Medically reviewed on June 7, This document contains side effect information about enalapril. Some of the dosage forms listed on this page may not apply to the brand name Vasotec. Common side effects of Vasotec include: Other side effects include: See below for a comprehensive list of adverse effects. Along with its needed effects, enalapril the active ingredient contained cows milk and egg white allergy Vasotec may cause some unwanted effects.
Although not all of these side effects may occur, if they do occur they may need medical attention, capsaicin and ramipril. Check with your doctor immediately if any of the following side effects occur while taking enalapril:. Some side cigarette smoking and erectile dysfunction of enalapril may occur that usually do not need medical attention.
These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:. For Healthcare Professionals Applies to enalapril: Predisposing risk factors for hypotension after enalapril the active ingredient contained in Vasotec administration are decreased intravascular volume angiotensin-dependencyhyponatremiaand concurrent use of a diuretic agent.
Angioedema [ Diabetes type 1 and type 2 ]. Vertigocapsaicin and ramipril, fatigue, peripheral paresthesias, insomniadizziness, syncope [ Ref ]. Enalapril, like other angiotensin converting enzyme inhibitorsmay decrease serum aldosterone levels, resulting in mild to moderate hyperkalemia. Diuretic use and advanced age increase the risk of renal impairment. Enalapril reduced the risk of renal impairment compared to placebo in diabetic patients.
The concomitant use of beta blockers with enalapril the active ingredient contained in Vasotec has been shown to be capsaicin and ramipril. Enalapril may worsen renal insufficiency, especially if the capsaicin and ramipril is hypovolemic or hypotensive. Patients with underlying congestive heart failure are predisposed to renal side effects associated with enalapril. Increased serum creatinine, uric acid, and potassium [ Ref ].
Rare case reports of enalapril-associated hepatitis, capsaicin and ramipril liver function tests rose despite resolution of congestive heart failure, are reported. A year-old woman with hypertension developed asymptomatic abnormal liver function tests associated with eosinophilia and relatively normal abdominal ultrasonography seven weeks after beginning enalapril the active ingredient contained in Vasotec An extensive work-up revealed no evidence of infection; liver biopsy revealed cellular degeneration, portal eosinophilic and mononuclear infiltration, and centrilobular necrosis.
The signs and symptoms of hepatitis resolved upon discontinuation of enalapril. An year-old capsaicin and ramipril with hypertension and mild heart failure developed hepatomegaly and icterus accompanied by increased conjugated bilirubin, alkaline phosphatase, and aspartate aminotransferase thirty days after beginning enalapril treatment.
The patient had not been taking any other medications or herbal products, capsaicin and ramipril. Serology for hepatitis AB, C and autoimmune screen were negative, capsaicin and ramipril. Other infectious causes were ruled out. Twenty days after admission, the patient developed grade III encephalopathy and severe coagulation disorders and died 30 days after admission.
In patients with liver dysfunction, frequent monitoring of liver effexor withdrawal and heart problems tests during enalapril administration is recommended. Cholestatic jaundicecentrilobular necrosis, fulminant hepatic necrosis, death [ Ref ].
Angioedema, obstructive laryngeal and glossal angioedema, intestinal angioedema, Henoch-Schonlein purpura [ Ref ]. Late-onset enalapril-induced angioedema more than three months is reported in at least one patient capsaicin and ramipril had taken enalapril without incident for three years.
Patients with intestinal angioedema generally present with abdominal pain with or without nausea or vomiting and in some cases there was no prior history of facial angioedema, capsaicin and ramipril, and C-1 esterase levels were normal. These symptoms resolve after stopping the ACE inhibitor. New bronchial hyperactivity, rhinorrhea, exacerbation of obstructive sleep apnea [ Ref ]. Rare case reports of asthma associated with some angiotensin converting enzyme inhibitors suggest that these drugs seem to play a role in the genesis and metabolism of bronchodilatory mediators.
For this reason, some experts recommend cautious use of enalapril in patients with preexisting asthma. A retrospective study has revealed a significantly higher incidence of discontinuation of angiotensin converting enzyme ACE inhibitor therapy due to cough among black patients compared with non-black patients 9.
Several agents have been studied for treating cough with ACE inhibitors. No long term trials exist to allow a definitive treatment option.
Cromolyn has the most data showing some benefit. Other agents studied include baclofentheophyllinesulindaccapsaicin and ramipril, and benzonatate. Rare, reversible cases of agranulocytosis associated with enalapril the active ingredient contained in Vasotec and other angiotensin converting enzyme ACE inhibitors have been reported.
ACE inhibitors have been capsaicin and ramipril to treat celebrities and accutane renal capsaicin and ramipril erythrocytosis, capsaicin and ramipril. Data have shown that they may decrease circulating erythropoietin levels in these patients.
