Post-MI: 2.5 mg orally twice daily; titrate as tolerated
Children: Individualized dosing based on weight; specialist guidance required
Note: Adjust dose in renal impairment; monitor blood pressure and renal function.
Route of Administration
Oral (tablet, oral solution)
Mechanism of Action
Enalapril inhibits angiotensin-converting enzyme (ACE), decreasing conversion of angiotensin I to angiotensin II. This results in vasodilation, decreased aldosterone secretion, reduced blood pressure, and decreased cardiac workload.
Common Adverse Effects
Cough (dry, persistent)
Dizziness
Fatigue
Rash
Hypotension
Serious Adverse Effects
Angioedema (life-threatening)
Severe hypotension
Hyperkalemia
Acute renal failure
Contraindications
History of angioedema related to ACE inhibitors
Pregnancy (especially 2nd and 3rd trimester)
Severe bilateral renal artery stenosis
Hypersensitivity to enalapril
Precautions
Monitor blood pressure, renal function, and electrolytes regularly
Use caution in elderly patients and those with renal impairment
Avoid potassium supplements unless indicated
Taper cautiously if switching from other antihypertensives
Drug Interactions
Potassium-sparing diuretics or potassium supplements – risk of hyperkalemia
NSAIDs – may reduce antihypertensive effect and impair renal function
Other antihypertensives – additive hypotensive effect
Diuretics – may potentiate hypotension at therapy initiation
Pregnancy & Lactation
Contraindicated in pregnancy (especially 2nd/3rd trimester). Use with caution during breastfeeding; consult healthcare provider.
Patient Counseling
Take at the same time each day
Monitor blood pressure regularly
Report cough, swelling, dizziness, or signs of hyperkalemia