HEALTH CANADA ADVISORY
February 4, 2014
Health Canada has issued new restrictions concerning the use of enalapril. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ACE inhibitors, including enalapril, although uncommonly. If you experience swelling of the face, tongue, or throat, you should stop taking this medication at once and get immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving an ACE inhibitor such as enalapril.
Cough: People taking enalapril may develop a dry, persistent cough that usually disappears only after stopping or lowering the enalapril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.
Kidney function: Changes in kidney function have been seen in certain people taking this medication.
Liver function: Changes in liver function have occurred in people with or without preexisting liver problems during treatment with this medication. In most cases, the changes were reversed when the medication was stopped.
Low blood pressure: Occasionally, blood pressure drops too low after taking enalapril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur in those who are on dialysis, are suffering from diarrhea or vomiting, are sweating excessively and not drinking enough fluids, have a salt-restricted diet, or are taking water pills. If low blood pressure causes you to faint or feel lightheaded, contact a doctor.
Potassium levels: Increases in blood levels of potassium occur for a small percentage of people taking enalapril. This rarely causes problems, but potassium levels should be monitored by your doctor.
Pregnancy: ACE inhibitors should not be taken by pregnant women. If you discover you are pregnant, you should stop taking enalapril at once.
Breast-feeding: Enalapril passes into breast milk in trace amounts. This medication should not be used by breast-feeding women.
Children: The safety and effectiveness of this medication have not been established for children. Its use by children is not recommended.