Vasotec

The active ingredient in Vasotec is enalapril maleate, which belongs to a class of drugs called angiotensin-converting enzyme inhibitors (ACE inhibitors).

Normally, your body produces a substance called angiotensin II, which tightens blood vessels and increases blood pressure. Enalapril blocks the enzyme (ACE) that makes angiotensin II, helping blood vessels relax and widen. As a result, blood pressure drops and the heart pumps blood more easily.

This mechanism of action also helps reduce the workload on the heart, which helps manage congestive heart failure, left ventricular dysfunction, and high blood pressure.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Vasotec. However, the following is a synopsis of the general guidelines for the use of Vasotec:

• Take Vasotec exactly as prescribed, usually once or twice daily, with or without food.
• The dosage depends on your medical condition, kidney function, and response to treatment.
• If you’re taking a diuretic (water pill), your doctor may adjust the dose to prevent low blood pressure.
• If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Don’t double the dose.
• Keep taking Vasotec even if you feel well, as high blood pressure often has no symptoms.
• Drink enough fluids, but talk to your healthcare provider before using salt substitutes, potassium supplements, or potassium-sparing diuretics like spironolactone or amiloride, since these can increase potassium levels in your blood.

Some mild or common side effects of Vasotec include:

• Dizziness or lightheadedness, especially when standing up quickly.
• Cough.
• Fatigue.
• Headache.
• Nausea or diarrhea.

Some individuals may experience serious side effects while using Vasotec. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Swelling of the face, lips, tongue, or throat (angioedema), which can be life-threatening.
• Fainting or severe low blood pressure (hypotension).
• Signs of high potassium levels (hyperkalemia) include muscle weakness or irregular heartbeat.
• Signs of kidney problems (reduced urine, swelling in legs or ankles).
• Sore throat, fever, or chills may indicate a low white blood cell count.
• Allergic reaction (rash, itching, or severe dizziness).

These are not all of the possible side effects of enalapril. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Vasotec, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• Kidney disease or are on dialysis.
• Liver problems.
• Heart failure or history of heart attack.
• Diabetes, especially if you take aliskiren or an ARB (like losartan, valsartan, or sacubitril/valsartan).
• High potassium levels or use potassium supplements.
• Narrowing of blood vessels to the kidneys (renal artery stenosis).
• Pregnant, planning to become pregnant, or breastfeeding.

Boxed Warning

When used during pregnancy, Vasotec (enalapril) can cause injury and even death to the developing fetus. If pregnancy is detected, stop Vasotec as soon as possible. Alternative treatment should be used to manage blood pressure in pregnant women.

Do not use Vasotec if you:

• Have ever had an allergic reaction or angioedema related to enalapril or previous ACE inhibitor therapy.
• Taking aliskiren and have diabetes.
• Taking at the same time or within 36 hours of a neprilysin inhibitor like Entresto (sacubitril/valsartan).

You may start to notice improvements in blood pressure within an hour of taking your first dose, but it can take up to two weeks for the full effect. For heart failure, it may take several weeks before you feel the maximum benefit. Always take Vasotec consistently as prescribed.

When Vasotec is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Potassium supplements or potassium-sparing diuretics (like spironolactone, amiloride) – may cause high potassium levels.
• NSAIDs (ibuprofen, naproxen, indomethacin) – may reduce Vasotec’s effectiveness and increase kidney risks.
• Diuretics (water pills) – may increase the risk of low blood pressure when starting Vasotec.
• Other blood pressure medicines, especially ARBs (valsartan, losartan, sacubitril/valsartan) or aliskiren, can cause kidney problems or dangerously low blood pressure.
• Lithium – Vasotec can raise lithium levels and increase toxicity risk.
• Immunosuppressants such as sirolimus, everolimus, or temsirolimus increase the risk of angioedema.
• Salt substitutes containing potassium can raise potassium to dangerous levels.

Vasotec (enalapril maleate) is available in the following dosage forms and strengths:

Tablets: 2.5 mg, 5 mg, 10 mg, and 20 mg

Oral solution: 1 mg/mL concentration

Your doctor will adjust your dosage based on your age, medical condition, and kidney function.

Store Vasotec tablets at room temperature, away from moisture, heat, and direct light.

Keep the oral solution tightly closed and refrigerated (between 2°C and 8°C / 36°F and 46°F) if instructed. Do not freeze.

Keep all medicines out of reach of children and pets.

Vasotec is manufactured by Merck & Co., Inc.

Yes. There are generic versions of Vasotec available.

Do not stop Vasotec without talking to your doctor. Stopping suddenly may cause your blood pressure to rise or worsen heart failure symptoms. If you need to discontinue, your doctor will guide you on how to taper or switch to another medication safely.

No. Vasotec should not be used during pregnancy. ACE inhibitors like enalapril can harm or even cause death to an unborn baby, particularly during the second and third trimesters. If you become pregnant, stop taking Vasotec immediately and contact your doctor for medical advice.

Enalapril passes into breast milk in small amounts. Talk to your doctor before breastfeeding while on Vasotec. Your healthcare provider will help determine whether to stop breastfeeding or change your treatment.