Envas 2.5

How it works?

This is the first line drug for controlling hypertension. Sometimes it is given for conditions assocaited with leakage of protein / albumin in urine even without hypertension. Renin is an important hormone in the development of hypertension, by its action on a protein, it produces Angiotension I (Angio - blood vessel; Tensin - increased tension). This is converted by an enzyme called as ACE (Angiotensin Converting Enzyme) to make a more potent protein Angiotensin II. This drugs inhibits this enzyme ACE, hence called as ACE inhibitors, thereby preventing the formation of Angiotensin II

Used in

Hypertension; Chronic Kidney Disease; Proteinuric kidney disease;  Heart failure; Heart attack (Myocardial Infarction); Stable Coronary Heart Disease;

Drug side effects

Incraeses potassium levels in the blood (Hyperkalemia); Rise in the serum creatinine (due to its effect)Sometimes allergic reactions in the mouth and lips (which in some cases may be severe enough to threaten the life with airways obstruction - Angioedema). It can be associated with chronic cough without any phlegm (sputum) production. It can cause light headedness and dizziness 

Kidney disease

Not a contraindication in any level of kidney function. But the dose adjustment may be required while starting the drug as it is primarily excreted by the kidneys. Need to monitor serum creatinine and blood (serum) potassium level especially in the elderly population. It may worsen the kidney function in patients who are having a condition called renal artery stenosis in both the kidneys

Liver disease

Enalapril is usually safe. It may sometimes cause damage to the liver cells in the formation of elevated liver function tests (The liver enzymes SGOT and SGPT) may mildly be increased. It can very rarely cause severe acute liver damage.

Pregnancy

Unsafe. Not recommended in pregnancy. It can particulary decrease the aminotic fluid (fluid around the baby) in the second and third trimester. This can damage the kidneys and lungs of the baby. This is category D drug in second trimester and category C during first trimester. Kindly discuss with your doctor if you planning for pregnancy and report immedicately to the doctor if you become pregnant when you are taking this drug.

Lactation

It is always good to discuss this concern with your doctor. Only tiny amount of this drug pass into breast milk, hence unlikey to cause the side effects in the baby. However, based on the risk assessment,  your doctor may either continue or change to an alternative drug.

Major interactions

Concaminat use of potassium supllemets or drugs like potassing sparing diuretics msy increase potassium levels in the blood.