Kaparlon-S (Enalapril Maleate)

• Enalapril acts on the renin‑angiotensin‑aldosterone system to lower blood pressure and improve cardiac function.
• Hypertension: reduces systolic and diastolic pressure, decreasing cardiovascular risk.
• Heart failure: improves symptoms and lowers hospitalization by decreasing afterload.
• Diabetic nephropathy: slows renal function decline by lowering intraglomerular pressure.

• Enalapril maleate is a prodrug that is hydrolyzed to enalaprilat, a potent inhibitor of angiotensin‑converting enzyme (ACE). By blocking ACE, it prevents conversion of angiotensin I to the vasoconstrictor angiotensin II, leading to vasodilation, reduced aldosterone secretion, and decreased sodium and water retention. These effects contribute to its therapeutic benefit in cardiovascular and renal disorders.

Enalapril may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Cough: persistent dry cough.
• Dizziness or light‑headedness, especially after the first dose.
• Headache.
• Fatigue.
• Mild hyperkalemia.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe hypotension: marked drop in blood pressure.
• Acute renal failure: sudden decline in kidney function.
• Neutropenia or agranulocytosis: rare blood disorder.

Before initiating enalapril therapy, several safety considerations should be reviewed.

• Blood pressure monitoring: check baseline and periodic readings to avoid excessive hypotension.
• Renal function assessment: evaluate serum creatinine and eGFR before and during treatment.
• Electrolyte surveillance: monitor potassium levels, especially when combined with potassium‑sparing agents.
• History of angioedema: avoid use in patients with prior ACE‑inhibitor‑induced angioedema.
• Pregnancy and lactation: use only if clearly needed, after risk‑benefit evaluation.
• Store at room temperature: keep in original container, protect from moisture and direct sunlight.

Enalapril can interact with several medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Aliskiren in diabetic patients: combined use may increase risk of renal impairment, hyperkalemia, and hypotension.
• Lithium: enalapril may increase lithium levels, risking toxicity.
• Potassium‑sparing diuretics (e.g., spironolactone): may cause significant hyperkalemia.

Moderate Interactions (Monitor Closely)

• NSAIDs (e.g., ibuprofen): may reduce antihypertensive effect and impair renal function.
• Thiazide diuretics: may enhance hypotensive response, requiring dose adjustment.
• Antidiabetic drugs (insulin, sulfonylureas): may need monitoring of blood glucose as enalapril can improve glycemic control.