Enalapril Dosage

This dosage information may not include all the information needed to use Enalapril safely and effectively. See additional information for Enalapril.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Diabetic Nephropathy

Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally per day in 1 to 2 divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Hypertension

Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally per day in 1 to 2 divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Hypertensive Emergency

Initial dose (oral): 5 mg orally once a day.
Maintenance dose (oral): 10 to 40 mg orally per day in 1 to 2 divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Congestive Heart Failure

Initial dose (oral): 2.5 mg orally once a day.
Maintenance dose (oral): 2.5 to 20 mg orally twice a day.
Doses should be titrated upward, as tolerated, over a period of a few days or weeks.
The maximum daily dose is 40 mg in divided doses.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Adult Dose for Left Ventricular Dysfunction

Initial dose (oral): 2.5 mg orally twice a day.
Maintenance dose (oral): 20 mg orally in divided doses.
If possible, the dose of any concomitant diuretic should be reduced which may diminish the likelihood of hypotension.
Intravenous: 1.25 to 5 mg every 6 hours.

Usual Pediatric Dose for Hypertension

Hypertension:
Oral:
Children 1 month to 17 years: Initial: 0.08 mg/kg/day (up to 5 mg) in 1 to 2 divided doses. Adjust dosage based on patient response.
Doses greater than 0.58 mg/kg (40 mg) have not been evaluated in pediatric patients


Heart failure (non-FDA approved):
Infants and Children:
Oral:
Initial: 0.1 mg/kg/day in 1 to 2 divided doses. Increase as required over 2 weeks to a maximum of 0.5 mg/kg/day. Mean dose required for CHF improvement in 39 children (9 days to 17 years) was 0.36 mg/kg/day.

Renal Dose Adjustments

CrCl < 30 mL/min:
Oral: 2.5 mg once a day, titrated upward until blood pressure is controlled.
Intravenous: 0.625 mg every 6 hours and increase dose based on response.

Liver Dose Adjustments

Data not available

Dose Adjustments

In some patients treated with once daily dosing, the antihypertensive effect may diminish toward the end of the dosing interval. If trough response is inadequate, increasing dosage or dividing the daily dose should be considered. If blood pressure is not adequately controlled with enalapril alone, a diuretic may be added.

Precautions

In patients who are currently being treated with a diuretic, symptomatic hypotension occasionally can occur following the initial dose of enalapril. To reduce the likelihood of hypotension, the diuretic should, if possible, be discontinued 2 to 3 days prior to beginning therapy with enalapril. Then, if blood pressure is not controlled with enalapril alone, diuretic therapy should be resumed. If diuretic therapy cannot be discontinued, an initial dose of 2.5 mg (oral) or 0.625 mg (IV) should be used with careful medical supervision for several hours and until blood pressure has stabilized.

Dialysis

Enalapril is removed by hemodialysis (20% to 50%).

Hemodialysis: 2.5 mg on dialysis days. The dosage on non-dialysis days should be adjusted according to blood pressure response.

Other Comments

Generally the use of IV enalapril is not recommended for more than 7 days.

Compared with Caucasian patients, Black patients have a reduced blood pressure response to monotherapy with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers; however, the reduced response is largely eliminated if combination therapy that includes an adequate dose of a diuretic is instituted.

Following first-time MI, all ACE inhibitors, at comparable appropriate dosages, appear to be equally effective for reducing mortality and recurrent MI rates.

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