Enalapril: Price, Dosage & Where to Buy

Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure. It lowers blood pressure and is also prescribed for symptomatic heart failure and certain patients whose main heart pumping chamber is weakened but who do not yet have symptoms. Enalapril requires a prescription in the United Kingdom and is available as tablets and an oral solution.

Enalapril is indicated for high blood pressure, either alone or alongside other blood pressure medicines, particularly thiazide-type diuretics. It is also indicated for symptomatic congestive heart failure, usually alongside diuretics and digitalis. In these patients, the label describes improved symptoms, increased survival and fewer hospital admissions.

Another indication is asymptomatic left ventricular dysfunction: weakness of the heart's main pumping chamber in clinically stable patients who do not have symptoms. In this group, enalapril reduces the development of overt heart failure and hospital admissions for heart failure.

Enalapril belongs to the ACE inhibitor class. These medicines block an enzyme involved in producing angiotensin, a substance that narrows blood vessels. Reducing this effect allows blood vessels to relax, lowering blood pressure and reducing the resistance against which the heart pumps.

ACE inhibitors also reduce signals that encourage the body to retain salt and water. Together, these effects help explain their role in treating high blood pressure and supporting the heart in heart failure.

The label lists oral tablets in strengths of 2.5 mg, 5 mg, 10 mg and 20 mg, and an oral solution of 1 mg/mL. The usual starting dose is 5 mg once a day for hypertension in patients not receiving diuretics. The label lists a usual hypertension dosage range of 10 mg to 40 mg per day, administered as a single dose or divided doses.

The label lists an initial dose of 2.5 mg under medical supervision when a diuretic cannot be discontinued. The label lists an initial heart failure dose of 2.5 mg and a recommended range of 2.5 mg to 20 mg twice a day. The label lists 2.5 mg twice daily initially for asymptomatic left ventricular dysfunction, with a targeted daily dose of 20 mg in divided doses.

Dose selection and adjustment depend on blood pressure response, tolerability, kidney function and other treatment. Medical supervision is described when treatment begins in patients at risk of low blood pressure.

A missed dose can interrupt the regular blood pressure-lowering effect of an ACE inhibitor. General pharmacy advice is to resume the usual schedule rather than double a dose to compensate.

If the next scheduled dose is near, the missed dose is usually omitted. A pharmacist can clarify the approach for the prescribed schedule.

Enalapril can cause injury and death to the developing baby. The label calls for discontinuation as soon as possible when pregnancy is detected.

Enalapril and enalaprilat have been detected in human breast milk. Because serious adverse reactions are possible in breastfed infants, a decision is needed about stopping breastfeeding or stopping enalapril, taking account of the medicine's importance to the mother.

The tablet label specifies storage at 20° to 25°C. Keep the container tightly closed and protect the tablets from moisture to maintain quality. Storage instructions for the oral solution should be checked on its own packaging.