Enalapril with Ramipril

Enalapril and ramipril are both medications belonging to the class of angiotensin-converting enzyme (ACE) inhibitors. They work by relaxing blood vessels, thus lowering blood pressure and improving blood flow.

Indications

-Hypertension (high blood pressure) -Heart failure -Prevention of cardiovascular events (e.g., heart attack, stroke) in patients at risk -Chronic kidney disease

Dosage

-Dosage varies depending on the patient's condition, age, and other factors. It is typically initiated at a low dose and adjusted gradually based on response and tolerability. -It is important to follow the prescribed dosage regimen provided by the healthcare provider.

Contra-Indications

-Hypersensitivity to enalapril, ramipril, or any ACE inhibitors -History of angioedema related to previous ACE inhibitor use -Pregnancy (especially in the second and third trimesters) -History of bilateral renal artery stenosis or stenosis of the artery to a solitary kidney

Special Precautions

-Renal impairment: Use with caution and monitor renal function regularly. -Hyperkalemia (high potassium levels): ACE inhibitors can increase potassium levels; monitor electrolytes. -Patients with a history of angioedema: Use with caution due to the risk of recurrence. -Dual blockade of the renin-angiotensin-aldosterone system (e.g., combination of ACE inhibitors and angiotensin II receptor blockers) may increase the risk of renal impairment, hypotension, and hyperkalemia. -Discontinue or adjust the dosage if signs of renal dysfunction or hyperkalemia develop.

Side Effects

-Hypotension (low blood pressure) -Cough -Dizziness -Hyperkalemia -Fatigue -Headache -Renal impairment -Angioedema (rare but serious) -Dry cough -Rash

Drug Interactions

-Potassium-sparing diuretics (e.g., spironolactone, triamterene): Increased risk of hyperkalemia. -Nonsteroidal anti-inflammatory drugs (NSAIDs): Reduced antihypertensive effect and increased risk of renal impairment. -Lithium: Increased lithium levels, potentially leading to lithium toxicity. -Dual blockade of the renin-angiotensin-aldosterone system: Increased risk of hyperkalemia, hypotension, and renal impairment.