1. Overview

Enalapril (Vasotec) is an Antihypertensive agent that belongs to a class of drugs known as angiotensin-converting enzyme inhibitors (ACE-inhibitors).Enalapril is rapidly converted to its active metabolite, Enalaprilat, by hepatic biotransformation.

This agent is a vasodilator that is used to treat high blood pressure and heart failure. Enalapril is sold under the brand name Vasotec, it is available as oral tablets, powder for oral solution and injection solution.

Maleate salt of Enalapril is called Enalapril maleate, it is also available as combinations with diuretics such as:

Enalapril maleate/ hydrochlorothiazide (Vaseretic).

2. How does Enalaprilat work?

Enalaprilat which is the active metabolite of Enalapril (Vasotec), acts by inhibiting the action of the ACE, this inhibition will prevent the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor). Reduced angiotensin II levels result in the reduction of aldosterone secretion, which reduces sodium and water reabsorption, this will lead to decreased peripheral resistance and blood pressure.

3. Uses of Enalapril

Enalapril (Vasotec) is used in the treatment of:

- Hypertension (high blood pressure)

- Symptomatic heart failure

- Asymptomatic left ventricular disorder

It is also used in preventing future heart attacks.

4. Dosage forms & strengths

Enalapril (Vasotec) is available as:

- Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg

- Injection solution: 1.25 mg/mL

- Powder for oral Solution: 1 mg/mL

Enalapril dosage in detail.

5. How and when to use Enalapril?

Be sure to tell your doctor if:

• You have kidney problems.
• You have liver problems.
• You have heart problems.
• You are allergic to ACE inhibitors.
• You have a history of angioedema from ACE inhibitors.
• You are taking other medicines.
• You intend to become pregnant.

Pregnancy and breastfeeding

This drug is not prescribed during pregnancy and breastfeeding. Enalapril can cross the placenta and distribute in breast milk, so it may cause harm and death to the developing fetus.

Can I drive and do hazardous work while I’m using Enalapril?

Enalapril causes dizziness since the drug can lower blood pressure; therefore, it’s recommended to avoid those activities until you have found out how Enalapril affects you.

6. Side effects

Adverse effects of Enalapril may diminish with time, but in some cases dose adjustment may be required.

Common side effects of Enalapril include:

- Rash

- Dry cough

- Headache

- Dizziness

- Blurred vision

- Depression

Rare side effects include:

- Breathing difficulty

- Hepatic disorders

- Autoimmune disorders

- Gynecomastia (abnormal enlargement of breasts in males)

Read Enalapril side effects in more detail

7. Interactions

Several drugs and substances can interact with Enalapril resulting in undesired effects. Interaction can affect the activity of the drug and the severity of its side effects.

Interactions with drugs

Enalapril can form drug-drug interactions with the following drugs:

Potassium-sparing diuretics and potassium supplements:

the effect of these drugs is enhanced by Enalapril, leading to an increase level of potassium in the blood.

Non-steroidal anti-inflammatory drugs (NSAIDs):

Enalapril effectiveness is reduced when used with these drugs. There is also an increased risk of acute renal failure.

Diuretics and other anti-hypertensive agents:

these drugs increase the blood pressure-lowering effect of Enalapril.

Lithium

Enalapril increases lithium concentration in the blood, leading to toxicity.

Interactions with Herbal medicines:

Ginseng, yohimbe and ephedra may make hypertension worse.

Garlic can increase the antihypertensive effect of Enalapril.

Licorice can cause sodium and water retention leading to additive hypertensive effects.