What is this medicine used for?
Used in the treatment of hypertension and heart failure. It may also be given prophylactically to patients with asymptomatic left ventricular dysfunction to delay the onset of symptomatic heart failure and to those with left ventricular dysfunction to reduce the incidence of coronary ischemic events, including myocardial infarction.
How much and how often should you use this medicine?
TREATMENT OF HYPERTENSION
Initial Dose: 5 mg daily
The first dose should preferably be given at bedtime.
For patients with renal impairment or those who are receiving a
diuretic: 2.5 mg daily
If possible, the diuretic should be withdrawn 2 or 3 days before enalapril is
started and resumed later if necessary.
Initial Dose: 2.5 mg daily
Maintenance Dose: 10 mg to 20 mg once daily up to 40 mg daily in
It may be given in 2 divided doses if control is inadequate with a single
MANAGEMENT OF HEART FAILURE
Initial Dose: 2.5 mg daily
Maintenance Dose: 20 mg daily as a single dose or in 2 divided doses.
Treatment should be initiated with a low dose under close medical
Gastric and duodenal ulcer, moderate and severe reflux esophagitis
Recommended Dose: 40mg per day
- For the management of reflux esophagitis, pantoprazole can be administered by slow IV injection over 2 to 5 minutes, or by IV infusion over 15 minutes.
Zollinger-Ellison Syndrome and other pathological hypersecretory conditions
Recommended Dose: 80mg IV injection per day
- The dose and duration of treatment should be adjusted according to patient’s response.
Daily doses above 80mg should be administered in two divided doses.
ACE inhibitors should not be used in patients with aortic stenosis or outflow tract obstruction. They should not generally be used in patients with renovascular disease, but are occasionally necessary for severe resistant hypertension in such patients when they should only be given with great caution and under close specialist supervision. It should be noted that the elderly or patients with peripheral vascular diseases or generalized atherosclerosis may be at high risk because they may have clinically silent renovascular disease. ACE inhibitors should not be used during pregnancy.
Warning and Precautions
Renal function should be assessed in all patients prior to administration of ACE inhibitors. Patients with existing renal disease or taking high doses should be monitored regularly for proteinuria. Regular white blood cell counts may be necessary in patients with collagen vascular disorders, such as systemic lupus erythematosus and scleroderma, or in patients receiving immunosuppressive therapy, especially when they have impaired renal function. Patients with heart failure and patients who are likely to be salt or water depleted (for example, those receiving concomitant treatment with diuretics or dialysis) may experience symptomatic hypotension during the initial stages of ACE inhibitor therapy. Treatment should, therefore, be started under close medical supervision, using a low dose and with the patient in a recumbent position to minimize this effect. Enalapril should be avoided during pregnancy
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