INTRODUCTION

ENACE 5MG contains Enalapril which belongs to the group of medicines called Angiotensin-converting enzyme (ACE) inhibitors. It is used in the treatment of high blood pressure (hypertension). It can also be used in the treatment and prevention of heart failure. Heart failure is a chronic condition in which the heart cannot pump adequate amount of blood properly, resulting in shortness of breath, swelling of the ankles and feet or tiredness after mild physical activity such as walking. 

Enalapril works by causing relaxation of the blood vessels, leading to lowering of blood pressure. It increases the supply of oxygen and blood to the heart muscles, which prevents heart failure and can lower the need to go to hospital by making some patients live longer. Along with the treatment, your doctor might ask you to make certain lifestyle changes such as quitting alcohol and smoking, improve your sleep at night, eating a healthy diet and manage weight.

This medicine usually starts to work within 1 hour, and its effect may last up to 24 hours. Duration of the treatment may differ from person to person depending upon their health condition. However, for some people, several weeks of treatment are required to see best effect on blood pressure. The most common side effects are dizziness, nausea or blurred vision. These symptoms are usually temporary and disappears with the course of treatment. Before taking this medicine, inform your doctor if you have kidney problems including kidney transplantation, as it may lead to higher levels of potassium in your blood which can be serious. Proper dose adjustments and regular monitoring of blood potassium levels and kidney functions are required in such patients. This medicine is not recommended for use in pregnant or breastfeeding women. Consult your doctor before taking this medicine.

USES OF ENACE 5MG

• Treat high blood pressure
• Treats and prevents heart failure

HOW ENACE 5MG WORKS

Enalapril is a potent ACE inhibitor which inhibits the activity of the enzyme called Angiotensin-converting enzyme, an enzyme responsible for the conversion of Angiotensin-I to Angiotensin-II in the RAAS system. Angiotensin-II is a potent vasoconstrictor which leads to increase in blood pressure and other heart problems.

Inhibition of ACE enzyme by enalapril, inhibits the production of Angiotensin-II, leading to widening of the blood vessels and reduction of blood pressure. It also increases the supply of oxygen and blood to the heart which reduces the risk of heart failure.

DIRECTIONS FOR USE

Take ENACE 5MG as directed by your physician. It can be taken with or without food. Swallow the medicine as whole with a sip of water. Do not crush or chew the medicine. Your doctor will decide the correct dose for you depending upon your condition. Continue to take this medicine, as long as your doctor tells you to do so, to obtain better results.

SIDE EFFECTS OF ENACE 5MG

HOW TO MANAGE SIDE EFFECTS

Nausea:

Try taking this medicine with, or just after meals. Stick to simple meals. Do not eat rich or spicy food.

Diarrhea:

Drink lots of fluids, such as water or juice, to avoid dehydration. Do not take any medicines without speaking to a doctor.

Abdominal pain:

Try to rest and relax. You can eat and drink slowly or have smaller and frequent meals. Keeping a heat pad on your stomach may also help. If still pain persists, speak to your doctor.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid traveling, driving or operating any tools or machines while you are feeling dizzy. If the symptom still persists, contact your doctor for advice.

WARNING & PRECAUTIONS

INTERACTIONS

Talk to your doctor, if you are taking,

• other medicines used to treat high blood pressure
• medicines that increases the level of potassium in your blood (e.g. potassium supplements, spironolactone, aldosterone)
• medicines used to treat bacterial infection (e.g. trimethoprim and co-trimoxazole)
• medicines used to treat depression (e.g. lithium, amitriptyline, desipramine, nortriptyline, imipramine)
• medicines used to treat mental problems (aripiprazole, clozapine, risperidone or quetiapine)
• medicines used to treat cough and cold (e.g. amphetamine)
• medicines used to treat pain or arthritis (e.g. aspirin, ibuprofen, methotrexate, gold therapy)
• medicines used to treat diabetes (e.g. metformin, vildagliptin, rosiglitazone, gliclazide, insulin)
• medicines used to treat blood clots (e.g. anistreplase, reteplase or streptokinase)
• medicines used to prevent graft rejection (e.g. ciclosporin, sirolimus, everolimus)
• heparin (used to prevent blood thinning)
• non-steroidal anti-inflammatory drugs (used to treat pain) e.g. celecoxib, paracetamol, aspirin
• racecadotril (used to treat acute diarrhea)
• sacubitril/ valsartan fixed-dose combination (used to treat heart failure)
• allopurinol (a medicine used to treat gout or kidney stones)
• procainamide (used to treat arrhythmia)

SYNOPSIS

MORE INFORMATION

Store below 20-25°C and keep out of reach of children.

FAQs ABOUT ENACE 5MG

How long does ENACE 5MG take to work?

This medicine usually starts to work within 1 hour, and its effect may last up to 24 hours.

Can I stop taking ENACE 5MG suddenly?

No. Do not abruptly discontinue this medicine without consulting your doctor. Continue to take this medicine, as long as your doctor tells you to do so, to obtain better results.

Can I consume alcohol while taking ENACE 5MG?

No. Avoid consumption of alcohol while taking this medicine, because it may cause a fall in your blood sugar levels and leads to dizziness, light-headedness or faintness.

REFERENCES

1. KD. Tripathi. Drugs Affecting Renin Angiotensin System and Plasma Kinins. Essentials of medical pharmacology. Seventh edition. 2013. Page – 502-503.

2. KD. Tripathi. Antihypertensive Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 561.

3. Randa Hilal-Dandan. Renin and Angiotensin. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 733.

4. Thomas Michel and Brian B. Hoffmann. Treatment of myocardial ischemia and hypertension. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 777-778.

5. Bradley A Maron and Thomas P. Rocco. Pharmacotherapy of Congestive heart failure. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 797-798.

6. Gerald G. Briggs and Roger K. Freeman. E. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 1332-1343.

7. Wake Forest University. Evaluation of Enalapril Versus Placebo in Patients with Diastolic Heart Failure (PIE-I). NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised on November 2017] [Accessed 7th December 2020] https://clinicaltrials.gov/ct2/show/NCT01411735

8. R. O. Davies, H. J. Gomez, J. D. Irvin, and J. F. Walker. An overview of the clinical pharmacology of enalapril. NCBI; PMC US National Library of Medicine, National Institute of Health. 1984. [Accessed 7th December 2020] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1463484/

9. Milpharm Limited, APL Swift Services (Malta) Ltd. Electronic Medicines Compendium (EMC); [Revised on March 2020] [Accessed 7th December 2020] https://www.medicines.org.uk/emc/files/pil.561.pdf

10. Dexcel-Pharma Ltd. Electronic Medicines Compendium (EMC); [Revised on October 2019] [Accessed 7th December 2020] https://www.medicines.org.uk/emc/files/pil.2671.pdf

USEFUL DIAGNOSTIC TESTS

• Electrocardiogram
• Blood pressure