Enalapril/Enalaprilat (Vasotec)

Category:

  • Antihypertensive

Description:

  • ACE inhibitor

Indications:

  • Hypertension

  • Heart failure

  • Left ventricular dysfunction (clinically stable asymptomatic patients, decreases rate of overt heart failure)

Precautions:

  • Pregnancy category C (1st trimester), category D (2nd and 3rd trimesters); ACE inhibitors can cause fetal and neonatal morbidity and death when administered to pregnant women

  • Impaired renal function, dialysis patients, hypovolemia, diuretic therapy

  • Collagen-vascular diseases, CHF, elderly, bilateral renal artery stenosis

Adverse Reactions (Side Effects):

  • CNS: anxiety, dizziness, fatigue, headache, insomnia, paresthesia

  • CV: angina, hypotension, palpitations, postural hypotension, syncope

  • GI: abdominal pain, constipation, melena, nausea, vomiting

  • GU: decreased libido, impotence, increased BUN/creatinine, UTI

  • METAB: hyperkalemia, hyponatremia

  • MS: arthralgia, arthritis, myalgia

  • RESP: asthma, bronchitis, cough, dyspnea, sinusitis

  • SKIN: angioedema, flushing, rash, sweating

 

Dosage:

Administered orally, intravenously

  • Adult:   PO 2.5-5mg daily, increase as needed, usually 10-40mg daily divided 1-2 times; IV (enalaprilat) 0.625-1.25 mg/dose given over 5 minutes every 6 hours; dosing adjustment in renal impairment: CrCl 10-50 ml/min, 75%-100% of normal dose; CrCl <10 ml/min, 50% of normal dose

  • Child:   PO 0.1 mg/kg/day initially, increase as needed over 2 weeks to max of 0.5 mg/kg/day; IV (enalaprilat) 5-10 mcg/kg/dose every 8-24 hours

Drug interactions:

  • Allopurinal: predisposition to hypersensitivity reactions to ACE inhibitors

  •  Aspirin, NSAIDS: inhibition of the antihypertensive response to Ace inhibitors

  •  Prazosin, terazosin, doxazosin: exaggerated first-dose hypotensive response to a-blockers

 

 

 

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Approved for public release; Distribution is unlimited.

The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks.

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300.

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001

United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

*This web version is provided by The Brookside Associates, LLC.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. The medical information presented was reviewed and felt to be accurate in 2001. Medical knowledge and practice methods may have changed since that time. Some links may no longer be active. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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