Uses and Administration
Enalapril is an ACE inhibitor used in the treatment of hypertension and heart failure. It may also be given prophylactically to patients with asymptomatic left ventricular dysfunction to delay the onset of symptomatic heart failure, and has been used in patients with left ventricular dysfunction to reduce the incidence of coronary ischaemic events, including myocardial infarction.
“ACE inhibitors are antihypertensive drugs that act as vasodilators and reduce peripheral resistance. They inhibit angiotensin-converting enzyme (ACE), which is involved in the conversion of angiotensin I to angiotensin II. Angiotensin II stimulates the synthesis and secretion of aldosterone and raises blood pressure via a potent direct vasoconstrictor effect.”
In the treatment of hypertension in Kenya, an initial dose of 5 mg of enalapril maleate daily may be given by mouth. Since there may be a precipitous fall in blood pressure in some patients when starting therapy with an Enalapril, the first dose should preferably be given at bedtime. An initial dose of 2.5 mg daily should be given to patients with renal impairment or to those who are receiving a diuretic/mostly Hydrochlorothiazide or Furosemide; if possible, the diuretic should be withdrawn 2 or 3 days before enalapril is started and resumed later if necessary. The usual maintenance dose is 10mg to 20 mg given once daily, although doses of up to 40 mg daily may be required in severe hypertension. It may be given in 2 divided doses if control is inadequate with a single dose.
In the management of heart failure, severe first-dose hypotension on introduction of Enalapril is common in patients on loop diuretics, but their temporary withdrawal may cause rebound pulmonary oedema. Thus treatment should be initiated with a low dose under close medical supervision. In patients with heart failure or asymptomatic left ventricular dysfunction enalapril maleate is given by mouth in an initial dose of 2.5 mg daily. The usual maintenance dose is 20 mg daily as a single dose or in 2 divided doses although up to 40 mg daily in 2 divided doses has been given.
Adverse Effects of Enalapril
Treatment with Enalapril in Kenya has been associated with the development of coughs in up to 20% of hypertensive Kenyan patients; cough may be less troublesome in those with heart failure, although the incidence may be higher. The cough is reported to be persistent, paroxysmal, and non-productive; it causes irritation of the throat, may be accompanied by voice changes (hoarseness or huskiness), and is often worse when lying down. It is more common in women and non-smokers, and may be delayed in onset by weeks or even months.
Other adverse effects of Enalapril include hypotension, dizziness, fatigue, headache, and nausea and other gastrointestinal disturbances.
Other Single-ingredient Preparations of Enalapril in Kenya
The symbol ? denotes a preparation which is discontinued or no longer actively marketed.
Arg.: Defluin; Ecaprilat; Enalafel; Enaldun; Enatral; Enatrial; Gadopril; Glioten; Kinfil; Lotrial; Nalapril; Presi Regul; Priltenk; Renitec; Sulocten; Vapresan; Austral.: Alphapril; Amprace; Auspril; Enahexal; Renitec; Austria: Alapril; Enac; Enalabene?; Enapril; Enaran; Enatyrol; Mepril; Regomed?; Renistad; Renitec; Belg.: Renitec; Braz.: Angiopril; Atens; Blootec?; Enalabal; Enalamed; Enalprin; Enapril?; Enaprotec; Enatec; Eupressin; Glioten; Hipertin; Lowpress; Maleapril?; Nalaprix; Neolapril; Pressel?; Pressotec; Renalapril; Renipress; Renitec; Sanvapress; Vasopril; Canad.: Vasotec; Chile: Bajaten; Enalten; Esalfon; Glioten; Grifopril; Hiperson; Hipoartel; Lotrial; Vasolat; Denm.: Aceren; Alacor; Alapren?; Corodil; Enadil; Renitec; Fin.: Enaloc; Enapress; Linatil; Renitec; Fr.: Renitec; Ger.: Benalapril; Corvo; Ena-Puren; Ena; Enabeta; enadura; Enahexal; Enal; Enalagamma; Enalind; Pres; Xanef; Gr.: Agioten; Analept; Antiprex; Erxetilan; Gnostocardin; Kaparlon-S; Kontic; Leovinezal; Megapress; Octorax; Ofnifenil; Protal; Rablas; Renitec; Stadelant; Supotron; Ulticadex; Virfen; Vitobel; Hong Kong: Anapril; Danssan; Renitec; Hung.: Acepril; Ednyt; Enap; Enapril; Invoril; Renitec; India: BQL; EnAce; Envas; Nuril; Irl.: Ednyt; Enap; Innomel; Innovace; Israel: Convertin; Enaladex; Ital.: Converten; Enapren; Naprilene; Malaysia: Acetec; Invoril; Renitec; Zynace; Mex.: Bionafil; Blocatril; Enaladil; Enoval; Feliberal; Glioten; Imotoran; Kenopril; Lipraken; Norpril; Palane; Pulsol; Quimalan; Renitec; Neth.: Renitec; Norw.: Linatil; Renitec; NZ: Enahexal; Renitec; Port.: Balpril; Cetampril; Denapril; Hipten; Malen; Prilan; Renipril; Renitec; Tensazol; S.Afr.: Alapren; Ciplatec; Enap; Hypace; Pharmapress; Renitec; Singapore: Anapril; Corprilor; Daren; Enap; Enaril; Invoril; Korandil; Renaton; Renitec; Spain: Acetensil; Baripril; Bitensil; Clipto; Controlvas; Corprilor; Crinoren; Dabonal; Ditensor; Herten; Hipoartel; Iecatec; Insup; Nacor; Naprilene; Neotensin; Pressitan; Presyndral?; Reca; Renitec; Ristalen?; Swed.: Linatil; Renitec; Switz.: Acepril; Enasifar; Enatec; Epril; Reniten; Vasocor; Thai.: Anapril; Enam; Enapril; Enaril; Invoril; Istopril; Korandil; Lapril; Nalopril; Naritec; Renitec; UAE: Narapril; UK: Ednyt?; Enacard?; Innovace; Pralenal; USA: Vasotec;