Enalapril Pharmacology


About Enalapril
Angiotensin converting enzyme (ACE) inhibitor, Antihypertensive.
Mechanism of Action of Enalapril
It is a prodrug and converted in to active Enalaprilat; which is an angiotensin converting enzyme inhibitor prevents the conversion of angiotensin-1 to angiotensin-2 and abolishes the pressor actions of angiotensin. It decreases aldosterone secretion, sodium and water retention, and total peripheral resistance, leads to fall in BP. The arterioles dilate and the compliance of larger arteries is increased. Both systolic and diastolic BP is lowered. It has no effect on cardiac output and cardiovascular reflexes. And there is little dilatation of capacitance vessels; so postural hypotension is not a problem. The drug does not compromise renal, cerebral, and coronary blood flow. The drug also increases plasma kinin levels and potentiate the hypotensive action of exogenously administered bradykinin. It is used for treatment of systolic heart failure, because it improves symptoms, decrease mortality and reduce ventricular hypertrophy. It reduces both preload and after load and thus increasing cardiac out put in patients with heart failure.
Pharmacokinets of Enalapril
Absorption: Absorbed orally up to60%
Distribution: Widely distributed, but poor brain penetration.
Metabolism: Metabolized in to active metabolite Enalaprilat
Excretion: Excreted mainly through urine and a small amount is excreted through faeces
Onset of Action for Enalapril
1 hour
Duration of Action for Enalapril
24 hour
Half Life of Enalapril
11 hours
Side Effects of Enalapril
1. Cough
2. Angioedema
3. Hypotension
4. Bradycardia
5. Hyperkalemia
6. Rashes
7. Urticaria
8. Swelling of lips, mouth, nose and larynx
9. Fetopathic in later half of pregnancy
10. Headache
11. Diarrhoea
12. Fatigue
13. Dizziness
14. Nausea
15. Acute renal failure is precipitated in renal artery stenosis
16. Transient increase in liver enzymes.

Contra-indications of Enalapril
1. Hypersensitivity to the drug
2. Renal artery stenosis
3. Aortic stenosis
4. Coarctation of aorta

Special Precautions while taking Enalapril
1. Renal impairment
2. Patient at high risk of cardiogenic shock, severe heart failure etc
3. Anaesthesia and surgery
4. Stops diuretics 2 to 3days before Enalapril therapy
Pregnancy Related Information
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Enalapril
1. Hypertension
2. Congestive heart failure
3. Left ventricular dysfunction

Interactions for Enalapril
Antacids: Decrease effeciency of Captopril.
Indomethacin: Reduces hypotensive effect.
Digoxin: Increases plasma digoxin levels.
Potassium preparations & potassium sparing diuretics: Hyperkalaemia and increased risk of renal failure.
Lithium: Toxicity due to increased serum concentration of lithium.
Immunosuppressive Drugs : Increased risk of bone marrow depression.
Antidepressants, diuretics, Beta-blockers, Nitrates, Dopaminergics, Calcium channel blockers, Phenothiazines: Enhance hypotensive effect.
Morphine: Enhanced analgesic effect and respiratory depression.
Typical Dosage for Enalapril
5mg once daily. Increases the dose to 10 to 20mg once daily or as two divided doses depending on patient`s response if required.
Maximum dose: 40mg/day
In patient on diuretic therapy & In CHF patients starts the dosage with 2.5mg once daily dosage and increases to usual dosage.
Left ventricular dysfunction: Starts with 2.5mg orally twice daily. Increases the dosage up to 20mg/day in two divided doses.
Children : 0.1 to 0.5mg/kg/day once daily or in divided doses as suspension of crushed tablets.
Schedule of Enalapril
Storage Requirements for Enalapril
Store at room temperature in a well closed container and protect from moisture.
Effects of Missed Dosage of Enalapril
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Do not double the dose.
Effects of Overdose of Enalapril
Treatment is supportive and symptomatic. To remove drug from the body perform induced emesis and gastric lavage. Administer activated charcoal to reduce absorption. In severe cases haemodialysis is considered if required. Treatment includes I.V. infusion of normal saline solution.

Home Delivery for Enalapril in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including enalapril.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for enalapril and other medicines and health products. Home delivery services for enalapril may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take enalapril only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for enalapril before they complete the sale. You can get this information while placing the order for enalapril with the pharmacy.

Enalapril is a generic medicine name and there are several brands available for it. Some of the brands for enalapril might be better known than enalapril itself. If the pharmacy that's willing to deliver medicines to your home doesn't have enalapril in stock, you can ask for one of the branded alternatives for enalapril.