Enalapril 10mg Tablets

Enalapril is a prodrug that is hydrolyzed to enalaprilat, its active metabolite. Enalaprilat is an angiotensin-converting enzyme (ACE) inhibitor. It prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to decreased angiotensin II levels, resulting in vasodilation, reduced aldosterone secretion (leading to decreased sodium and water reabsorption and increased potassium retention), and decreased sympathetic activity. It also inhibits the degradation of bradykinin, a vasodilator, which may contribute to its antihypertensive effect and some side effects like cough and angioedema.

Serious Side Effects: Seek Medical Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden weight gain
Signs of high potassium levels, such as:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Severe dizziness or fainting
Persistent cough
Chest pain or pressure
Liver problems, which can be indicated by:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes (jaundice)

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:

Dizziness
* Cough

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions before starting this medication:

Any allergies you have, including allergies to this drug, its components, or other substances, such as foods or medications. Describe the allergic reaction you experienced, including any symptoms that occurred.
Kidney disease, as this may affect how your body processes the medication.
A history of angioedema, a severe and potentially life-threatening reaction characterized by swelling of the hands, face, lips, eyes, tongue, or throat, difficulty breathing, swallowing problems, or unusual hoarseness.
If you are taking a medication containing aliskiren, particularly if you have diabetes or kidney problems.
If you have taken a medication containing sacubitril within the last 36 hours.
If you are breastfeeding, as this medication is not recommended for nursing mothers.

Special Considerations for Children:

If the patient is under 1 month of age, do not administer this medication, as it is not suitable for infants at this age.
If the child was born prematurely and has not yet reached the corrected age of 44 weeks, consult with your doctor before giving this medication.

Additional Important Information:

This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you may have. This will help ensure your safety while taking this medication. Never start, stop, or change the dose of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, avoid driving and other activities that require alertness until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position, and be cautious when climbing stairs.

Follow your doctor's instructions for monitoring your blood pressure and having regular blood tests. If you are using a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium product, consult your doctor. Additionally, if you are on a low-salt or salt-free diet, discuss this with your doctor.

This medication can cause a decrease in white blood cell count, which may increase your risk of infection. This is more likely to occur in individuals with kidney problems, especially those with other underlying health conditions. If you experience symptoms of infection, such as fever, chills, or sore throat, contact your doctor immediately.

If you have high blood pressure and are taking this medication, consult your doctor before using over-the-counter products that may increase blood pressure, including cough and cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Before consuming alcohol, discuss it with your doctor. In hot weather or during physical activity, be cautious and drink plenty of fluids to avoid dehydration. If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these conditions may lead to low blood pressure.

It is crucial to note that this medication may be less effective in lowering blood pressure in Black patients. In some cases, additional medication may be necessary. If you have any questions or concerns, discuss them with your doctor.

A severe and potentially life-threatening reaction called angioedema has been associated with this medication. The risk of angioedema may be higher in Black patients.

• Aliskiren (in patients with diabetes or renal impairment [GFR <60 mL/min/1.73 m²])
• Sacubitril/valsartan (Entresto) - concomitant use or within 36 hours of switching
• History of angioedema related to previous ACE inhibitor treatment
• Hereditary or idiopathic angioedema

• Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) - increased risk of hyperkalemia
• Potassium supplements - increased risk of hyperkalemia
• Lithium - increased serum lithium levels and toxicity
• NSAIDs (e.g., ibuprofen, naproxen) - may reduce antihypertensive effect and increase risk of renal impairment, especially in elderly or volume-depleted patients
• Dual blockade of the RAAS (e.g., with ARBs or direct renin inhibitors) - increased risk of hypotension, hyperkalemia, and renal impairment
• mTOR inhibitors (e.g., sirolimus, everolimus, temsirolimus) - increased risk of angioedema
• Neprilysin inhibitors (e.g., sacubitril) - increased risk of angioedema

• Diuretics (thiazide or loop) - increased risk of symptomatic hypotension, especially with initial doses
• Antidiabetic agents (insulin, oral hypoglycemics) - increased risk of hypoglycemia
• Gold (sodium aurothiomalate) - nitritoid reactions (facial flushing, nausea, vomiting, hypotension) reported rarely with concomitant injectable gold and ACE inhibitor therapy
• Tricyclic antidepressants, antipsychotics, anesthetics - may enhance hypotensive effect

• Not available

• Angioedema (swelling of face, lips, tongue, glottis, larynx)
• Persistent dry cough
• Dizziness or lightheadedness (especially upon standing)
• Fatigue
• Signs of hyperkalemia (e.g., muscle weakness, irregular heartbeat)
• Signs of infection (e.g., fever, sore throat) - rare, but indicates neutropenia

CONTRAINDICATED in the 2nd and 3rd trimesters of pregnancy due to significant risk of fetal injury and death. Discontinue as soon as pregnancy is detected. Use in the 1st trimester is generally discouraged due to potential risks, though less severe than later trimesters.

Enalapril and its active metabolite, enalaprilat, are excreted into breast milk in small amounts. Generally considered compatible with breastfeeding, especially for older infants. Monitor breastfed infants for hypotension, hyperkalemia, and renal dysfunction.

Approved for hypertension in children ≥1 month of age. Dosing is weight-based. Close monitoring of blood pressure, renal function, and electrolytes is crucial. Not recommended for heart failure in pediatric patients.

Use with caution in elderly patients, who may be more sensitive to the hypotensive effects and more likely to have age-related decreases in renal function. Lower initial doses may be appropriate. Monitor renal function and potassium closely.

• Enalapril is a prodrug; its active form is enalaprilat. This means it needs to be metabolized by the liver to become active.
• The most common side effect is a persistent dry cough, which occurs in 5-20% of patients and is due to bradykinin accumulation. If bothersome, an ARB may be considered as an alternative.
• Angioedema is a rare but potentially life-threatening side effect. Patients should be educated on symptoms and to seek immediate medical attention if it occurs.
• Risk of hyperkalemia is increased with concomitant use of potassium-sparing diuretics, potassium supplements, NSAIDs, or in patients with renal impairment or diabetes.
• First-dose hypotension can occur, especially in volume-depleted patients (e.g., those on high-dose diuretics). Consider discontinuing diuretics 2-3 days prior to initiation if possible, or starting with a very low dose and monitoring closely.
• Enalapril is effective in reducing cardiovascular morbidity and mortality in patients with heart failure and left ventricular dysfunction.

• Other ACE inhibitors (e.g., lisinopril, ramipril, captopril)
• Angiotensin Receptor Blockers (ARBs) (e.g., valsartan, losartan, candesartan)
• Beta-blockers (e.g., metoprolol, carvedilol)
• Calcium Channel Blockers (e.g., amlodipine, nifedipine)
• Thiazide diuretics (e.g., hydrochlorothiazide, chlorthalidone)
• Direct Renin Inhibitors (e.g., aliskiren - limited use)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide information about the medication taken, the amount, and the time it happened.