Enalapril Maleate and Hydrochlorothiazide

ACE Inhibitor · ACE inhibitor/Thiazide diuretic

Indications

Hypertension where combination therapy is appropriate.

Dosage

Adults: Usually 1 or 2 tab once daily. Children: Not recommended.

Adverse Effects

Hypotension, arrhythmias, angina, tachycardia, angioedema, renal failure angioedema, rash, headache, depression, fatigue, dizziness, blurred vision, asthaenia, GI upset, dyspnoea, hypokalaemia, hyperkalaemia, muscle cramps, increased serum creatinine, hyperlipidaemia, hyperuricaemia, syncope, chest pain, cough. Very rarely anaphylactoid reactions during desensitization and LDL apheresis. Withdraw if jaundice or angioneurotic oedema occur.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Sulfonamide hypersensitivity. Severe renal impairment, anuria, renal artery stenosis, recent kidney transplant, severe hepatic impairment, angioedema ( hereditary, idiopathic or associated with previous ACE inhibitor therapy). Precautions: Collagen vascular disease, anaesthesia, apheresis, diabetes, SLE, gout. Haemodialysis (avoid in patients dialysed with high-flux memebranes). Monitor serum electrolytes. Fluid or electrolyte imbalance, aortic valve stenosis, hypertrophic cardiomyopathy, outflow obstruction, renovascular hypertension, ischaemic heart or cerebrovascular disease. Mild to moderate renal or hepatic impairment.

Interactions

Other antihypertensives, lithium, K+ supplements or K+ sparing diuretics, tubocurarine, alcohol, barbiturates, narcotics, antidiabetic agents, corticosteroids, pressor amines, NSAIDs, lithium, heparin, trimethoprim, muscle relaxants, insulin, allopurinol, drugs that prolong QT interval (e.g., procainamide), immunosuppressants, sympathomimetics, sodium aurothiomalate (gold), TCADs, antipsychotics, anaesthetics, alcohol, colestyramine, colestipol, cytostatics, laxatives.

Pharmacokinetics

ENALAPRIL MALEATE: Onset of action: Approx. 1 hr. Peak effect: 4-6 hrs. Duration: 12-24 hrs. Absorption: 55%-75%. Metabolism: Prodrug, undergoes hepatic biotransformation to enalaprilat. Half-life elimination: Enalapril: CHF: Neonates (PNA=10-19 days): 10.3 hrs. CHF: Infants and Children =6.5 yrs: 2.7 hrs. Adults: Healthy: 2 hrs; CHF: 3.4-5.8 hrs. Enalaprilat: CHF: Neonates (PNA=10-19 days): 11.9 hrs. CHF: Infants and Children =6.5 yrs: 11.1 hrs. Infants 6 wks-8 mth: 6-10 hrs. Adults: Approx. 35 hrs. Time to peak, serum: Oral: Enalapril: 0.5-1.5 hrs. Enalaprilat (active metabolite): 3-4.5 hrs. Excretion: Urine (61%). Faeces (33%). HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized.…

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.