Enalapril - an ACE inhibitor

About enalapril

Enalapril belongs to a class of medicines called angiotensin-converting enzyme (ACE) inhibitors. You may have been prescribed it to reduce high blood pressure (hypertension), or to prevent (or treat) insuficiencia cardíaca. Heart failure is a condition where your heart does not work as well as it should.

ACE inhibitors like enalapril prevent your body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme. This widens your blood vessels and helps to reduce the amount of water put back into your blood by your kidneys. These actions help to decrease blood pressure. Although people with high blood pressure often do not feel unwell, if left untreated, high blood pressure can harm the heart and damage blood vessels, leading to a heart attack or stroke. Enalapril can be used on its own or alongside other medicines which reduce blood pressure. A combination brand called Innozide® (which contains enalapril with another medicine called hydrochlorothiazide) can help to reduce the total number of tablets people with high blood pressure need to take each day.

In heart failure, there can be too much circulating fluid in your blood vessels because your heart is not working as efficiently as it once did. Enalapril helps to reduce this. It also appears to have a protective effect on the heart and slows the progression of the heart failure.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking enalapril it is important that your doctor knows:

• Si estás embarazada o amamantando.

• If you have any problems with the way your kidneys work, or any problems with the way your liver works.

• Si te falta líquido en el cuerpo (deshidratado) - por ejemplo, si has tenido diarrea o vómitos recientemente.

• Si le han dicho que tiene una acumulación de depósitos grasos en las paredes de sus arterias, una condición llamada aterosclerosis.

• Si tienes un tipo particular de mala circulación llamado enfermedad arterial periférica.

• Si tienes una enfermedad vascular del colágeno, esto incluye condiciones como el lupus eritematoso sistémico (LES) y la esclerodermia.

• Si le han dicho que tiene una enfermedad del músculo cardíaco (miocardiopatía) o un estrechamiento del vaso sanguíneo principal de su corazón (estenosis aórtica).

• Si alguna vez ha tenido una reacción en la que su cara, lengua o garganta se hinchan (angioedema).

• Si estás recibiendo tratamiento de desensibilización para protegerte contra las picaduras de abejas y avispas.

• Si estás recibiendo tratamiento de diálisis, o tratamiento para eliminar el colesterol de tu sangre mediante una máquina (aféresis de LDL).

• Si está tomando otros medicamentos. Esto incluye cualquier medicamento que esté tomando y que esté disponible para comprar sin receta, así como medicamentos herbales y complementarios.

• If you have ever had an allergic or unusual reaction to any other ACE inhibitor (such as captopril, ramipril or perindopril), or to any other medicine.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about enalapril and will provide you with a full list of side-effects which you could experience from taking it.

• Take the tablets exactly as your doctor tells you to.

• If you are being treated for high blood pressure: enalapril is taken once a day. You will be advised to take your very first dose at bedtime. This is because you can feel quite dizzy when you first start taking it. After the first dose, you can generally take enalapril at a time of day you find easy to remember. For most people this will be in the morning.

• If you are being treated for heart failure: your doctor will give you a small once-daily dose to begin with, and then your dose will be increased gradually over a few weeks. Once the dose has been increased, enalapril is commonly taken as two doses a day, one taken in the morning and the other in the evening. Increasing your dose slowly like this helps to avoid unwanted side-effects, such as dizziness.

• Try to take your doses at the same time(s) of day each day as this will help you to remember to take your doses regularly. You can take enalapril tablets either with or without food. It is best to swallow the tablet with a drink of water.

• There are several strengths of enalapril tablet. Your doctor will prescribe the strength which is suitable for your condition. Each time you collect a new supply, check to make sure the tablets are the strength that you are expecting.

• If you forget to take a dose at your usual time, take it as soon as you remember (unless it is nearly time for your next dose, in which case do not take the forgotten dose but take the next dose when it is due). Do not take two doses together to make up for a missed dose.

• Intenta mantener tus citas regulares con tu médico. Esto es para que se pueda monitorear tu progreso. Tu médico querrá que te hagas algunos análisis de sangre de vez en cuando para verificar que tus riñones estén funcionando bien.

• It is very important that you follow any dietary and lifestyle advice that you have been given by your doctor. This can include advice about eating a healthy diet, not smoking, and taking regular exercise.

• If you buy any medicines, check with a pharmacist that they are suitable to take with enalapril. This is because some medicines (such as anti-inflammatory painkillers and indigestion remedies) can interfere with your treatment.

• It is likely that your doctor will advise that you do not use salt substitutes while you are taking enalapril. These products have a high content of potassium which could be harmful for you.

• If you drink alcohol, ask your doctor for advice about drinking alcohol while you are on enalapril. Alcoholic drinks can make you feel light-headed or dizzy, and they may not be advisable for you.

• If you have diabetes you may need to check your blood glucose more frequently, as the tablets can lower the levels of sugar in your blood. Your doctor will advise you about this.

• If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking enalapril. This is because some anaesthetics could cause your blood pressure to drop too low.

• Treatment with enalapril is often long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise.

Si también está tomando hidroclorotiazida en combinación con este medicamento

• Los estudios han sugerido que tomar dosis más altas de hidroclorotiazida durante largos períodos de tiempo puede aumentar el riesgo de ciertos tipos de cáncer de piel.

• Informe a su médico si alguna vez ha sido tratado por cáncer de piel.

• Informe a su médico sobre cualquier lunar nuevo o cambiado, o marcas preocupantes en su piel.

• Use a sunscreen in strong sunlight. Do not use sunbeds.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with enalapril. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Importante: if you experience any of the following potentially serious symptoms, stop taking enalapril and contact your doctor for advice straightaway:

• Cualquier dificultad para respirar, o hinchazón de su cara, boca, lengua o garganta. Estos son signos de una reacción alérgica.

• Any yellowing of your skin or the whites of your eyes. These may be signs of a liver problem called jaundice, which is a rare side-effect.

• Una erupción cutánea severa.

Si experimenta cualquier otro síntoma que crea que puede deberse a las tabletas, hable con su médico o farmacéutico para obtener más consejos.

• Mantenga todos los medicamentos fuera del alcance y la vista de los niños.

• Almacenar en un lugar fresco y seco, lejos del calor y la luz directos.