Enalapril dosage

For conversion from IV to oral therapy, the recommended initial dose of enalapril maleate tablets for patients who have responded to 0.625 mg enalaprilat every 6 hours is 2.5 mg once a day with subsequent dosage adjustment as needed. 

A 52-year-old woman took glipizide and enalapril and then, because of persistent hyperglycemia, metformin 1000 mg/day (103). Her liver enzymes were normal, and after 2 weeks the dosage of metformin was increased to 2000 mg/day. Two weeks later she became icteric and her bilirubin and liver enzymes were increased. Serological studies were negative. All drugs were withdrawn. A liver biopsy was consistent with... 

There have been numerous reports of different rashes in association with ACE inhibitors. The most common skin reaction is a pruritic maculopapular eruption, which is reportedly more common with captopril (2-7%) than with enalapril (about 1.5%). This rash occurs in the usual dosage range and is more common in patients with renal insufficiency (70). Lichenoid reactions, bullous pemphigoid, exfoliative dermatitis, flushing and erythroderma, vasculitis/purpura, subcutaneous lupus erythematosus, and reversible alopecia have aU been reported (70-72). 

Even low dosages of angiotensin-converting enzyme (ACE) inhibitors, such as enalapril, can cause profound first-dose hypotension in hypertensive patients treated with a thiazide (37). This is rare if volume depletion and sodium depletion are avoided. 

Orally effective product. More potent than enalapril. Once-a-day dosage... 

Qin, X.-Z. DeMarco, J. Ip, D.P. Simultaneous determination of enalapril, felodipine and their degradation products in the dosage formulation by reversed-phase high-performance liquid chromatography using a Spherisorb Cs column. J.Chromatogr.A, 1995, 707, 245-254... 

Sane, R.T. Vaidya, A.J. Ghadge, J.K. Jani, A.B. Kotwal, S.K. Estimation of enalapril maleate in pharmaceutical dosage by HPLC. Indian Drugs, 1992,29, 244-245... 

Lisinopril (prinivil, zestril) Lisinopril is the Lys analog of enalaprilat unUke enalapril, lisinopiil itself is active. Lisinopril is slightly more potent than enalaprilat. Lisinopril is absorbed slowly, variably, and incompletely (about 30%) after oral administration (bioavailability is not reduced by food) peak concentrations in plasma are achieved in -7 hours. It is cleared intact by the kidney, and its tj, in plasma is about 12 hours. The oral dosage of lisinopril ranges from 5 to 40 mg daily (single or divided dosage), with 5 and 10 mg daily being appropriate for the initiation of therapy for heart failure and hypertension, respectively. A daily dose of 2.5 mg is recommended for patients with heart failure who are Na+-depleted or have renal impairment. 

Low-dose aspirin (less than or equal to 100 mg daily) does not alter the antihypertensive efficacy of captopril and enalapril. No special precautions would therefore seem to be required with ACE inhibitors and these low doses of aspirin. A high dose of aspirin (2.4 g daily) has been reported to interact in 50% of patients in a single study. Aspirin 300 mg daily has been reported to interact in about 50% of patients in another study, whereas 325 mg daily did not interact in further study. Thus, at present, it appears that if an ACE inhibitor is used with aspirin in doses higher than 300 mg daily, blood pressure should be monitored more closely, and the ACE inhibitor dosage raised if necessary. Intermittent use of aspirin should be eonsidered as a possible cause of erratic control of blood pressure in patients on ACE inhibitors. 

The manufacturer of spirapril briefly noted in a review that there was no relevant pharmacokinetic interaction between spirapril and diclofenac. Oxaprozin 1.2 g daily for 3 weeks did not affect the pharmacokinetics of enalapril 10 to 40 mg daily in 29 patients with hypertension. A brief mention is made in a review that, in healthy subjects, the pharmacokinetics of ramipril were unaffected by indometacin [dosage not stated] given for 3 days. ... 

A woman taking lithium carbonate developed signs of lithium toxicity (ataxia, dysarthria, tremor, confusion) within 2 to 3 weeks of starting to take enalapril 20 mg daily. After 5 weeks her plasma-lithium levels had risen from 0.88 to 3.3 mmol/L, and moderate renal impairment was noted. No toxicity occurred when the enalapril was later replaced by nifedipine. Lithium toxicity following the use of enalapril, and associated in some cases with a decrease in renal function, has been seen in another 5 patients, " and a reduced lithium dosage was found adequate in another patient. Enalapril 5 mg daily for 9 days had no effect on the mean serum-lithium levels of 9 healthy male subjects. However, one subject had a 31% increase in lithium levels. "... 

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