About Vasotec
This drug is an ACE (Angiotensin Converting Enzyme) Inhibitor.
These medications work to block an enzyme system, which causes
artery walls to relax, reducing blood pressure. This class
of drug is recommended for individuals who wish to be able
to exercise more normally. Vasotec may be prescribed as a
combination product with the diuretic hydrochlorthiazide,
another treatment for reducing blood pressure.
Vasotec is prescribed to treat: advanced heart failure,
high blood pressure (any level), reduce the risk of death
after congestive heart failure or heart attack, and may be
a treatment well-suited for diabetics with kidney problems.
You will know if treatment will be effective within a few
weeks, but as there is no cure for high blood pressure, you
may need to take this medication on a permanent basis.
Other uses may include: aiding aortic regurgitation, decreasing
high blood pressure caused by blood vessels in the kidneys
in cases where surgery is not an option, or easing rheumatoid
arthritis symptoms.
Vasotec is only available by prescription. Take daily at
consistent times for best results.
Vasotec Side Effects
Expected Side Effects: Constipation, cough, dizziness,
fainting, lightheadedness, nausea, scalding sensation in mouth.
Adverse Side Effects: The following side effects should
be reported to your doctor immediately, or medical advice
sought if your doctor is not available. If they are serious,
you will need to contact emergency personnel and seek treatment
at once.
Mild: Abdominal pain or discomfort, allergy (itching,
psoriasis, rash), altered sense of taste, fainting, fast heartbeat
when standing, headache, increased risk of infection, joint
pain, low blood sugar, nightmares, ringing in ears, sores
on mouth or tongue, swelling in extremities, vulvovaginal
itching (rare). Report infection or swelling to your doctor
at once.
Severe: Allergy (swelling of face, tongue, and/or
throat, possibly life threatening), anemia, bone marrow depression
(bleeding or bruising, fever, sore throat, weakness), fluid
retention around hallucinations, heart, high potassium levels,
liver damage, Lupus or other severe skin problems, pancreatitis.
These severe side effects are classed as rare, or may have
only occurred in isolated case reports, but be alert for them
and get all tests and check-ups as recommended by your physician.
Undesirably High Levels of Potassium: Confusion, difficulty
breathing, irregular heartbeat, nervousness, numbness or tingling
(feet, hands, lips), shortness of breath, weakness or heavy
sensation in legs.
Cautions: This medication may not be suitable for
everyone, and certain individuals may require dosage adjustments
or more careful medical supervision. To ensure the maximum
safety and effectiveness of treatment, discuss any current
instances or medical history of the following.
- Allergies: Any allergic reaction to an ACE inhibitor
means that you should not use the drug again. The development
of swelling of the tongue, face, or throat should be reported
to medical personnel at once, and you should stop taking
the medication immediately. Inform your doctor of any food
or dye allergies, this might influence a decision on which
formulation of the treatment to use.
- Bee Sting Allergy - If you had an allergic reaction
during therapy to reduce sensitivity to bee stings, you
should inform your doctor before beginning treatment.
- Blood or Bone Marrow Disease - Do not use.
- Diabetes - Dosage adjustments may be necessary.
ACE inhibitors are preferred by some doctors for the treatment
of high blood pressure in diabetics who have protein in
the urine.
- Heart Attack: Under a doctor's supervision, may
be given within 24 hours of heart attack, after the heart
has stabilized. The usual dose is 5 mg daily if it seems
effective, increased to 10 mg daily for 6 or more weeks
to prevent recurrence.
- Kidney Problems: Lower doses will be necessary,
usually from 2.5 mg-5 mg. Your doctor will advise you regarding
a safe and effective amount.
- Liver Disease - As this medication is activated
by the liver, the dosage may need to be increased in order
to get the full benefit.
- Low Sodium Diet - May increase risk of high blood
levels of potassium. Speak with your doctor about the best
course of treatment.
- Lupus - Speak to your doctor, this treatment may
or may not be suitable for you.
- Medical Tests - This medication may alter results
on a number of medical tests. Inform the lab technician
that you are using an ACE inhibitor before your test.
- Other Medications - Any other prescription or over
the counter medications that you take or may plan to take
should be discussed with your prescribing physician and
pharmacist. It's particularly important to mention treatments
for high blood pressure, including diuretics, nitrates,
drugs that supress the immune system, gout medication, anti-inflammatories
(NSAIDs), or potassium supplements.
- Potassium - If your blood levels of potassium are
very high, you should not use an ACE inhibitor.
- Pregnancy - ACE inhibitors are not generally advised
during pregnancy, and should not be taken at all during
the last two trimesters (6 months). Speak to your doctor
about safety precautions if you intend to breastfeed.
- Renal Artery Stenosis - Speak with your doctor
about this condition before deciding on a treatment.
- Scleroderma - Speak to your doctor, this treatment
may or may not be suitable for you.
- Surgery - If you will have any type of surgery
or dental work performed under general anesthesia, it is
important for your safety that your surgeon and anesthesiologist
be aware that you use this treatment.
Vasotec Interactions
This medication may not mix well with all prescription and over the counter treatments, be sure to discuss with your doctor and pharmacist any other treatments you may plan to take, especially any of the following.
- Alcohol - May lower blood pressure even further. Speak
with your doctor about recommended use.
- Anafranil (clomipramine) - This medication may build up
to toxic levels, and cause wild mood swings.
