Original GlobalRPh source
- Product / population
- Preserved GlobalRPh source, not a freshly verified product label
- Renal measure
- Use the method specified in the original source
Historical source: not automatically current. Review current official labeling and separately attributed additions before use.
Usual Dosing (Adults)
Hypertension: an initial dose can cause symptomatic hypotension with concomitant diuretics. If possible, stop the diuretic for 2 to 3 days before enalapril and resume if needed for control. If the diuretic cannot be stopped, start 2.5 mg under medical supervision for at least 2 hours and until pressure is stable for at least an additional hour.
Without a diuretic: initial 5 mg daily, adjust to blood pressure. Usual 10 to 40 mg/day in one or two doses. If effect diminishes before the next daily dose, consider a dose increase or twice-daily dosing. Add a diuretic if required.
Symptomatic heart failure: usually in combination with diuretics/digitalis. Survival studies titrated as tolerated up to 40 mg/day in two doses. Initial 2.5 mg; recommended 2.5 to 20 mg twice daily, titrated over days/weeks. Trial maximum 40 mg/day in divided doses.
Asymptomatic LV dysfunction: trial initial 2.5 mg twice daily to a target of 20 mg/day in divided doses. After the first dose, observe at least 2 hours and until blood pressure is stable for another hour.
Renal Dosing
Hypertension: CrCl >30 mL/min (serum creatinine approximately up to 3 mg/dL), usual dose. CrCl <=30 (source creatinine >=3 mg/dL), start 2.5 mg once daily, titrating until blood pressure control or maximum 40 mg/day.
| Renal status | CrCl | Initial dose |
|---|---|---|
| Normal | >80 mL/min | 5 mg/day |
| Mild impairment | >30 to <=80 | 5 mg/day |
| Moderate/severe | <=30 | 2.5 mg/day |
| Dialysis | Not specified | 2.5 mg on dialysis days; adjust nondialysis-day dose to blood pressure |
Hemodialysis
See the dialysis-day and blood-pressure instructions above.