Enalapril

• Blood pressure reducer
• Also used to treat heart failure
• Tablets for oral use
• Avoid drinking alcohol while taking this medicine
• Not to be used while pregnant or breastfeeding

Enalapril belongs to a class of antibiotics called ACE inhibitors. These medicines work by causing your blood vessels to widen. This helps reduce your blood pressure.

Enalapril is prescribed to treat the following conditions:

• High blood pressure (hypertension).
• Weakening of heart function (heart failure).

Enalapril tablets should be taken with a drink of water. They can be taken with or without food.

Dosage

Dosage varies per person and is determined by a doctor depending on the symptoms. The general recommended dose in adults is:

For high blood pressure:

• The usual starting dose ranges from 5 to 20 mg taken once a day, depending on your blood pressure.
• The usual maintenance dose is 20 mg a day. The maximum daily dose is 40 mg.

For more information and dosage for high blood pressure, see the package leaflet.

For heart failure:

• The usual starting dose is 2.5 mg a day, taken once a day. This dose can be raised step by step until the dose that is right for you has been achieved.
• The usual maintenance dose is 40 mg a day, taken in one or two doses. The maximum daily dose is 40 mg, split into two doses of 20 mg.

For more information on dosage for heart failure, see the package leaflet.

A doctor may decide to adjust the dosage for elderly, children and patients with kidney problems or other health problems. This also applies to people who take water tablets (diuretics). Enalapril should not be used in infants and children with impaired kidney function.

Alcohol/driving

If you drink alcohol while taking Enalapril it may cause your blood pressure to drop too much and you may feel dizzy, light-headed or faint. Take care with the amount of alcohol you drink.

Enalapril can cause side effects such as dizziness and tiredness. If this happens, do not drive or use any tools or machines.

If you use too much/forget to use/stop using Enalapril

If you take more Enalapril tablets than you should, talk to your doctor straight away.

If you forget to take a dose, skip the missed dose. Just take your next dose at the usual time. Do not take a double dose to make up for a forgotten one.

Do not stop using Enalapril without talking to your doctor.

Do not take Enalapril if:

• You are allergic to the active ingredient or to any of the other ingredients in this medicine, or have ever had an allergic reaction to a type of medicine similar to this medicine called an ACE inhibitor (see section 'What Enalapril contains').
• You are more than three months pregnant (see also section ‘Pregnancy and breastfeeding’).
• You have ever had swelling of your face, lips, mouth, tongue or throat which caused difficulty in swallowing or breathing (angioedema) when the reason why was not known or it was inherited.

When should this medicine be used with caution?

In some situations, special care should be taken with Enalapril. These situations include:

• You have kidney problems.
• You are on a saltrestricted diet or have been very sick (excessive vomiting) or had bad diarrhoea recently.
• You have an ischaemic heart condition, aortic stenosis, hypertrophic cardiomyopathy, or outflow obstruction.
• You have a condition involving the blood vessels in the brain.
• You have collagen vascular disease or are on therapy that suppresses your immune system.
• You are taking the medicines allopurinol or procainamide, or any combinations of these. Contact a doctor immediately if you get an infection.
• You have ever had swelling of your face, lips, mouth, tongue or throat which caused difficulty in swallowing or breathing (angioedema) while taking medication.
• You have diabetes and are treated with blood pressurelowering medicines, including insulin.
• You are taking potassium supplements, potassiumsparing agents, potassium-containing salt substitutes or other medicines that may increase potassium in your blood (e.g., heparin).
• You are taking lithium (a medicine used to treat a certain kind of depression).
• You have an intolerance to some sugars.

If you are about to have any of the following procedures, tell your doctor that you are taking Enalapril:

• Any surgery or receive anaesthetics (even at the dentist).
• A treatment to remove cholesterol from your blood called (LDL apheresis).
• A desensitisation treatment, to lower the effect of an allergy to bee or wasp stings.

For more warnings about the use of Enalapril, please see the package leaflet. Always consult a doctor if an above-listed warning or situation applies to you.

Pregnancy and breastfeeding

Enalapril is not recommended in early pregnancy and must not be taken when more than three months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breastfeeding newborn babies (first few weeks after birth), and especially premature babies, is not recommended whilst taking this medicine. In the case of an older baby your doctor should advise you on the benefits and risks of taking this medicine whilst breastfeeding, compared to other treatments.

Other medicines and Enalapril

Tell your doctor if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription and herbal medicines.

This is because Enalapril can affect the way some medicines work. Also, some other medicines can affect the way Enalapril work. These medicines include:

• Diuretics (water pills).
• Potassium supplements or potassiumcontaining salt substitutes.
• Other medicines to lower blood pressure.
• Lithium. Do not take Enalapril at the same time as this medicine.
• Certain antidepressants and antipsychotics.
• Certain pain medicines (e.g., morphine or anaesthesia).
• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Medicines for diabetes (e.g., insulin).

For a list of all medicines that interact with Enalapril, please see the package leaflet. Consult a doctor or pharmacist if you are taking any of these medicines or if you are not sure if Enalapril is suitable for you.

Like all medicines, this medicine can cause side effects, although some people may not experience any. Side effects that are known to be associated with Enalapril include:

Very common (may affect more than 1 in 10 people):

• Feeling sick, dizzy or weak.
• Blurred vision.
• Coughing.

Common (may affect up to 1 in 10 people):

• Headache, depression, low blood pressure, fainting.
• Changes in heart rhythm, fast heartbeat, angina or chest pain, shortness of breath.
• Diarrhoea, abdominal pain, change in sense of taste, fluid retention (oedema), fatigue.
• Skin rash, allergic reactions.
• High levels of potassium in the blood, increased levels of creatinine in the blood.

For a list of all possible side effects, see the package leaflet. Consult a doctor if you experience side effects, also if the side effects are not listed in the package leaflet. Get emergency medical help if you have signs of a severe allergic reaction.

The active substance is enalapril maleate.

Read the package leaflet before use. The official package leaflet of Enalapril is available for download here.