Generic name: enalapril (e NAL a pril)
Brand name: Vasotec
Drug class: Angiotensin Converting Enzyme Inhibitors
Vasotec (enalapril) is an ACE inhibitor. ACE stands for angiotensin converting enzyme.
Vasotec is used to treat high blood pressure (hypertension) in adults and children who are at least 1 month old.
Vasotec is also used to treat congestive heart failure in adults.
Vasotec is also used to treat a disorder of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart). This disorder can decrease the heart's ability to pump blood to the body.
Warnings
Do not use Vasotec if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.
You should not use Vasotec if you have ever had angioedema. Do not take Vasotec within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).
If you have diabetes, do not use enalapril together with any medication that contains aliskiren (a blood pressure medicine).
Vasotec can affect your heart or your electrolyte levels. Call your doctor if you have chest pain, pounding heartbeats or fluttering in your chest, a slow heart rate or weak pulse, a tingly feeling, muscle weakness, or muscle tightness or contraction.
Before taking this medicine
You should not use Vasotec if you are allergic to enalapril:
- you have hereditary angioedema;
- you recently took a heart medicine called sacubitril; or
- you have ever had a severe allergic reaction to any ACE inhibitor (benazepril, captopril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril).
Do not take Vasotec within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).
If you have diabetes, do not use enalapril together with any medication that contains aliskiren (a blood pressure medicine).
You may also need to avoid taking enalapril with aliskiren if you have kidney disease.
To make sure this medicine is safe for you, tell your doctor if you have:
- kidney disease (or if you are on dialysis);
- liver disease; or
- an electrolyte imbalance (such as high levels of potassium in your blood).
Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Enalapril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.
You should not breast-feed while you are using Vasotec.
Enalapril is not approved for use by anyone younger than 1 month old.
How should I take Vasotec?
Take Vasotec exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested.
Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking Vasotec. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.
If you need surgery, tell the surgeon ahead of time that you are using enalapril.
If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
Dosing information
Usual Adult Dose for Hypertension:
Initial dose: 5 mg orally once a day
Maintenance dose: 10 to 40 mg orally per day as a single dose or in 2 divided doses
Maximum dose: 40 mg orally daily as a single dose or in 2 divided doses
In combination with diuretics:
Initial dose: 2.5 mg orally once a day
If feasible, the diuretic should be discontinued 2 to 3 days prior to initiation of therapy with enalapril. If required, diuretic therapy may be gradually resumed.
Usual Adult Dose for Congestive Heart Failure:
Initial dose: 2.5 mg orally once a day
Maintenance dose: 2.5 to 20 mg daily in 2 divided doses
Maximum dose: 40 mg orally per day in 2 divided doses
Comments:
-Treatment is usually combined with diuretics and digitalis.
-Doses should be titrated upward, as tolerated, over a period of a few days or weeks.
Usual Adult Dose for Left Ventricular Dysfunction:
Initial dose: 2.5 mg orally twice a day
Maintenance dose: 20 mg orally per day in 2 divided doses
Comments:
-After the initial dose, the patient should be observed for at least 2 hours and until blood pressure has stabilized for at least an additional hour.
-If possible, the dose of any concomitant diuretic should be reduced which may diminish the likelihood of hypotension.
Usual Pediatric Dose for Hypertension:
Children 1 month to 17 years:
Initial dose: 0.08 mg/kg/day (up to 5 mg) in 1 to 2 divided doses. Adjust dosage based on patient response.
Maximum dose: Doses greater than 0.58 mg/kg (40 mg) have not been evaluated in pediatric patients.
Comment:
-Not recommended in neonates and in pediatric patients with glomerular filtration rate less than 30 mL/min, as no data are available.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What to avoid
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Enalapril can decrease sweating and you may be more prone to heat stroke.
Drinking alcohol can further lower your blood pressure and may increase certain side effects of enalapril.
Do not use potassium supplements or salt substitutes, unless your doctor has told you to.
Vasotec side effects
Get emergency medical help if you have signs of an allergic reaction to Vasotec: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.
Call your doctor at once if you have:
- a light-headed feeling, like you might pass out;
- chest pain;
- jaundice (yellowing of the skin or eyes);
- little or no urination;
- fever, chills, sore throat; or
- high potassium - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.
Common Vasotec side effects may include:
- dizziness;
- tiredness; or
- feeling light-headed.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Vasotec?
Tell your doctor about all your current medicines. Many drugs can interact with enalapril, especially:
- a diuretic ("water pill"), or any other blood pressure medications;
- lithium;
- gold injections to treat arthritis;
- insulin or oral diabetes medicine; or
- NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
This list is not complete and many other drugs may interact with Vasotec. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.