Enalapril Maleate
Enalapril Maleate is a prescription medication used to treat high blood pressure (hypertension) and heart failure. It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing blood vessels, making it easier for the heart to pump blood. By reducing blood pressure, enalapril helps prevent strokes, heart attacks, and kidney problems. It is also used in certain patients to improve survival after a heart attack or to treat conditions like left ventricular dysfunction.
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Frequently Asked Questions
How long does it take for enalapril to lower blood pressure?
Enalapril begins to lower blood pressure within 1 hour of taking the dose, with peak effects occurring in 4 to 6 hours. However, full benefits may take several weeks to be realized.
Can I take enalapril if I’m pregnant?
No, enalapril should not be taken during pregnancy, as it can cause serious harm to the fetus, especially in the second and third trimesters. If you become pregnant while taking enalapril, contact your doctor immediately.
What should I do if I miss a dose of enalapril?
If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and resume your regular schedule. Do not double up on doses.
Can I drink alcohol while taking enalapril?
It is best to limit alcohol consumption while taking enalapril, as alcohol can enhance the blood pressure-lowering effects and increase the risk of dizziness or fainting.
Will enalapril cause a dry cough?
A dry cough is a common side effect of enalapril and other ACE inhibitors. If the cough becomes bothersome, talk to your doctor, as they may recommend switching to a different medication, such as an ARB.
Comprehensive Drug Guide
How Does Enalapril Maleate Work?
Enalapril works by inhibiting the angiotensin-converting enzyme (ACE), which converts angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing levels of angiotensin II, enalapril causes blood vessels to relax and widen, lowering blood pressure and decreasing the workload on the heart. This also reduces fluid retention, making it useful for treating heart failure.
Common Dosages
- 2.5 mg tablets
- 5 mg tablets
- 10 mg tablets
- 20 mg tablets
Typical Dosing
- For hypertension: The usual starting dose is 5 mg once daily, which may be increased based on blood pressure response, up to 40 mg daily in divided doses.
- For heart failure: The initial dose is usually 2.5 mg twice daily, with the dose gradually increased to an effective maintenance dose.
- In patients with kidney disease, lower doses may be required, and adjustments are often made based on kidney function.
Typical Dosing
FDA Approved Indications
- Hypertension (high blood pressure)
- Heart failure
- Asymptomatic left ventricular dysfunction
- To improve survival after a heart attack in certain patients
Who Shouldn't Take Enalapril Maleate?
- Angioedema related to previous ACE inhibitor therapy
- Pregnancy (ACE inhibitors can cause fetal harm)
- Severe renal artery stenosis (narrowing of the arteries leading to the kidneys)
- Known hypersensitivity to enalapril or any component of the formulation
Advice From The Pharmacist
- Take enalapril as prescribed, with or without food, typically once or twice daily.
- Do not stop taking enalapril suddenly, as this can lead to a rebound increase in blood pressure.
- If you develop a persistent dry cough, this may be a side effect of enalapril, and you should contact your healthcare provider.
- Stay hydrated and avoid excessive salt substitutes or potassium supplements, as enalapril can increase potassium levels in the body.
- Women who are pregnant or planning to become pregnant should discontinue use, as enalapril can cause birth defects.
Side Effects of Enalapril Maleate
Common Side Effects
- Cough (persistent, dry)
- Dizziness or lightheadedness
- Fatigue
- Headache
- Elevated potassium levels (hyperkalemia)
Uncommon/Severe Side Effects
- Angioedema (swelling of the face, lips, tongue, or throat, which can be life-threatening)
- Severe hypotension (low blood pressure)
- Kidney dysfunction
- Liver problems (yellowing of the skin or eyes)
Risks and Warnings of Enalapril Maleate
- Angioedema: Patients who develop swelling of the face, lips, tongue, or throat while taking enalapril should seek immediate medical attention, as this can be life-threatening.
- Pregnancy: Enalapril is contraindicated in pregnancy, especially during the second and third trimesters, as it can harm or cause death to the developing fetus.
- Hyperkalemia: Enalapril can increase potassium levels, leading to hyperkalemia, which can cause heart problems. Potassium levels should be monitored during treatment.
- Kidney Function: Patients with kidney disease may require dose adjustments, and kidney function should be regularly monitored while on enalapril.
Interactions with Enalapril Maleate
Common Drug Interactions
- Diuretics: Taking enalapril with diuretics (water pills) can enhance its blood pressure-lowering effects but may increase the risk of dehydration and low blood pressure.
- Potassium-Sparing Diuretics and Supplements: Combining enalapril with potassium supplements or potassium-sparing diuretics (e.g., spironolactone) can increase the risk of hyperkalemia.
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs like ibuprofen or naproxen can reduce the effectiveness of enalapril and increase the risk of kidney damage.
- Lithium: Enalapril may increase lithium levels, leading to toxicity.
Alternatives to Enalapril Maleate
- Lisinopril (Prinivil, Zestril): Another ACE inhibitor commonly used for treating high blood pressure and heart failure.
- Losartan (Cozaar): An angiotensin II receptor blocker (ARB) used as an alternative to ACE inhibitors for patients who cannot tolerate them.
- Amlodipine (Norvasc): A calcium channel blocker used to treat high blood pressure and angina.
Hydrochlorothiazide (HCTZ): A diuretic often used in combination with ACE inhibitors to treat high blood pressure.
