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Risk Factors:

Contraindications: Hypersensitivity to enalapril. History of angioedema from previous treatment with ACE inhibitors. Idiopathic/hereditary angioedema. Concomitant use of aliskiren in pts with diabetes.Pregnancy/Lactation: Crosses placenta. Distributed in breast milk. May cause fetal/neonatal mortality morbidity. Children: Safety and efficacy not esTabletlished. Elderly: May be more susceptible to hypotensive effects.

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Indications:

Treatment of hypertension alone or in combination with other antihypertensives.
Adjunctive therapy for symptomatic HF. Treatment of asymptomatic left
ventricular dysfunction. (Epaned): Treatment of hypertension in adults and
children older than 1 mo. OFF-LABEL: Proteinuria in steroid-resistant
nephrotic syndrome.

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Adverse Effects:

Frequent (7%?5%): Headache dizziness. Occasional (3%?2%): Orthostatic
hypotension fatigue diarrhea cough syncope. Rare (less than 2%): Angina
abdominal pain vomiting nausea rash asthenia.
Adverse effects/toxic reactions
Excessive hypotension ("first-dose syncope") may occur in pts with HF severe
salt or volume depletion. Angioedema (facial lip swelling) hyperkalemia occur
rarely. Agranulocytosis neutropenia may be noted in pts with renal impairment
collagen vascular diseases (scleroderma systemic lupus erythematosus).
Nephrotic syndrome may be noted in those with history of renal disease.

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Don’t Use:

Renal impairment
hypertrophic cardiomyopathy with outflow tract obstruction; severe aortic
stenosis; before during or immediately after major surgery. Concomitant use of
potassium supplement; unstented unilateral or bilateral renal artery stenosis.