Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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VASOTEC |
| Manufacturer |
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Biovail Pharmaceuticals, Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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ACE inhibitor. |
| Generic Name |
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Enalapril maleate 2.5mg+, 5mg+, 10mg, 20mg; tabs; +scored. |
| Indications |
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Symptomatic CHF, usually with digitalis and diuretics. Asymptomatic left ventricular dysfunction (ejection fraction ≤35%). |
| Children |
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Not recommended. |
| Adults |
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Initially 2.5mg 1–2 times daily. May increase to 5–20mg daily in 1–2 divided doses; max 40mg/day. Reduce diuretic dosage before 1st dose, if possible; observe patient for at least 2 hrs after 1st dose, until BP has stabilized for at least 1 hr. CHF with hyponatremia or renal dysfunction: see literature. Left ventricular dysfunction: Initially 2.5mg twice daily; max 20mg daily in divided doses. |
| Contraindications |
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History of ACEI-associated or other angioedema. Pregnancy (Cat.D in 2nd and 3rd trimesters). |
| Precautions |
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Renal impairment. Salt/volume depletion. CHF. Dialysis (esp. high-flux membrane). Renal artery stenosis. Surgery. Monitor for hyperkalemia in diabetics. Monitor WBCs in renal or collagen vascular disease. Discontinue if neutropenia, angioedema, or laryngeal edema occurs. Pregnancy (Cat.C in 1st trimester). Nursing mothers. |
| Interactions |
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Hypotension with diuretics. Hyperkalemia with K+-sparing diuretics or K+ supplements. May increase lithium levels. |
| Adverse Reactions |
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Cough, headache, dizziness, fatigue, diarrhea, rash, orthostatic hypotension, asthenia, hyperkalemia, renal impairment, nausea. |
| How Supplied |
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Tabs—90, 100, 1000 |
| Additional Resources |
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• Related Prescribing Note |
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