How should I use this medication?
The recommended starting dose for high blood pressure is 2.5 mg to 5 mg taken once a day. The usual treatment dose ranges from 2.5 mg once daily to 20 mg twice daily, depending on the needs and circumstances of the person using the medication. The dose may need to be adjusted according to how well the kidneys are functioning and the effectiveness of the medication.
The starting dose for children less than 16 years of age is based on body weight and will be calculated by your child’s doctor.
The recommended starting dose to treat congestive heart failure is 2.5 mg taken once a day. The dose may be increased gradually to a maximum of 40 mg daily, depending on the effectiveness of the medication.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, and it is within 6 hours of your regularly scheduled time, administer it as soon as possible and continue with your regular schedule. If more than 6 hours has passed, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from moisture and keep out of reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
What form(s) does this medication come in?
Each white, oval, biconvex tablet debossed with "2.5" scoreline "G" on one side and a scoreline on the other contains 2.5 mg of enalapril maleate. Nonmedicinal ingredients: corn starch, lactose monohydrate, magnesium stearate, pregelatinized starch, and sodium bicarbonate.
Each white, arc-triangle-shaped, biconvex tablet debossed with "5" over "G" on one side and a scoreline on the other contains 5 mg of enalapril maleate. Nonmedicinal ingredients: corn starch, lactose monohydrate, magnesium stearate, pregelatinized starch, and sodium bicarbonate.
Each rusty red, arc triangle shaped, biconvex tablet debossed with "10" over "G" on one side and scoreline on the other contains 10 mg of enalapril maleate. Nonmedicinal ingredients: corn starch, iron oxide red 30, lactose monohydrate, magnesium stearate, pregelatinized starch, and sodium bicarbonate.
Each peach coloured, arc-triangle-shaped, biconvex tablet debossed with "20" over "G" on one side and scoreline on the other contains 20 mg of enalapril maleate. Nonmedicinal ingredients: corn starch, iron oxide brown 70, lactose monohydrate, magnesium stearate, pregelatinized starch, and sodium bicarbonate.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal pain
- cough (dry, persistent)
- loss of appetite
- sore throat
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- chest pain
- dizziness, lightheadedness, or fainting (signs of low blood pressure)
- flu-like symptoms (sudden lack of energy, fever, cough, sore throat)
- shortness of breath
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- signs of too much potassium in the body (e.g., confusion; irregular heartbeat; nervousness; numbness or tingling in the hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness of legs)
- symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heart beat, weakness
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of angioedema (e.g., swelling of face, mouth, hands, or feet)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
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.
Diabetes: Enalapril may cause a loss of blood glucose control, and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: Changes in kidney function have been seen in certain people taking this medication. The use of diuretics (water pills) or aliskiren may further increase the risk of kidney problems for those already at risk for this problem. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
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. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
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 take aliskiren, are on dialysis, are experiencing diarrhea or vomiting, are sweating excessively and not drinking enough fluids, have a salt-restricted diet, or are taking water pills. People with these conditions should be monitored closely by their doctor for the first weeks of treatment and whenever the dose of the medication is increased. To reduce the risk of dizziness, get up slowly from a lying down or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.
Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.
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. Avoid using salt substitutes that contain potassium while you are taking enalapril.
Pregnancy: ACE inhibitors such as enalapril may cause severe harm or death to the developing fetus if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk in small amounts. If you are a breast-feeding mother and are taking enalapril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for infants and children with decreased kidney function.
Seniors: Seniors have an increased risk of experiencing side effects when taking enalalpril due to reduced kidney function. Lower doses may be necessary to minimize side effects.