• In patients who are currently being treated with a diuretic, symptomatic hypotension occasionally may occur following the initial dose of enalapril maleate tablets. The diuretic should, if possible, be discontinued for two to three days before beginning therapy with enalapril maleate tablets to reduce the likelihood of hypotension. If the patient’s blood pressure is not controlled with enalapril maleate tablets alone, diuretic therapy may be resumed.
• If the diuretic cannot be discontinued an initial dose of 2.5 mg should be used under medical supervision for at least two hours and until blood pressure has stabilized for at least an additional hour.
• The recommended initial dose in patients not on diuretics is 5 mg once a day. Dosage should be adjusted according to blood pressure response. The usual dosage range is 10 to 40 mg per day administered in a single dose or two divided doses. In some patients treated once daily, the antihypertensive effect may diminish toward the end of the dosing interval. In such patients, an increase in dosage or twice daily administration should be considered. If blood pressure is not controlled with enalapril maleate tablets alone, a diuretic may be added. Concomitant administration of enalapril maleate tablets with potassium supplements, potassium salt substitutes, or potassium-sparing diuretics may lead to increases of serum potassium.

• Enalapril maleate tablets are contraindicated in patients who are hypersensitive to this product and in patients with a history of angioedema related to previous treatment with an angiotensin-converting enzyme inhibitor and in patients with hereditary or idiopathic angioedema.
• Do not coadminister aliskiren with enalapril maleate tablets in patients with diabetes.
• Enalapril maleate tablets are contraindicated in combination with a neprilysin inhibitor (e.g., sacubitril). Do not administer enalapril maleate tablets within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor.

• Aortic Stenosis/Hypertrophic Cardiomyopathy: As with all vasodilators, enalapril should be given with caution to patients with obstruction in the outflow tract of the left ventricle.
• Impaired Renal Function: As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible individuals. In patients with severe heart failure whose renal function may depend on the activity of the renin-angiotensin-aldosterone system, treatment with angiotensin-converting enzyme inhibitors, including enalapril maleate tablets, may be associated with oliguria and/or progressive azotemia and rarely with acute renal failure and/or death.

• Dry, tickly cough. Cough medicines do not usually help coughs caused by enalapril.
• Feeling dizzy. If enalapril makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better.
• Headaches.
• Diarrhoea.
• Itching or a mild rash.
• Blurred vision.

Store at room temperature.

ENPIL – 2.5: 10×15’s
ENPIL 5: 20×15’s
ENPIL – 10: 10×14’s