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The FDA modified its labeling in February 2009 to include a precaution of drug interaction with gold. "Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and hypotension) have been reported rarely in patients on therapy with injectable gold ( sodium aurothiomalate ) and concomitant ACE inhibitor therapy including Monopril ...
Furthermore, enalapril is an emerging treatment for psychogenic polydipsia. A double-blind, placebo-controlled trial showed that when used for this purpose, enalapril led to decreased water consumption (determined by urine output and osmolality) in 60% of patients.
Enalapril/hydrochlorothiazide, sold under the brand name Vaseretic among others, is a fixed-dose combination medication used for the treatment of hypertension (high blood pressure). [2] It contains enalapril , an angiotensin converting enzyme inhibitor , and hydrochlorothiazide a diuretic . [ 2 ]
The PARADIGM-HF trial (in which Milton Packer was one of the principal investigators) compared treatment with sacubitril/valsartan to treatment with enalapril. [44] People with heart failure and reduced LVEF (10,513) were sequentially treated on a short-term basis with enalapril and then with sacubitril/valsartan.
Enalaprilat is the active metabolite of enalapril. It is the first dicarboxylate-containing ACE inhibitor and was developed partly to overcome these limitations of captopril. The thiol functional group of captopril was replaced with a carboxylic acid group, but additional modifications were required to achieve a potency similar to captopril.
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Interactions : No interactions were recorded when administered with atenolol (beta blocker), enalapril (ACE inhibitor) and theophylline. [32] Furosemide has drop effect on plasma level for tamsulosin, and a rise in plasma level with cimetidine. No dose adjustment needs to be done when the levels are in normal range.
Treatment should be mainly symptomatic and supportive, with volume expansion using normal saline to correct hypotension and improve renal function, and gastric lavage followed by activated charcoal and a cathartic to prevent further absorption of the drug. Captopril, enalapril, lisinopril and perindopril are known to be removable by hemodialysis.
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