Lanex (Enalapril Maleate)

Enalapril Maleate is used to treat conditions related to the renin‑angiotensin system and cardiovascular disease.

• Hypertension: lowers elevated blood pressure and reduces cardiovascular risk.
• Heart failure: improves symptoms and decreases mortality in patients with reduced ejection fraction.
• Diabetic nephropathy: slows progression of kidney damage in patients with diabetes.

• Enalapril Maleate is converted in vivo to enalaprilat, which binds to the active site of angiotensin‑converting enzyme (ACE). This inhibition prevents the conversion of angiotensin I to the potent vasoconstrictor angiotensin II, leading to vasodilation, reduced aldosterone secretion, and decreased sodium and water retention, thereby lowering blood pressure and easing cardiac workload.

Adverse reactions may occur with any ACE inhibitor and should be monitored.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Dizziness: especially upon standing.
• Headache: mild to moderate intensity.
• Fatigue: general feeling of tiredness.
• Hyperkalemia: elevated blood potassium levels.
• Renal function changes: modest rise in serum creatinine.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe hypotension: markedly low blood pressure.
• Acute renal failure: sudden loss of kidney function.
• Hepatic injury: abnormal liver enzymes or hepatitis.
• Neutropenia: reduced white blood cell count.
• Stevens‑Johnson syndrome: severe skin reaction.

Before initiating therapy, consider patient‑specific factors and monitor appropriately.

• Pregnancy: avoid use; potential fetal harm is unknown.
• Breastfeeding: consult a physician; drug may pass into milk.
• Renal impairment: dose adjustment may be required.
• Hyperkalemia risk: monitor serum potassium, especially with potassium‑sparing agents.
• Concomitant diuretics: watch for volume depletion and hypotension.
• Store at ambient temperature: keep below 25 °C, retain original packaging, protect from moisture and direct sunlight.

Enalapril may interact with several drug classes; awareness helps prevent adverse events.

Major Interactions (Avoid)

• Aliskiren: combined use in diabetes or renal impairment can increase risk of renal dysfunction.
• Lithium: may raise lithium levels, leading to toxicity.
• Potassium‑sparing diuretics or supplements: can cause dangerous hyperkalemia.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may blunt antihypertensive effect and affect renal function.
• Diuretics: may enhance hypotensive response, especially during initiation.
• Antihyperglycemics: ACE inhibitors can improve glycemic control, requiring dose adjustments.
• Rifampin: may reduce enalapril plasma concentrations.
• Certain antibiotics (e.g., trimethoprim‑sulfamethoxazole): increase risk of hyperkalemia.