Enalapril
Note: for the active metabolite available in IV, see Enalaprilat
General
- Type: ACE inhibitor
- Dosage Forms: 2.5mg, 5mg, 10mg, 20mg
- Common Trade Names: Vasotec, Epaned
General information:
- Doses > 40mg/day rarely more effective
- Decreased efficacy as monotherapy in African-American patients
- Obtain Chem 10 if starting in ED to assess renal function
Adult Dosing
- hypertension: 10 - 40mg PO Qday, max 40mg/day
Pediatric Dosing
- 1 month -16 year old: 0.1 - 0.5mg/kg/day PO divided q12 - 24h, max 40mg/day
Special Populations
- Pregnancy Rating: D
- Lactation: Probably Safe
- Renal Dosing
- Adult: CrCl < 30, start 2.5mg qday, max 40mg q/day
- Pediatric creatinine Cl 10-50: decrease dose 25%, CrCl < 10: decrease dose 50%
- Hepatic Dosing
- Adult: Not defined
- Pediatric: Not defined
Contraindications
- Allergy to class/drug
- history of angioedema
- pregnancy
- caution if renal artery stenosis
- caution if severe CHF
- caution if renal impairment
Adverse Reactions
Serious
- angioedema
- hypotension
- hyperkalemia
- renal impairment
- hepatotoxicity
- neutropenia
- pancreatitis
- steven johnson syndrome
- fetal/neonatal harm
- congenital malformations
Common
- dizziness
- elevated Cr
- headache
- diarrhea
- hypotension
- abdominal pain
- hyperkalemia
Pharmacology
- Half-life: 12 hours
- Metabolism: Liver
- Excretion: urine, feces
- Mechanism of Action: inhibits angiotensin converting enzyme, interferes with conversion of angiotensin 1 to angiotensin 2