Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Enalaprilat, Vasotec IV, Epaned, Vasotec
Synonyms :
enalapril
Class :
ACE Inhibitors
Brand Name :
Enalaprilat, Vasotec IV, Epaned, Vasotec
Synonyms :
enalapril
Class :
ACE Inhibitors
Dosage Forms & StrengthsÂ
Injectable solutionÂ
1.25mg/mlÂ
TabletÂ
2.5 mgÂ
5 mgÂ
10 mgÂ
20 mgÂ
Powder for oral solution Â
150 mg bottleÂ
Oral
Initial dose: 2.5 to 5 mg orally every day
Maintenance dose: 10 to 40 mg orally every day or divided every 2 times a day
Intravenous
1.25 mg/dose Intravenous over 5 minutes every 4 times a day; doses till 5 mg/dose Intravenous every 4 times a day can be administered
Left Ventricular Dysfunction Following Myocardial InfarctionÂ
Initial dose: 2.5 mg orally every 2 times a day
May titrate to 20 mg daily
Congestive Heart Failure (CHF)Â
Initial dose: 2.5 mg orally every day or 2 times a day
Maintenance dose: 5 to 40 mg/Day orally divided every 2 times a day; titrate slowly every 2Weeks
Intravenous: 1.25 to 5 mg every 4 times a day; avoid Intravenous administration incase of acute myocardial infarction or unstable heart failure
Conversion from IV to oral dosage form
For those who are not using diuretics, start with 5 mg orally every day; when it comes to taking diuretics and responding to 0.625 mg Intravenous every 4 times a day, start with 2.5 mg orally every day and titrate up as needed
Dose Adjustments
Dosage Modifications
Hepatic impairment: dose adjustment is not required
Renal impairment
CrCl less than 30 mL/min: Initiate 2.5 mg orally; titrate based on response; should not exceed more than 40 mg
Dialysis: 2.5 mg orally on day of the dialysis; adjust dosage on nondialysis days according to the BP
CrCl less than 30 mL/min: Initiate 0.625 mg intravenous every 4 times a day; titrate to response
CrCl more than 30 mL/min: Initiate 5 mg/day orally; titrate to the maximum of 40 mg
CrCl more than 30 mL/min: 1.25 mg intravenous every 4 times a day; titrate to response
Dosage Forms & StrengthsÂ
Injectable solutionÂ
1.25mg/mlÂ
TabletÂ
2.5 mgÂ
5 mgÂ
10 mgÂ
20 mgÂ
Powder for oral solutionÂ
150 mg bottle Â
1 month to 16 yrs (oral)
Initial dose: 0.08 mg/kg/day orally or divided every 2 times a day; should not exceed more than 5 mg/day
May increase, when necessary, every two weeks according to the blood pressure should not exceed more than 0.58 mg/kg/day (40 mg/day)
1 month to 16 yrs (Intravenous)
0.01 to 0.02 mg/kg daily divided every 2 times a day by Intravenous infusion
Hypertensive Crisis
0.05 to 0.1 mg/kg by direct Intravenous injection
Renal Impairment
The GFR less than 30 mL/min/1.73 m²: usually Not recommended
may increase the adverse effect of angiotensin II receptor blockers
may increase the adverse effect of angiotensin II receptor blockers
may enhance the concentration of serum when combined with lithium
may enhance the concentration of serum when combined with lithium
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
angiotensin II Receptor Blockers may enhance the adverse/toxic effect of angiotensin-Converting Enzyme Inhibitors
may increase the toxic effect of angiotensin receptor II blockers
lisinopril/hydrochlorothiazideÂ
may increase the toxic effect of angiotensin receptor II blockers
valsartan/hydrochlorothiazideÂ
may increase the toxic effect of angiotensin receptor II blockers
may diminish the serum concentration when combined with angiotensin-converting enzyme inhibitors
may enhance the serum concentration when combined with lithium
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increased adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increased adverse effect when combined with angiotensin-converting enzyme inhibitors
may have an increased adverse effect when combined with angiotensin-converting enzyme inhibitors
may enhance the concentration of serum when combined with lithium
may enhance the concentration of serum when combined with lithium
may diminish the effects of indomethacin by pharmacodynamic antagonism
may diminish the effects of indomethacin by pharmacodynamic antagonism
may diminish the effects of ketoprofen by pharmacodynamic antagonism
may diminish the effects of indomethacin by pharmacodynamic antagonism
may have an increasingly adverse effect when combined with sacubitril
may have an increasingly adverse effect when combined with ACE inhibitors
may enhance the risk of angioedema when combined with Enalapril
when both the drugs are combined, there might be an increase in the anticoagulant effect
A decrease in renal function may be seen when aspirin rectal and enalapril are coadministered due to pharmacodynamic antagonism
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
angiotensin-Converting Enzyme Inhibitors may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
ACE Inhibitors may enhance the therapeutic effect of angiotensin II receptor antagonists
may enhance the hypotensive effect of ACE Inhibitors
may enhance the hypotensive effect of ACE Inhibitors
may enhance the hypotensive effect of ACE Inhibitors
may enhance the hypotensive effect of ACE Inhibitors
may diminish the serum concentrations of enalapril and its active metabolites
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
It may enhance the toxicity when combined with mipomersen
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
anticholinergic agents decrease the efficacy of other ACE inhibitors
may have an increasingly adverse effect when combined with NSAIDs
may have an increasingly adverse effect when combined with NSAIDs
may have an increasingly adverse effect when combined with NSAIDs
