ENETEC
ENALAPRIL MALEATE · by ALLIANCE
Composition
Tab 5 mg/10 mg/20 mg: Enalapril maleate 5 mg/10 mg/20 mg. Inj 1 mg: Per ml: Enalapril maleate 1 mg.
Indications & Dosage
Hypertension: ORAL: Adult: Initially 5 mg once daily, lower initial doses may be required when used in addition to diuretic or in renal impairment; maintenance 20 mg once daily; max. 40 mg per day Children 2-12 yrs & body-weight >20 kg: initially 100 mcg/kg once daily, monitor blood pressure carefully for 1-2 hr, increased as necessary up to max 1 mg/kg daily in 1-2 divided doses; 12-18 yr: initially 2.5 mg once daily, monitor blood pressure carefully for 1-2 hr, usual maintenance dose 10-20 mg daily in 1-2 divided doses, max 40 mg daily in 1-2 divided doses if body-weight over 50 kg. BY IV INJ: Adult: 2.5-5 mg/day then increase as required, usual therapeutic dose for hypertension is 10-40 mg/day in 1-2 divided doses. Congestive Heart failure: Adult: Initially 2.5 mg once daily, increased if tolerated to 10-20 mg twice daily, dose to be increased gradually over 2-4 weeks. Prevention of symptomatic heart failure in patients with asymptomatic left ventricular dysfunction: Adult: Initially 2.5 mg once daily, increased if tolerated to 10-20 mg twice daily, dose to be increased gradually over 2-4 weeks.
Administration
Give direct IVP over at least 5 min or dilute up to 50 ml and infuse.
Compatibility
Stable in NS, D5W, DSNS.
Stability
IV solution is stable for 24 hours at room tempera-ture in D5W or NS.
Contraindications
Aortic stenosis, outflow obstruction.
Precautions
: Haemodialysis (avoid in patients dialysed with high-flux membranes), renal impairment, renovascular hypertension, severe congestive heart failure; monitor renal function before and during therapy, anaesthesia, desensitization, apheresis; withdraw ACE inhibitor before procedure.
Interactions
K+ supplement, K+ -sparing diuretics, NSAIDs, antidiabetic agents, lithium, neuroleptics, narcotic drugs, antihypertensives, antacids, sympathomimetics, cyclosporin, immunosuppressants, cytostatic agents, corticosteroids, procainamide, allopurinol, alcohol.
Pregnancy
Contraindicated in pregnancy.
Lactation
Caution advised
Side Effects
Asthenia, blurred vision, depression, dyspnoea, alopecia, anorexia, arrhythmias, confusion, drowsiness, dry mouth, flushing, hyponatraemia, ileus, impotence, insomnia, muscle cramps, nervousness, palpitation, peptic ulcer, sweating, tinnitus, vertigo. Rare: Abnormal dreams, allergic alveolitis, exfoliative dermatitis, glossitis, gynaecomastia, pemphigus, pulmonary infiltrates, Raynauds syndrome, Stevens- Johnson syndrome, stomatitis, toxic epidermal necrolysis