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Enalapril
- Inhibits
angiotensin converting enzyme
- Decreased
Angiotensin II
-----> peripheral vasodilation
------> decreased peripheral resistance
- Decreased
Angiotensin II
------> decreased Aldosterone
------> decreased Na+ & H2O retention
- Useful in
hypertension, congestive cardiac failure
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Pharmacokinetics
- Absorbed
from G. I. Tract
- Absorption not affected by food
- Converted to active form Enalaprilat
- Excreted as Enalaprilat and as unchanged drug in urine & faeces
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Enalapril In
Hypertension
- Decreased
Angiotensin II + Decreased Aldosterone
------> Decreased Peripheral resistance
------> Decreased B. P.
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Effect lasts 24 hours, hence convenience of once daily administration
- Useful in all grades of hypertension, renal hypertension, diabetic
nephropathy with hypertension
- Particularly useful in obese / diabetic hypertensives
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Enalapril In
Congestive Cardiac Failure (CCF)
- Reduces afterload
----> Improves Cardiac output
- Forms basic therapy in CCF : diuretics / digoxin may be added in
selected cases
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Dosage
Hypertension
:
Initially 5 mg/day (2.5 mg in Renal impairment / elderly) Dose to
be titrated according to response
Usual Maintenance Dose :
10-20 mg/day Severe Hypertension : Upto 40 mg/day
CCF
:
Initially : 2.5 mg/day Maintenance : 5-20 mg/day
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Tolerability
- Generally
well tolerated
- Skin rashes, cough, angioedema
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Salient Features
- ACE inhibitor
- Reduces peripheral resistance
- Effective in hypertension and congestive cardiac failure - Convenient
once daily dosage
- Most widely used among the ACE inhibitors
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