Enalapril Maleate (EN…

Enalapril Maleate (ENALAPRIL MALEATE)

Warnings

Anaphylactoid and Possibly Related Reactions

Presumably because angiotensin-converting enzyme inhibitors affect the metabolism of eicosanoids and polypeptides, including endogenous bradykinin, patients receiving ACE inhibitors (including enalapril maleate) may be subject to a variety of adverse reactions, some of them serious.

Head and Neck Angioedema

Angioedema of the face, extremities, lips, tongue, glottis, and/or larynx has been reported in patients treated with angiotensin-converting enzyme inhibitors, including enalapril maleate. This may occur at any time during treatment.

Intestinal Angioedema

Intestinal angioedema has been reported in patients treated with ACE inhibitors. These patients presented with abdominal pain (with or without nausea or vomiting); in some cases, there was no prior history of facial angioedema and C1 esterase levels were normal.

Anaphylactoid Reactions During Desensitization

Two patients undergoing desensitizing treatment with hymenoptera venom while receiving ACE inhibitors sustained life-threatening anaphylactoid reactions.

Hypotension

Excessive hypotension is rare in uncomplicated hypertensive patients treated with enalapril maleate alone. Patients with heart failure given enalapril maleate commonly have some reduction in blood pressure, especially with the first dose, but discontinuation of therapy for continuing symptomatic hypotension usually is not necessary when dosing instructions are followed.

Neutropenia/Agranulocytosis

Another angiotensin-converting enzyme inhibitor, captopril, has been shown to cause agranulocytosis and bone marrow depression, rarely in uncomplicated patients but more frequently in patients with renal impairment, especially if they also have a collagen vascular disease.

Hepatic Failure

Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis, and (sometimes) death.

Fetal Toxicity

Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death.

FAQs about Enalapril Maleate

1. What is the most important information I should know about enalapril maleate?

The most critical aspect to understand about enalapril maleate is its potential to cause serious allergic reactions, including angioedema, and hypotension, especially in certain patient populations such as those with heart failure or renal impairment.

2. Are there any specific patient populations that should be cautious when taking enalapril maleate?

Patient populations at risk for excessive hypotension, neutropenia/agranulocytosis, or hepatic failure should be closely monitored and supervised when initiating therapy with enalapril maleate. These include patients with heart failure, hyponatremia, high-dose diuretic therapy, renal dialysis, severe volume and/or salt depletion, renal impairment, and collagen vascular disease.

3. What should pregnant women know about enalapril maleate?

Enalapril maleate should not be used during the second and third trimesters of pregnancy due to the risk of fetal toxicity, including reduced fetal renal function, increased fetal and neonatal morbidity and death, and potential fetal abnormalities.

Disclaimer: This content is for informational purposes only and should not be considered medical advice. Always consult with a healthcare professional before making any decisions about your health or medication.