Detailed Drug Information:

DRUG CLASS AND MECHANISM: Enalapril is an ACE(angiotensin converting enzyme) inhibitor. ACE is an enzyme in the bodywhich is important for the formation of angiotensin II. Angiotensin IIcauses constriction of arteries in the body, thereby elevating bloodpressure. ACE inhibitors, such as enalapril, lower blood pressure byinhibiting the formation of angiotensin II, thus relaxing the arteries.Relaxing the arteries not only lowers blood pressure, but also improvesthe pumping efficiency of a failing heart and improves cardiac output inpatients with heart failure.

PREPARATIONS: tablets: 2.5 mg, 5 mg, 10 mg, 20 mg.

STORAGE: Tablets should be stored at room temperature in a tightly closed container.

PRESCRIBED FOR: Enalapril can be used alone in treating highblood pressure. Its blood pressure lowering effect can be further enhancedby the addition of a diuretic medication. Vaseretic is an example of amedication that combines the effect of enalapril with a thiazide-typediuretic (water pill) to reduce blood pressure. By reducing resistance inthe arteries, enalapril can be useful in the treatment of congestive heartfailure. In treating heart failure, enalapril usually supplementsconventional treatment, including a diuretic and digoxin (Lanoxin). Aftera heart attack, enalapril has been found to be effective in improvingfunctioning of the damaged heart, and in reducing symptoms andhospitalizations related to heart failure.

PROPER USE: Should be taken on an empty stomach one hour before meals.

PRECAUTIONS: Enalapril should not be taken by people with aknown allergy to ACE inhibitors. Swelling of the facial tissues and eventhe upper airways has been reported with ACE inhibitors on very rareoccasions, and can lead to serious breathing difficulties. Enalapril caninteract with diuretics (water pills) and other blood pressure medicinesto cause an excessive drop in blood pressure, which can cause symptoms ofweakness, dizziness, and lightheadedness. Impairment of kidney functionhas been reported with ACE inhibitors, especially in patients with severeheart failure or pre-existing kidney disease.

Combining enalapril with potassium supplements, potassium containingsalt substitutes, and potassium-conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium.

In rare instances, low white blood cell counts have been reported withthe use of captopril, another ACE inhibitor. Low white blood cellsincrease the patient's risk of infections. When taken with lithium,enalapril can increase lithium to toxic levels in the blood. Safe use inchildren is not established. It is not habit forming.

PREGNANCY: ACE inhibitors, including enalapril, can be harmful to the fetus and should not be taken by pregnant women.

NURSING MOTHERS: ACE inhibitors, including enalapril, should be avoided in nursing mothers.

SIDE EFFECTS: Enalapril is generally well tolerated and side effects are usually mild and transient. A dry, persistent cough has beenreported with the use of ACE inhibitors. Coughing resolves after discontinuing the medication. Other side effects are rare and includeabdominal pain, diarrhea, dizziness, fatigue, headache, loss of appetite, nausea and vomiting, chest pain, severe dizziness or fainting, numbness or tingling in the hands or feet, rash, and a sore or swollen throat. In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors.