enalaprilat
Enalaprilat is a type of medication known as an angiotensin-converting enzyme (ACE) inhibitor. It's used to treat high blood pressure in adults who can't take medications by mouth. In particular, the medication is typically used for people in the hospital who need their blood pressure lowered quickly. Enalaprilat is given as an injection into the veins as often as every 6 hours. Side effects include low blood pressure and dizziness.
What is Enalaprilat?
What is Enalaprilat used for?
- High blood pressure in adults who can't take oral medications
How Enalaprilat works
Enalaprilat is an angiotensin-converting enzyme (ACE) inhibitor. ACE is a protein in your body that works to squeeze your blood vessels and help your blood pressure go up. Enalaprilat blocks how ACE works. This helps relax your blood vessels to lower blood pressure.
Drug facts
More on Enalaprilat essentials
Side effects of Enalaprilat
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Low blood pressure (3%)
- Headache (3%)
- Nausea (1%)
Less Common Side Effects
- Fatigue
- Dizziness
- Fever
- Rash
- Constipation
- Cough
Enalaprilat serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema: swelling (in the face, lips, tongue, throat, hands, or feet); trouble breathing; wheezing; nausea; vomiting
- Severely low blood pressure: lightheadedness, dizziness, feeling faint, tiredness, confusion
- Serious kidney problems: urinating less often than usual; swelling in your feet, ankles, or hands; unexplained weight gain
- High blood potassium levels: nausea, tiredness, chest pain, muscle weakness, tingling or numbness, pounding heart
- Severe allergic reaction: trouble breathing; swelling of the face, lips, tongue, or throat
More on Enalaprilat side effects
The following Enalaprilat side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Less common
Blurred vision
confusion
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
sweating
unusual tiredness or weakness
Rare
Chest pain or discomfort
pain or discomfort in arms, jaw, back or neck
shortness of breath
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Enalaprilat
Pros
- Works well to lower blood pressure
- Starts to work within minutes
- Available as a lower-cost generic
Cons
- Can cause dry cough
- Can't take if you're pregnant (risk of harm to unborn baby)
- Given as an injection into the veins by a healthcare provider
Pharmacist tips for Enalaprilat
- Be sure your healthcare team knows about all the medications you're taking before you start treatment with enalaprilat. Enalaprilat can interact with a lot of other medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil). Taking NSAIDs and enalaprilat together might raise your risk for kidney problems.
- Tell your provider if you're pregnant before you get enalaprilat. This medication isn't safe to take during pregnancy and should be avoided if possible. Your provider might prescribe you a different medication that's safer during pregnancy.
- Your provider might order blood tests to monitor you closely during treatment with enalaprilat. Sometimes, this medication can cause side effects that you might not feel but lab tests can pick up. Lab tests can include those that measure your liver and kidney health, blood potassium levels, and blood cell counts. Based on your results, your provider will decide whether it's safe for you to continue enalaprilat.
- You might feel dizzy after getting enalaprilat for the first time and after your dose is raised. This should get better as you continue treatment. Lie down and call your healthcare team over if you feel dizzy.
- Make sure to drink enough water to stay hydrated while you're taking enalaprilat. Your blood pressure might drop too much if you don't have enough fluids in your body. This can worsen dizziness and raise your risk of falls. Tell your healthcare team if you feel lightheaded. Your provider can give you IV fluids to bring your blood pressure back up.
Common questions about Enalaprilat
Enalaprilat usually starts to work within 15 to 30 minutes. But it might take up to 4 hours until you see the most blood pressure-lowering effect from the medication.
It's possible for you to get a cough from taking enalaprilat. Dry cough is a well-known side effect of ACE-inhibitors like enalaprilat. This side effect can appear at any time during treatment. Tell your provider if you're coughing. Your provider might decide to stop enalaprilat and choose a different blood pressure medication for you. In general, the coughing should go away after you stop enalaprilat.
It's possible for enalaprilat to lower your heart rate. In a study with people with severely high blood pressure, heart rate dropped by an average of 20 beats per minute within 3 hours of taking enalaprilat. Your provider will check your heart rate along with your blood pressure before, during, and after treatment with enalaprilat.
Enalaprilat is very closely related to enalapril, but not exactly the same thing. Enalapril is a prodrug of enalaprilat. This means that when you take enalapril by mouth, your body needs to turn it into its active form, enalaprilat, for it to work to lower blood pressure. Enalaprilat is the injectable version of enalapril and is already in the active form. Enalaprilat is a good choice for people in the hospital who have severely high blood pressure and need to lower it fast.
