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Vasotec 10mg Tablet
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Indications & Clinical Uses
- Vasotec 10 mg tablets contain enalapril maleate, an angiotensin-converting enzyme (ACE) inhibitor.
- In the US, Vasotec is approved to treat hypertension (high blood pressure) in adults and in children aged 1 month to 16 years, and to treat symptomatic heart failure and asymptomatic left ventricular dysfunction.
- Vasotec is available in 2.5 mg, 5 mg, 10 mg and 20 mg strengths, so check the strength you are given; the 10 mg tablet is rust red and triangular.
- It is a different product from Vaseretic, which combines enalapril with the diuretic hydrochlorothiazide.
- Vasotec is taken by mouth at home, once or twice daily depending on the condition, with the dose set by the prescriber.
Side Effects
- In people treated for high blood pressure, the most frequent reactions were headache (5.2%), dizziness (4.3%), fatigue (3.0%), rash (1.4%) and cough (1.3%).
- In heart failure, low blood pressure (6.7%), dizziness (7.9%), cough (2.2%) and fainting (2.2%) were reported.
- Serious reactions include angioedema (swelling of the face, lips, tongue or throat, which can be life-threatening), very low blood pressure, kidney problems, high potassium, liver failure and neutropenia.
- BOXED WARNING: fetal toxicity - drugs that act on the renin-angiotensin system can cause injury and death to a developing baby, so stop Vasotec as soon as pregnancy is detected.
- Seek urgent help for facial or throat swelling or difficulty breathing.
Precautions & Warnings
- BOXED WARNING: when pregnancy is detected, discontinue Vasotec as soon as possible, because use in the second and third trimesters can reduce fetal kidney function and cause fetal and newborn injury or death.
- Do not use Vasotec if you have had angioedema with an ACE inhibitor, have hereditary or idiopathic angioedema, take sacubitril/valsartan, or take aliskiren with diabetes.
- Angioedema is more frequent in Black patients.
- Low blood pressure is likelier with dehydration or high-dose diuretics, and blood potassium and kidney function should be monitored, especially in kidney impairment (start 2.5 mg if creatinine clearance is 30 or lower).
- Enalapril passes into breast milk, so discuss feeding with your healthcare provider.
- A persistent dry cough can occur.
Avoid Interactions
- Medicines that increase risk: potassium supplements and potassium-sparing diuretics (high potassium), NSAIDs (worse kidney function, especially in older or dehydrated patients), lithium (lithium toxicity; frequent blood level checks are needed), aliskiren and other renin-angiotensin blockers (low blood pressure, high potassium; aliskiren contraindicated in diabetes), and strong diuretics (excess blood pressure fall).
- Sacubitril/valsartan must not be taken within 36 hours of switching to or from Vasotec.
- The label lists no medicines that reduce its effect.
- Tell your prescriber about all medicines and supplements, including any potassium supplements.
- Potassium-sparing agents should generally not be used in heart failure patients receiving Vasotec, and aliskiren should be avoided in kidney impairment (GFR below 60).
References
Frequently Asked Questions
Vasotec (enalapril) is an ACE inhibitor that treats high blood pressure in adults and children aged 1 month to 16 years. It also treats symptomatic heart failure and asymptomatic left ventricular dysfunction. It relaxes blood vessels so the heart works less hard.
Take Vasotec (enalapril) by mouth as your prescriber directs. For high blood pressure, adults usually start at 5 mg daily (2.5 mg if on a diuretic) and maintain 10 to 40 mg daily. For heart failure, the target is 2.5 to 20 mg twice daily.
Common Vasotec (enalapril) side effects are headache, dizziness, tiredness and a dry cough. Get urgent help for swelling of the face, lips, tongue or throat (angioedema), which can be fatal. Also report fainting, very low blood pressure, reduced urination or signs of high potassium.
Avoid taking Vasotec (enalapril) with sacubitril/valsartan (wait 36 hours between them) or, if you have diabetes, aliskiren. Be cautious with potassium supplements, potassium-sparing diuretics, NSAIDs and lithium. Do not use it if you have had angioedema with an ACE inhibitor.
For heart failure, Vasotec (enalapril) is started at 2.5 mg daily and increased to a target of 2.5 to 20 mg twice daily, with a maximum of 40 mg daily in divided doses. If kidney function is reduced (creatinine clearance 30 or lower), the starting dose is lower.
No. Vasotec (enalapril) has a boxed warning for fetal toxicity: it can injure or kill a developing baby, especially in the second and third trimesters. Stop it as soon as pregnancy is detected and call your healthcare provider straight away. Enalapril also passes into breast milk.
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