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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

 

 

 


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

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates 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. All material presented here is unclassified.

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