Enalapril is a medication used to treat cardiovascular diseases, belonging to the class of angiotensin-converting enzyme (ACE) inhibitors. Its primary function is to inhibit the angiotensin-converting enzyme, thereby lowering blood pressure and improving cardiac function. Common indications include hypertension, heart failure, and treatment of diabetic nephropathy.
This drug can dilate arteries and veins, reduce cardiac load, and long-term use can decrease the risk of myocardial infarction. Its mechanism involves blocking the production of vasoconstrictive substances, promoting vasodilation to reduce vascular resistance, which is especially important for patients with concurrent cardiac damage.
The generic name of Enalapril is "Enalapril," with common brand names including Vasotec® among others. Different pharmaceutical companies may sell it under various trade names, but the active ingredient is always Enalapril maleate.
When purchasing, verify that the international non-proprietary name (INN) on the packaging is Enalapril to avoid confusion with other antihypertensive classes.
Enalapril is classified as an ACE inhibitor, a medication used for hypertension and heart disease treatment. This class of drugs uniquely improves hemodynamics and cardiac metabolism, offering particular benefits for patients with cardiac dilation or ventricular systolic dysfunction.
Unlike beta-blockers or calcium channel blockers, ACE inhibitors regulate the renin-angiotensin system to protect renal and nervous system functions.
Mild reactions include dizziness, fatigue, and persistent dry cough, which usually resolve within a few weeks. If the cough persists or worsens, affecting daily life, seek medical evaluation immediately.
Serious side effects include:
Contraindications: Not to be used during the second and third trimesters of pregnancy, as it may cause fetal death or congenital abnormalities. Use with caution in patients with bilateral renal artery stenosis as it may lead to acute renal failure.
Black box warnings include:
When combined with diuretics or calcium channel blockers, blood pressure should be closely monitored to prevent excessive hypotension. Concomitant use with potassium-sparing diuretics may lead to hyperkalemia.
Avoid concurrent use with non-steroidal anti-inflammatory drugs (NSAIDs), which may reduce the antihypertensive effect. Use caution when combined with potassium supplements or potassium-containing medications, and consult a physician.
The starting dose is usually 5-10 mg once daily, taken orally in 1-2 doses. Patients with severe renal impairment should start at 2.5 mg daily, with dose adjustments guided by a physician. Do not alter the dose on your own.
Take at a fixed time, with or without food, but maintain consistency. Tablets should be swallowed whole; do not chew. If a dose is missed, take it immediately; if close to the next dose, skip the missed dose and do not double the dose.
If a dose is missed on the day, take it as soon as remembered. If it is within 2 hours of the next scheduled dose, skip the missed dose and continue with the regular schedule. Do not take double doses to make up for missed ones.
Set reminders or associate medication with daily routines (such as meals) to prevent missed doses.
Overdose may cause severe hypotension, syncope, and acute renal failure. If overdose is suspected, seek emergency medical attention immediately, which may include hospitalization, blood pressure support, and other supportive treatments.
Emergency measures include gastric lavage, blood pressure and electrolyte monitoring, and in severe cases, vasopressor support or dialysis. Do not attempt to treat overdose yourself.
What should I do if I experience persistent cough while taking Enalapril?
Some patients may develop a dry cough as a side effect of Enalapril, related to its inhibition of the angiotensin-converting enzyme. If the cough affects daily life, contact your physician promptly. Dose adjustment or switching to another class of antihypertensive may be necessary. Do not stop medication on your own to avoid rebound hypertension.
When taking diuretics together with Enalapril, what precautions should I take regarding timing?
Doctors may recommend taking diuretics several days before starting Enalapril to reduce the risk of excessive blood pressure lowering. During combined therapy, close monitoring of blood pressure, serum potassium, and renal function is essential to prevent electrolyte imbalance or organ overload.
What foods should I avoid to enhance the effectiveness of Enalapril?
Limit high-potassium foods (such as bananas, avocados, spinach), as Enalapril may increase blood potassium levels, and high-potassium diets can lead to arrhythmias. Regular blood tests to monitor serum potassium are advised, following your physician’s dietary recommendations.
How should I handle medication use if I need surgery during Enalapril therapy?
Inform your surgeon about your Enalapril use before surgery, as anesthesia may enhance the blood pressure-lowering effect, leading to intraoperative hypotension. Your doctor may advise temporarily stopping the medication before surgery and reassessing after based on hemodynamic status.
What should long-term Enalapril users include in their regular check-ups?
Long-term users should have blood tests for serum creatinine, estimated glomerular filtration rate (eGFR), and serum potassium every 3-6 months to monitor kidney function and electrolyte balance. Diabetic patients should also monitor blood glucose control, as Enalapril may affect insulin sensitivity.
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