Medical Editor: John P. Cunha, DO, FACOEP
Enalaprilat injection is an ACE (angiotensin converting enzyme) inhibitor used to treat high blood pressure (hypertension) when oral therapy is not practical. Enalaprilat is available in generic form. Common side effects of Enalaprilat include low blood pressure (hypotension), headache, nausea, fatigue, tiredness, dizziness, fever, rash, constipation, cough, decreased sexual function or desire, and sun sensitivity.
The dose of Enalaprilat in hypertension is 1.25 mg every six hours administered intravenously over a five-minute period. Enalaprilat may interact with diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), potassium supplements, potassium-containing salt substitutes, and lithium. Tell your doctor all medications and supplements you use. During pregnancy, Enalaprilat should be used only if prescribed during the first trimester. Enalaprilat is not recommended for use during the second or third trimesters as it may harm a fetus. Enalaprilat passes into breast milk. Consult your doctor before breastfeeding.
Our Enalaprilat injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Enalaprilat has been found to be generally well tolerated in controlled clinical trials involving 349 patients (168 with hypertension, 153 with congestive heart failure and 28 with coronary artery disease). The most frequent clinically significant adverse experience was hypotension (3.4 percent), occurring in eight patients (5.2 percent) with congestive heart failure, three (1.8 percent) with hypertension and one with coronary artery disease. Other adverse experiences occurring in greater than one percent of patients were: headache (2.9 percent) and nausea (1.1 percent).
Angioedema: Angioedema has been reported in patients receiving enalaprilat, with an incidence higher in black than in non-black patients. Angioedema associated with laryngeal edema may be fatal. If angioedema of the face, extremities, lips, tongue, glottis and/or larynx occurs, treatment with enalaprilat should be discontinued and appropriate therapy instituted immediately. (See WARNINGS.)
Cough: See PRECAUTIONS, Cough.
Since enalapril is converted to enalaprilat, those adverse experiences associated with enalapril might also be expected to occur with enalaprilat.
The following adverse experiences have been reported with enalapril and, within each category, are listed in order of decreasing severity.
Cardiovascular: Cardiac arrest; myocardial infarction or cerebrovascular accident, possibly secondary to excessive hypotension in high risk patients (see WARNINGS, Hypotension) ; pulmonary embolism and infarction; pulmonary edema; rhythm disturbances including atrial tachycardia and bradycardia; atrial fibrillation; orthostatic hypotension; angina pectoris; palpitation, Raynaud's phenomenon.
Digestive: Ileus, pancreatitis, hepatic failure, hepatitis (hepatocellular [proven on rechallenge] or cholestatic jaundice) (see WARNINGS, Hepatic Failure) , melena, diarrhea, vomiting, dyspepsia, anorexia, glossitis, stomatitis, dry mouth.
Musculoskeletal: Muscle cramps.
Skin: Exfoliative dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, pemphigus, herpes zoster, erythema multiforme, urticaria, pruritus, alopecia, flushing, diaphoresis, photosensitivity.
Miscellaneous: A symptom complex has been reported which may include some or all of the following: a positive ANA, an elevated erythrocyte sedimentation rate, arthralgia/arthritis, myalgia/myositis, fever, serositis, vasculitis, leukocytosis, eosinophilia, photosensitivity, rash and other dermatologic manifestations.
Hypotension: Combining the results of clinical trials in patients with hypertension or congestive heart failure, hypotension (including postural hypotension, and other orthostatic effects) was reported in 2.3 percent of patients following the initial dose of enalapril or during extended therapy. In the hypertensive patients, hypotension occurred in 0.9 percent and syncope occurred in 0.5 percent of patients. Hypotension or syncope was a cause for discontinuation of therapy in 0.1 percent of hypertensive patients. (See WARNINGS.)
Fetal/Neonatal Morbidity and Mortality - See WARNINGS, Fetal/Neonatal Morbidity and Mortality.
Clinical Laboratory Test Findings
Creatinine, Blood Urea Nitrogen: I n controlled clinical trials minor increases in blood urea nitrogen and serum creatinine, reversible upon discontinuation of therapy, were observed in about 0.2 percent of patients with essential hypertension treated with enalapril alone. Increases are more likely to occur in patients receiving concomitant diuretics or in patients with renal artery stenosis. (See PRECAUTIONS.)
Hematology: Small decreases in hemoglobin and hematocrit (mean decreases of approximately 0.3 g percent and 1.0 vol percent, respectively) occur frequently in hypertensive patients treated with enalapril but are rarely of clinical importance unless another cause of anemia coexists. In clinical trials, less than 0.1 percent of patients discontinued therapy due to anemia. Hemolytic anemia, including cases of hemolysis in patients with G-6-PD deficiency, has been reported; a causal relationship to enalapril cannot be excluded.
Read the entire FDA prescribing information for Enalaprilat (Enalaprilat Injection)
© Enalaprilat Patient Information is supplied by Cerner Multum, Inc. and Enalaprilat Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.