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Back to Cardiology Drug index
Name: Enalapril maleate
Pregnancy Category C
Drug classes
Mechanism of action
Renin, synthesized by the kidneys, is released into the circulation
where
it acts on a plasma precursor to produce angiotensin I, which is
converted by angiotensin-converting enzyme to angiotensin II, a potent
vasoconstrictor that also causes release of aldosterone from the
adrenals; both of these actions increase blood pressure. Enalapril
blocks
the conversion of angiotensin I to angiotensin II, decreasing blood
pressure, decreasing aldosterone secretion, slightly increasing serum
potassium levels, and causing sodium and fluid loss; increased
prostaglandin synthesis also may be involved in the antihypertensive
action.
Indications
- Treatment of hypertension alone or in combination with thiazide-type
diuretics
- Treatment of acute and chronic CHF
Contraindications/cautions
- Contraindicated in the presence of allergy to enalapril.
- Use caution in the presence of impaired renal function; salt/volume
depletion-hypotension may occur; lactation.
Adverse effects
- CNS: Headache, dizziness, fatigue, insomnia, paresthesias
- GI: Gastric irritation, nausea, vomiting, diarrhea, abdominal pain,
dyspepsia, elevated liver enzymes
- CV: Syncope, chest pain, palpitations, hypotension in salt/volume
depleted patients
- Hematologic: Decreased hematocrit and hemoglobin
- GU: Proteinuria, renal insufficiency, renal failure, polyuria,
oliguria,
urinary frequency, impotence
- Other: Cough, muscle cramps, hyperhidrosis
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