ENALAPRIL

Do not take enalapril if you are pregnant. If you become pregnant while taking enalapril, call your doctor immediately. Enalapril may harm the fetus.

Major Side Effects:

You should check with your doctor immediately if any of these side effects occur when taking enalapril:

More common:

• Blurred vision
• Confusion
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Sweating
• Unusual tiredness or weakness
• Less common:
• Chest pain
• Cough producing mucus
• Diarrhea
• Difficult or labored breathing
• Fainting
• Fever or chills
• Nausea
• Sneezing
• Sore throat
• Tightness in the chest
• Vomiting

Minor Side Effects:

Some of the side effects that can occur with enalapril may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

• Dizziness
• Less common:
• Lack or loss of strength
• Rash

Precautions

Before taking enalapril,

• Tell your doctor and pharmacist if you are allergic to enalapril; other ACE inhibitors such as benazepril, captopril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril; any other medications; or any ingredients in enalapril tablets. Ask your pharmacist for a list of the ingredients.
• Tell your doctor if you have diabetes and you are taking aliskiren. Your doctor will probably tell you not to take enalapril if you have diabetes and you are also taking aliskiren.
• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin; diuretics (‘water pills’); lithium; and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• Tell your doctor if you have or have ever had heart or kidney disease; lupus; scleroderma (a condition in which extra tissue grows on the skin and some organs); diabetes; or angioedema (a condition that causes difficulty swallowing or breathing and painful swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs).
• Tell your doctor if you are breastfeeding.
• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking enalapril.
• You should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

Interactions

May potentiate hypotensive action with diuretics, and other anti-hypertensives, TCAs, nitrates or anesthesia. Concomitant administration with lithium carbonate may cause lithium toxicity. Increased risk of renal impairment with NSAIDs. May increase hyperkalemic effect (increased potassium level) w/ potassium-sparing diuretics and supplements. May increase hypotensive effect (low blood pressure) with alcohol.

Symptoms of overdose may include the following lightheadedness and fainting. If overdose is suspected, bring the victim to the hospital immediately.

Available brands:

• Hypril (Intas)
• Pharex Enalapril Maleate (Pascual Lab/Pharex)
• Renitec (MSD)
• RiteMED Enalapril (RiteMED)