Only $2.99/month

Terms in this set (235)

Class: ACE-I, Antihypertensive
Dosage Forms. Oral Tablet: 2.5 mg, 5 mg, 10 mg, 20 mg; Oral Solution: 1 mg/mL
Common FDA Label Indication, Dosing, and Titration.
Heart failure: Infants ≥4 d of age and Adolescents, 0.1-0.5 mg/kg po daily, max 0.94 mg/kg po daily; Adults, 2.5 mg po daily, titrate to 20-40 mg po daily in divided doses
Hypertension: Infants ≥1 mo of age and Adolescents, 0.08 mg/kg up to 5 mg po daily, max 0.58 mg/kg or 40 mg po daily; Adults, 5 mg po daily, max 40 mg po daily in divided doses
Kidney disease, nondiabetic: Children 7-18 y of age, 0.1-0.5 mg/kg po daily, max 20 mg po daily; Adults, 5 mg po daily, max 20 mg po daily
Off-Label Uses.
Diabetic nephropathy: 5-20 mg po daily
MI: 2.5 mg po daily, may titrate to 20 mg po daily
MOA. Enalapril is a prodrug that is rapidly converted to its active metabolite, enalaprilat, a competitive ACE-I. It reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein-kinin system, inhibits the sympathetic nervous system, and inhibits the tissue renin-angiotensin system. The net effect is reduction in total peripheral resistance and blood pressure in hypertensive patients, and reduction of elevated afterload in patients with heart failure.
Drug Characteristics: Enalapril
Dose Adjustment Hepatic Not required Absorption F = 60%, no effect of food on absorption
Dose Adjustment Renal CrCl <30 mL/min, initial dose 2.5 mg po daily, max 40 mg po daily Distribution 50-60% protein bound
Dialyzable Yes Metabolism Extensive hepatic to 1 active metabolite
Pregnancy Category D Elimination Renal 61% with a half-life of 1.3 h (parent drug), 11 h (metabolite)
Lactation Weigh risks and benefits Pharmacogenetics None known
Contraindications Hypersensitivity to enalapril, history of angioedema, pregnancy, concurrent sacubitril Black Box Warnings Pregnancy

Flickr Creative Commons Images

Some images used in this set are licensed under the Creative Commons through Flickr.com.
Click to see the original works with their full license.