ACE refers to angiotensin converting enzyme. One of the mostly preferred medicine to work as an ACE inhibitor is Enalapril.
Enalapril is mainly used to control hypertension caused due to high blood pressure in adults & in children (who are at least 1 month old). Another use of this medicine is used to treat patients with congestive heart failure. It can be further used to any disorder in the lower chambers of the heart which help the blood to flow out, that is, the ventricles. Any disorder in the ventricles can compromise the ability of the heart to pump blood out of the body.
You should never take in enalapril if you are pregnant or should stop taking it if you become pregnant & in that case your doctor should be informed immediately.
If you have ever suffered from angioedema then you should not take enalapril. You should not take in enalapril while you are suffering from diabetes & you are on medicines containing aliskiren (like Tekturna, Tekamlo, & Amturnide). Even your electrolyte levels can get fluctuated while you are on enalapril. You should immediately get medical assistance if you feel tingly & develop a chest pain, pounding heartbeats, heart rate getting slow, chest fluttering, pulse weakening, & difficulty while contracting muscles, muscles becoming weak & stiff.
How Does Enalapril Work?
Angiotensin-converting enzymes inhibitors or ACE inhibitors are a group of medicines under which enalapril belongs.
The main purpose of enalapril is to inhibit the action of the enzyme called angiotensin-converting enzyme. The enzyme works as a vasoconstrictor & narrows arteries by producing a powerful angiotensin II. This further leads to the release of the hormone aldosterone from adrenal glands which increase the blood pressure. By opening up the arteries, enalapril works as an inhibitor & prevents high blood pressure levels.
How Effective is Enalapril?
The medicine enalapril is highly effective on the patients suffering from heart failure and high blood pressure.
Without causing an orthostatic effect, that is, lowering blood pressure suddenly while standing from sitting causing loss of balance, enalapril helps to lower blood pressure level both while lying down & standing. Yet, patients who are dehydrated may suffer from an orthostatic effect.
When a patient of heart failure is given enalapril, it decreases the size of the heart & manages how much blood can be pumped through the heart. The medicine enalapril further develops & increases exercise tolerance level without bringing any effect on the heart rate. Enalapril further effectively brings down the risk of severe heart failure & can prevent hospitalization, breathlessness & tiredness. These benefits can be noticed if the dosage is continued regularly.
Enalapril can work alone & also with other medicines to control blood pressure level & keep it down.
Enalapril can be taken in empty stomach or with food.
If you recognize any sign of angioedema like swelling of the face, throat or breathlessness, inform your doctor immediately.
A sudden fall in the blood pressure may occur. You should consult your doctor & he or she may suggest then to continue the therapy to get over this symptom or not. But you must remember to always keep yourself dehydrated.
You should avoid using potassium containing slats unless you consult your doctor about consuming it.
If you develop a sore throat or fever then report your doctor immediately. It may be so that you are developing a decrease in the count of the white blood cells known as neutropenia which can be confirmed after preforming tests.
The response & effectiveness of enalapril is excellent. You can see the reaction of enalapril from within an hour of consuming it. Within an hour of taking it in orally, peak concentration is reached & then enalapril is hydrolyzed in enalaprilat. This is a stronger ACE inhibitor & it reaches its peak concentration within 3 to 4 hours of taking in enalapril.
The lowering of blood pressure level is noticed in an hour of taking in enalapril. The highest effect is reached within 6 hours & this effect of low blood pressure remains up to 24 hours. For some patients the effect may wear off at towards the end of 24 hours. It may take several weeks before the blood pressure level is made optimum. If you quit taking enalapril suddenly, there will be a sudden rise in blood pressure. It is usually suggested that such anti hypersensitive drugs is discontinued slowly over time.
What is the Recommended Dosage of Enalapril?
General Adult Dose of Enalapril for Hypertension:
Dosage initially: take in 5 milligrams in the form of oral tablets or solution once a day
Dosage for maintenance: take in 10 to 40 milligrams in the form of oral tablets in a single dose or divide it into 2 dosages equally.
Maximum dosage: take in 40 milligrams in the form of oral tablets once a day or divide equally into 2 dosages.
Along with diuretics:
Initial dosage: take in 2.5 milligrams once a day orally.
If possible, at least 2 to 4 days prior to the therapy with enalapril, diuretic should be stopped or discontinued. Diuretics therapy shall only resume continuation slowly if required.
General Adult Dose of Enalapril for Congestive Heart Failure:
Dosage initially: take in 2.5 milligrams in the form of oral tablets once a day
Dosage for maintenance: take in 2.5 to 20 milligrams in the form of oral tablets divided into 2 dosages equally.
Maximum dosage: take in 40 milligrams in the form of oral tablets divided into 2 dosages.
General Adult Dose of Enalapril for Left Ventricular Dysfunction:
Dosage initially: take in 2.5 milligrams in the form of oral tablets twice a day
Dosage for maintenance: take in 20 milligrams in the form of oral tablets divided into 2 dosages equally.
General Pediatric Dose of Enalapril for Hypertension:
For children of age 1 month to 17 years
Dosage initially: take in up to 5 milligrams (0.08 milligrams/kg/day) in the form of oral tablets or solution once a day or divide the dosage equally in 2 intakes. After watching the response of the patient, the dosage can be adjusted.
Maximum dosage: take in only up to 40 milligrams. Evaluation of higher dosage in children like any dosage that is greater than 0.58 milligrams/kg (or 40 milligrams) has not be done yet.
What are the Side Effects of Enalapril?
You can experience certain kinds of effects if you are between the age 18 & 60 & you re under any other medication along with enalapril. The symptoms you may face are:
- The most common side effects are headache, fatigue & dizziness.
- Coughing is another side effect which arises if any ACE inhibitor is discontinued suddenly.
- If the patient is dehydrated, is going through diuretic therapy or having depletion in the sodium level of the body, there is a higher risk of sudden & a large fall of blood pressure level.
- Angioedema on the face, lips, tongue, throat & other extremities may arise. If angioedema leads to breathing trouble, then discontinuation of enalapril dosage is recommended.
- Only rarely sudden blood disorders & liver failure may occur.
- The lowering of blood pressure level with the use of enalapril is not usually highly effective on the patients of African-American ethnicity. Such patients are more inclined to developing angioedema which leads to swelling of the head & neck along with other skin reactions.
- Enalapril may lead to the rise of blood potassium level which may in turn cause risk for the patients suffering from diabetes or kidney failure & therefore is going through potassium-sparing diuretics as a treatment method.
- For some people enalapril may not suit when he or she is under other medications like NSAIDs & therefore always consult a doctor before taking in any other medicine along with enalapril.
If you develop any kind of allergic reaction to enalapril like hives & rashes on the skin, breathing problems, swelling of the face, lips, tongue, throat or stomach pain then get medical help immediately.
You should go to a doctor in you develop:
- Slow heartbeat
- Pounding heartbeat & fluttering of the chest
- Burning, tingly or numbness in the feet & hands.
- Bruising easily & bleeding unusually
- Cough, cold & flu
- Loss of movement, dizziness & weakness due to high potassium level.
There can be other side effects too & thus you must consult your doctor or call the medical helpline if you develop any kind of unusual effect.
To treat patients of high blood pressure & heart failure, enalapril is effectively used, this medicine is found to be not effective on the people who descent from the African-American origin.