What is enalapril?
Enalapril is a second-generation ACE inhibitor and has been used for treating high blood pressure and heart failure since the 1980s. As a prodrug, it is converted into active enalaprilate in the body.
It is available as a monopreparation and in combination with hydrochlorothiazide (Enalapril-ratiopharm® comp.) or Lercanidipine (Enalapril/Lercanidipine-ratiopharm). Enalapril is usually taken twice a day.
Active Ingredients & Mechanism of Action
Active ingredient: Enalapril
Enalapril acts like all ACE inhibitors via inhibition of angiotensin converting enzyme:
Active mechanism:
- is converted into enalaprilate (active form) in the body
- inhibits the conversion of angiotensin I to angiotensin II
- Angiotensin II is a strong vascular constrictor
- The vessels expand, blood pressure drops
Special features:
- Prodrug with active metabolism in the liver
- Effect after 1 hour
- duration of action 12-24 hours
- Protects heart and kidneys from reconstruction
Additional effects:
- Reduction of the load at the heart
- Improving heart performance in heart failure
- Reduction of protein excretion via kidneys
Who is it suitable for?
Enalapril is suitable for:
- Adults with high blood pressure
- Patients with heart failure
- Prevention of symptomatic heart failure
Advantages:
- Long-standing experience and good study situation
- Also approved for heart failure
- Conveniently available as a generic
Not suitable:
- Pregnancy and breastfeeding
- Angioedema in History
- Side-side kidney arterial stenosis
- Children (except for special indication)
Available Dosages
High blood pressure:
- start dose: 5 mg once a day
- usual maintenance dose: 10-20 mg daily (one or two)
- Maximum dose: 40 mg daily
Sufficiency:
- start dose: 2.5 mg once a day
- Slow increase
- Target dose: 20 mg daily (divided on two doses)
Available starches:
- 2.5 mg, 5 mg, 10 mg, 20 mg tablets
Combination preparations:
- Enalapril + Hydrochlorothiazid (Enalapril comp.)
- Enalapril + Lercanidipine
How to Take
Intake:
- One to twice a day, always at the same time
- Independent meals
- With sufficient water
**
- Take the first dose in the evening (blood pressure drop)
- Slow dose increase over weeks
- Regular blood pressure and laboratory controls
- Do not drop abruptly
For forgotten dose:
- Over a few hours
- Otherwise next dose at the usual time
- Never take double dose
Contraindications
**Enalapril must not be taken at:* *
- hypersensitivity to Enalapril or other ACE inhibitors
- Angioedema in History
- Side-sided kidney arterial stenosis
- Pregnancy (especially 2nd and 3rd trimester)
- Still time
Preview at:
- Restricted kidney function
- Liver malfunction
- Increased potassium level
- Simultaneous diuretics therapy
- Aortenstenose
pregnant: Contraindicated. Can cause severe damage to the unborn. In case of child request, change to a safe preparation in time.
Possible Side Effects
Acid (1-10%):
- Dry stimulus cough
- Squeeze
- Headaches
- Weakness
- Hidden vision
** Occasionally (0,1-1%):* *
- Blood pressure drop (orthostatic)
- nausea, diarrhea
- Muscle cramps
- Skin rash
- Increased potassium values
Selten:
- Angioedema (sofort emergency doctor call!)
- Severe kidney function disorder
- Liver malfunction
- Blood-image changes
** The dry cough occurs in about 5-10% of patients and is the most common reason for a drug change.
Interactions
Enhanced blood pressure reduction:
- Other antihypertensive agents
- Diuretics
- Nitrate
Calium increase:
- Potassium-saving diuretics
- potassium supplements
- Trimethoprim
Reduced effect:
- NSAR (Ibuprofen, Diclofenac)
- High salt feed
More interactions:
- Lithium (increased mirrors)
- Antidiabetics (increased blood sugar reduction)
- Allopurinol (increased allergy risk)
Frequently Asked Questions
Similar Medications
Is enalapril right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.