Drug Index


Mechanism :

Enalapril is a specific competitive inhibitor of angiotensin I-converting enzyme (ACE), the enzyme responsible for the conversion of angiotensin I to angiotensin II.

Indication :

  • Hypertension
  • Hypertensive crisis
  • Congestive cardiac failure
  • Proteinuria

Contraindications :

Enalapril is contraindicated in patients who are hypersensitive to this product or any other angiotensin-converting enzyme inhibitor. Avoid in neonates, in volume depletion and renovascular disease. Not recommended in neonates and in pediatric patients with glomerular filtration rate <30 mL/min/1.73 m2.

Dosing :

Use in children above 1 month of age.
0.1-0.5 mg/kg/day PO OD or in 2 divided doses. Max: 40 mg/day. Adjust according to blood pressure.
0.01-0.02 mg/kg/day in two divided doses.
Hypertensive crisis:
0.05-0.1 mg/kg given as an intravenous injection.

Adverse Effect :

Neutropenia, agranulocytosis, anemia, thrombocytopenia, pancytopenia, rash, pruritus, arthralgia, fever, eosinophilia, hypotension, angioedema, cough.

Interaction :

Diuretics: A precipitous reduction of blood pressure usually within the first hour of receiving the initial dose of enalapril.
Potassium-sparing diuretics such as spironolactone, triamterene, or amiloride: Since enalapril decreases aldosterone production, elevation of serum potassium may occur.
Nonsteroidal anti-inflammatory agents: Reduces the antihypertensive effect of enalapril.
Lithium: Increased serum lithium levels and symptoms of lithium toxicity.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Start with 2.5 mg per day and increase according to response
<10Start with 2.5 mg per day and increase according to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. Dose as in GFR<10 mL/ min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDDialysed. Dose as in GFR=10– 20 mL/min

Hepatic Dose :

No dosage adjustments are recommended.
03/20/2024 23:30:42 Enalapril
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