may have an increasingly adverse effect when combined with NSAIDs
may have an increasingly adverse effect when combined with NSAIDs
It may enhance toxicity when combined with metformin by unspecified interactions mechanism
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
When enalapril is used together with ouabain, this leads to reduction in enalapril excretion
may have an increasingly adverse effect when combined with NSAIDs
combination may enhance the risk of neutropenia
angiotensin-Converting Enzyme Inhibitors may enhance the hyperkalemic effect of finerenone
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
ACE Inhibitors may enhance the adverse/toxic effect of NSAIDs
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
choline magnesium trisalicylate
salicylates may enhance the nephrotoxic effect of ACE Inhibitors
angiotensin-converting Enzyme (ACE) inhibitors may increase the risk of adverse effects of alteplase
Icatibant may diminish the effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may enhance the hyperkalemic effect of ACE Inhibitors
may increase the anti-coagulant action of anti-coagulants
choline magnesium trisalicylate
may enhance the nephrotoxic effect of ACE inhibitors
may have an increased allergic or hypersensitivity reactions when combined with allopurinol
may have an increasingly adverse effect when combined with alteplase
may have an increased orthostatic hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increasingly adverse effect when combined with angiotensin-converting enzyme inhibitors
may enhance the nephrotoxic effect of salicylates
polyethylene glycol and electrolytesÂ
They may increase the nephrotoxic effect when combined with polyethylene Glycol-electrolyte Solution
Dipeptidyl Peptidase-IV Inhibitors: they may increase the toxic effect of angiotensin-converting enzyme inhibitors
Dipeptidyl Peptidase-IV Inhibitors: they may increase the toxic effect of angiotensin-converting enzyme inhibitors
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
may enhance the hyperkalemic effect
may have an increased risk of rhabdomyolysis & myoglobinuria when combined with enalapril
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
Nonsteroidal Anti-Inflammatory Agents: they may decrease the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors
may have an increasingly adverse effect when combined with iron dextran complex
spironolactone and hydrochlorothiazide
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
choline magnesium trisalicylate
may have an increased nephrotoxic effect when combined with angiotensin-converting enzyme inhibitors
may increase the hypotensive effect of angiotensin-converting enzyme inhibitors
may increase the hypotensive effect of angiotensin-converting enzyme inhibitors
may increase the hypotensive effect of angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hypotensive effect when combined with angiotensin-converting enzyme inhibitors
may have an increased hyperkalemic effect when combined with angiotensin-converting enzyme inhibitors
the rate of excretion of enalapril may be reduced
may have a decrease in excretion when combined with enalapril
the risk of angioedema may be increased
angiotensin II receptor blockers increase the toxicity of ACE inhibitors
Action and Spectrum:Â
The renin-angiotensin-aldosterone system and sympathetic system collaborate to regulate blood pressure and fluid balance. This synergistic signalling pathway helps maintain homeostasis.Â
Adverse reaction:Â
1-10%Â
DizzinessÂ
HeadacheÂ
Chest painÂ
Hypotension Â
CoughÂ
RashÂ
Frequency Not DefinedÂ
NauseaÂ
VomitingÂ
AstheniaÂ
Black box warning:Â
In pregnancy situations discontinue this drug because it causes fetal injury.Â
Contraindications/caution:Â
Contraindications:Â
Cautions:Â
Pregnancy Warnings:Â
Pregnancy category: N/AÂ
Lactation: Excretion of the drug into the human breast milk is knownÂ
Pregnancy categories:Â
Category A: Satisfactory and well-controlled studies show no evidence of risk to the fetus in the first trimester or in the later trimester.Â
Category B: No evidence of risk to fetus found in animal reproduction studies and there are not enough studies on pregnant women.Â
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women.Â
Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.Â
Category X: Drugs listed in this category clearly outweigh risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.Â
Category N: No data for the drug under this category is available.Â
Pharmacology:Â
The renin-angiotensin-aldosterone system and sympathetic system regulates blood pressure. Stimulation causes increased release of norepinephrine, that affects vascular growth and salt retention in the kidneys.Â
Â
Pharmacodynamics:Â
Enalapril depends on biotransformation for therapeutic effects as a weak ACE inhibitor. It is an antihypertensive drug with natri-uretic and uricosuric properties. It reduces blood pressure in various types of hypertensions.Â
Pharmacokinetic:Â Â
Absorption:Â
It shows bioavailability around 40%, peak plasma concentrations reach in 1 hour.Â
Excretion and elimination:Â
The metabolites excreted in the urine, average half-life of 35 to 38 hours.Â
Administration:Â
Enalapril tablets can be taken orally with water.Â
Patient information leaflet:Â
Generic Name: EnalaprilÂ
Why do we use Enalapril?Â
Enalapril is an anti-hypertensive drug that belongs to the subclass ACE inhibitors used to treat hypertension. Â
It is used to decrease high blood pressure also prevents risk of heart stroke and heart attacks.Â
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