No, enalaprilat isn't a beta blocker. Instead, enalaprilat is a medication known as an ACE inhibitor. Beta blockers and ACE inhibitors help lower blood pressure in different ways. Your provider might decide to treat you with a beta blocker along with enalaprilat, depending on how well your blood pressure improves with enalaprilat by itself.
How to save using GoodRx
Risks and warnings for Enalaprilat
Enalaprilat can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not safe during pregnancy
Enalaprilat can cause severe and sometimes life-threatening harm to unborn babies. For this reason, avoid using enalaprilat during pregnancy. Be sure your providers know if you might be pregnant before you get treated with this medication so they can consider using a safer medication to help lower your blood pressure.
Angioedema (swelling)
- Risk factors: Black people | Having angioedema in the past
People who take ACE inhibitors, like enalaprilat, can experience a rare, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, and tongue. Swelling of the tongue or throat area can be potentially life-threatening since it can make it difficult to breathe. Angioedema can happen at any time during treatment. You might be more likely to experience angioedema if you're Black, an older adult, or of female sex. Get medical help as soon as possible if you notice any unusual swelling, stomach pain, or difficulty breathing. Your provider will stop treatment with enalaprilat if angioedema happens.
Low blood pressure
- Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking higher doses of diuretic medications | Dialysis | Heart failure
Sometimes, taking enalaprilat can cause your blood pressure to drop too much. This can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start enalaprilat or when the dose is raised. Your providers will closely monitor your blood pressure and make sure you stay well-hydrated. Lie down and contact your healthcare team if you feel dizzy, lightheaded, faint, tired, or confused while you're getting treated with enalaprilat. Your providers might give you IV fluids to help bring your blood pressure back to safe levels.
Worsening kidney problems
- Risk factors: Severe heart failure | Kidney problems or renal artery stenosis | Not enough fluid in your body | Taking other medications that can cause kidney damage
Enalaprilat is usually good for the kidneys. But in some cases, it can make kidney problems worse. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or kidney problems due to severe heart failure. Your provider might order lab tests every so often to make sure your kidneys are healthy and working properly. Your providers will check your kidneys before starting enalaprilat and periodically during treatment. Your providers will adjust your dose or make other changes to your treatment plan to prevent any damage from getting worse if they notice kidney problems on your lab test results.
High potassium levels
- Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium
Enalaprilat can raise the amount of potassium in your body, which can sometimes be dangerous. Your risk of developing high potassium is greater if you have diabetes or kidney problems or if you're taking other medications that also raise potassium levels. For this reason, make sure your provider knows your full medical history and what medications you're taking before starting treatment. Tell your healthcare provider right away if you experience signs of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat.
Liver problems
- Risk factors: History of liver problems | Drinking large amounts of alcohol
In some rare cases, people who took ACE inhibitors like enalaprilat developed a blockage in their bile duct. This condition can lead to liver problems or liver failure. Your provider might order blood tests to check your liver health from time to time. Let your provider know right away if you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin.
Enalaprilat dosage
Typical dosage for Enalaprilat
- Adults who aren't taking a diuretic (water pill): The typical dose is 1.25 mg injected into the veins (IV) over a 5-minute period every 6 hours.
- Adults who are taking a diuretic (water pill): The typical starting dose is 0.625 mg IV over a 5-minute period. Another 0.625 mg dose can be given if blood pressure doesn't improve 1 hour after the first dose. Then, enalaprilat can be given at a dose of 1.25 mg every 6 hours.
Your dose might be different if you have kidney problems or if you're at risk for severely low blood pressure (e.g., heart failure, dialysis, dehydration).
Interactions between Enalaprilat and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aliskiren
- Sacubitril
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Allopurinol
- Alteplase, Recombinant
- Amiloride
- Azathioprine
- Azilsartan
- Azilsartan Medoxomil
- Candesartan Cilexetil
- Canrenoate
- Eplerenone
- Eprosartan
- Everolimus
- Interferon Alfa-2a
- Irbesartan
- Lithium
- Losartan
- Mercaptopurine
- Olmesartan Medoxomil
- Oxypurinol
- Potassium Phosphate
- Sirolimus
- Spironolactone
- Telmisartan
- Triamterene
- Trimethoprim
- Valsartan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aspirin
- Azosemide
- Bromfenac
- Bufexamac
- Bumetanide
- Bupivacaine
- Bupivacaine Liposome
- Capsaicin
- Celecoxib
- Choline Salicylate
- Clomipramine
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Furosemide
- Gold Sodium Thiomalate
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piretanide
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rifampin
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Valdecoxib
Enalaprilat contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Enalaprilat will not be safe for you to take.
- History of angioedema (severe swelling) from previous treatment with an ACE inhibitor
- History of angioedema from other or unknown causes
- Hereditary angioedema