Enalapril contraindications and warnings


The following provides information on contraindications to the use of enalapril in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).

When should not Enalapril be used?

Enalapril must not be given at

  • Hypersensitivity to enalapril or another ACE inhibitor
  • Angioneurotic edema (Quincke’s edema) with swelling of the face, lips, tongue, larynx, mucous membrane and eyes.
  • following kidney disease: bilateral renal artery stenosis (renal artery stenosis) or unilateral renal artery narrowing in a single kidney, after a kidney transplant
  • diabetics or patients with impaired kidney function who receive the antidiabetic aliskiren
  • the following heart diseases: cardiac shock, valvular constriction (mitral valve or aorta) affecting circulation, abnormal enlargement of the heart with occlusion of circulating blood from the heart
  • primary hyperaldosteronism (here, ACE inhibitors are ineffective).

Enalapril must be given at

    only after strict medical benefit-risk consideration and under regular control

  • severe renal impairment (creatinine clearance below 30 milliliters per minute, increased urine protein greater than 1 gram per day) and in patients undergoing dialysis. The concomitant use of enalapril and poly (acrylonitrile, sodium-2-methallylsulfonate) high-flux membranes (used in dialysis) is strictly prohibited.
  • Liver disease or liver dysfunction.
  • Blood salt disorders (electrolyte imbalance)
  • impaired immune response or collagen diseases (such as lupus erythematosus and scleroderma)
  • untreatable, severe heart failure
  • LDL apheresis with dextran sulfate as part of blood cholesterol clearance and other therapies where blood may come in contact with negatively charged surfaces
  • concurrent desensitization therapy with insect venoms.
  • Circulatory disorders of brain and heart.

Under medical supervision of blood pressure and laboratory results, Enalapril may be used in the treatment of severe hypertension and in patients over the age of 65.

What should you watch out for during pregnancy and lactation?

Taking Enalapril is strictly prohibited during pregnancy and lactation.

If pregnancy is planned or diagnosed, the treatment must be switched to other drugs by the doctor.

In the unborn child, the intake of enalapril may reduce renal function and delay the formation of cranial bones. A reduction of the amniotic fluid may occur. In neonates, the drug can cause kidney failure, low blood pressure and increased blood potassium concentration. With regard to these side effects, all children whose mothers have taken enalapril must be carefully monitored by a doctor. If a pregnant woman has been treated with enalapril during or after the second trimester of pregnancy, the doctor should use ultrasound to examine the kidney function and the skull of the child.

Enalapril passes into breast milk. If the doctor considers it necessary to take enalapril while breastfeeding, it must be weaned.

What should be considered in children?

In children, enalapril should generally not be used as there is too little experience with the use of the active substance in this age group. Nevertheless, some manufacturers still have at least dosage instructions for the treatment of children.

Warnings and Precautions

  • If angioneurotic edema (swelling of the face, lips, tongue, larynx, mucous membranes, eyes) occurs, discontinue therapy and seek medical attention.
  • If jaundice (icterus) develops, call the doctor and, if necessary, stop the therapy.
  • Before starting therapy, a fluid or body salt deficiency should be corrected.
  • Physical activity should not be increased suddenly during therapy.
  • Therapy should not be interrupted or stopped without medical advice.
  • In case of long-term therapy, all important laboratory values (urea, creatinine, potassium, sodium, urine protein, bilirubin, liver enzymes) must be regularly monitored by a doctor.
  • The active substance may cause birth defects during pregnancy. Pregnancy is therefore to be reliably prevented.
  • If symptoms such as fever, swollen lymph nodes and / or strep throat occur, the doctor should immediately examine the blood count.
  • In patients of African origin, enalapril therapy is often less effective. They may need higher dosages of the drug.
  • Reactivity may be so impaired by a sharp fall in blood pressure that it can be dangerous to drive or drive machinery.
  • During therapy, work without a secure hold is dangerous.

Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.