- Antacids - May decrease absorption. Do not use within
two hours of taking your medication.
- Aspirin, salicylic acid, or other salicylates - ACE inhibitor
treatment may be less effective.
- Cotrimoxazole - May increase blood levels of potassium
and the risk of disturbances in heart rhythm.
- Cox II inhibitors like Celebrex
(celecoxib) and Vioxx (rofecoxib)
may make ACE inhibitors less effective.
- Diuretics (loop) - Drugs like Bumex (bumetanide) or Lasix
(furosemide) may result in very low blood pressure when
standing, but they may be required as a combination therapy
in some cases, particularly when treating diabetics.
- Diuretics (potassium sparing) - Drugs like Aldactazide
(spirinolactone), Dyazide (triamterene), or Moduretic (amiloride)
may increase potassium levels and the risk of disturbances
in heart rhythm.
- Diuretics (thiazide) - Drugs like hydrochlorothiazide
may result in higher levels of medication in your body,
which may be used therpeutically. Many ACE inhibitors have
formulations that are combined with these drugs. This combination
is unsuitable for diabetics.
- Erythropoietin - This medication may be less effective
when taken with an ACE inhibitor.
- Glucophage (metformin) - May cause high potassium levels
or lactic acidosis when diabetic patients combine these
treatments.
- Imuran (azathioprine) - Risk of severe anemia.
- Interferons (alpha, & beta) - Do not combine, high
risk of blood disorders when these medications are used
together.
- Iron, supplemental - Do not take within 2 hours of an
ACE inhibitor, this mineral may decrease symptoms of cough
that can develop with long-term use. Do not use supplemental
iron without the supervision of a doctor, high levels may
be dangerous.
- Lithium - Toxic levels of this
drug may build up, the combination is not generally advised.
- Low salt milk - Increases risk of high blood levels of
potassium.
- Mycobutin (rifabutin) - ACE inhibitors may be less effective.
- Narcan (naloxone) - May decrease effectiveness of treatment.
- Non-Steroidal Anti-Inflammatories, or NSAIDs, such as
Butazolidine (phenylbutazone), Clinoril
(sulindac), Ibuprofen (Motrin), Indocin (indomethacin),
Feldene (piroxicam), Naprosyn (naproxen), Toradol
(ketorolac), and others may decrease the effectiveness
of treatment.
- Phenothiazines - Medications like Compazine (prochlorperazine),
Mellaril (thioridazine), Phenergan (promethazine), Prolixin
(fluphenazine), Serentil (mesoridazine), Sparine (promazine),
Stelazine (trifluoperazine), Temaril (trimeprazine), Tindal
(acetophenazine), Thorazine (chlorpromazine), Trilafon (perphenazine),
and Vesprin (triflupromazine). These tranquilizers and antipsychotics
increase the risk of low blood pressure when standing in
combination with ACE inhibitors.
- Potassium - Do not take any supplements containing potassium
without the approval of your doctor. Individuals using ACE
inhibitors are at risk for elevated levels of blood potassium.
- Rifadin (rifampin) - ACE inhibitors may be less effective.
- Salt substitutes - Increases risk of high blood levels
of potassium.
- Sandimmune (cyclosporine) - May cause delayed kidney failure.
- Zyloprim (allopurinol) - Increased risk of serious skin
reactions.
Vasotec Dosages
Vasotec is available in 2.5 mg, 5 mg, 10 mg, & 20 mg tablets.
The combination form with Hydrochlorothiazide comes with 25
mg of Hydrochlorothiazide, and 10 mg of enalapril.
Typical starting doses are 5 mg daily. Usual ongoing adult
dose is 10-40 mg daily, taken in two equal doses or a single
dose. For individuals who still have blood pressure fluctuations,
a combination treatment with a diuretic may be tried. The
maximum daily dose for individuals with kidney impairment
is 40 mg.
Vasotec Directions
For best results, take your medication at the same time every
day.
If you miss a dose, take it as soon as you remember. If it's
nearly time for your next dose, skip the missed dose and resume
your regular schedule. Do not take double doses, or change
your dose without permission from your doctor. Sudden changes
in blood pressure are undesirable, and may put elderly patients
at greater risk of stroke or heart attack.
Tablets may be taken with or without food, and they may be
crushed to aid consumption. If an extended release form should
come on the market, however, consult the instructions on the
packaging. Extended release medications should generally be
taken as is, and may be less effective or cause overdose if
crushed.
Store Vasotec away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.
Keep Vasotec away from children; both when storing it, and when discarding any unused medication.
Vasotec and Pregnancy
During the first trimester, this medication should only be
used if absolutely necessary. Use during the last two trimesters
of pregnancy could potentially inflict severe bone deformations,
low birth weight, or death on the unborn child.
If you are breast-feeding, seek your doctor's advice. Not
absolutely contraindicated, but infant should be monitored
closely.
Vasotec and Children
This medication may be used to treat malignant hypertension
in children. Consult with a physician for more specific information,
keep this medication away from children.
Vasotec and Seniors
ACE inhibitors should be started in the smallest possible doses.
Sudden changes in blood pressure, including rapid decreases,
can increase the risk of heart attack or stroke.
Vasotec should not affect seniors differently than the general
population, though dosage should be corrected to reflect kidney
function.
Vasotec and Vaseretic are trademarks of Merck
Lexxel is a trademark of AstraZeneca
Generic Enalapril is manufactured by Geneva, Mylan, Par,
and Watson
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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