Rare less than 0. Neutropeniacapsaicin and ramipril, agranulocytosis [ Ref ]. Pancreatitisacute small bowel mucosal edema [ Ref ]. A year-old woman with hypertension and diabetes developed acute abdominal pain, nausea, and vomiting associated upper abdominal tenderness, hyperamylasemia, hyperlipasemia, and normal upper abdominal ultrasonography within 24 hours of starting enalapril.
Capsaicin and ramipril signs and symptoms of pancreatitis resolved over the next several days once the drug was discontinued. No rechallenge was performed. The patient had been receiving capsaicin and ramipril, HCTZ, differentiating croup and asthma amiloride for one year. The pancreatitis resolved over 7 days.
The patient upon rechallenge with enalapril developed severe upper abdominal pain, vomiting, and hypotension. CT scan showed intrapancreatic necrosis and peripancreatic fluid. Four weeks later a CT scan showed three pseudocysts that took 4 months to resolve. The author of the report concluded that rechallenging patients who develop acute pancreatitis while on enalapril is not recommended.
A year-old Korean woman with hypertension experienced a generalized, erythematous, scaly rash associated with a positive Nikolsky sign and biopsy results consistent with pemphigus foliaceous within three weeks after beginning enalapril the active ingredient contained in Vasotec Direct immunofluorescence revealed intercellular IgG deposition.
The pemphigus remained active at least 12 months after enalapril was discontinued. A year-old woman with hypertension developed alopecia during enalapril therapy, which resolved upon discontinuation of the drug, and recurred upon rechallenge. A year-old man with heart failure developed a generalized morbilliform rash after starting enalapril. Biopsy was consistent with toxic pustuloderma. Alopecia, photosensitive lichenoid eruptions, erythema with vasculitisbullous pemphigoidpemphigus foliaceous, toxic pustuloderma [ Ref ], capsaicin and ramipril.
Depressionacute psychosis [ Ref ]. A year-old woman with hypertension and a history of depression associated with the use of beta-blockers, developed fatigue, malaise, and clinical signs and symptoms of depression, capsaicin and ramipril, including suicidal ideation, capsaicin and ramipril, within five weeks after starting enalapril.
The depression gradually resolved with substitution of a thiazide diuretic and a low sodium diet. Rechallenge resulted in recurrent depression. A year-old man with hypertension became agitated, capsaicin and ramipril, anxious, depressed, and unable to sleep four weeks after starting enalapril, capsaicin and ramipril.
The psychosis resolved when enalapril was stopped, and recurred upon rechallenge. Syndrome of inappropriate ADH secretion, gynecomastia [ Ref ]. A year-old woman with diabetes mellitus and hypertension developed symptomatic hyponatremia associated with decreased plasma and increased urine osmolalities, normal thyroid and basal cortisol studies, and a positive water load test four months after beginning enalapril. The syndrome resolved upon discontinuation of enalapril, and recurred upon rechallenge.
Severe arthralgias and myalgias [ Ref ]. A year-old woman with hypertension, on enalapril monotherapy for three weeks, developed progressive myalgias, asthenia, morning stiffness, and weakness associated with no abnormal laboratory values.
In at least one other case, rechallenge resulted in recurrent symptoms. Positive fluorescent antinuclear antibody test [ Ref ]. Vulvovaginal pruritusdysuriaincontinence [ Ref ]. Francis GS, Rucinska EJ "Long-term effects of a once-a-day versus twice-a-day regimen of enalapril for congestive heart failure. Gimenez JC "Angioneurotic edema produced by enalapril. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors. Fagher B, capsaicin and ramipril, Katzman P, Hulthen UL, et al "Antihypertensive efficacy and tolerability of enalapril and slow-release verapamil in essential hypertension: Leon AS "Efficacy and safety of enalapril versus extended-release nifedipine for the treatment of mild-to-moderate hypertension - a multicenter week study.
Bajaj AK "Topics in clinical pharmacology: Ahmad S "Enalapril and peripheral neuropathy. Hormigo A, Alves M "Peripheral neuropathy in a patient receiving enalapril. Dallavolta S "Safety and efficacy study of delapril versus enalapril in patients with congestive heart failure. Schwartz D, Averbuch M, Pines A, et al "Renal toxicity of enalapril in very elderly patients with progressive, severe congestive heart failure. Champ JD "Case report: Ljungman S, Kjekshus J, Swedberg K "Renal function in severe congestive heart failure during treatment with capsaicin and ramipril. Thind GS "Renal insufficiency during angiotensin-converting enzyme inhibitor therapy in hypertensive patients with no renal artery stenosis.
Shionoiri H, Nomura S, Oda H, et al "Hepatitis associated with captopril and enalapril but not with delapril in a patient with congestive heart failure receiving chronic hemodialysis. Late onset, irregular course, and potential role of triggers. Jain M, Armstrong L, capsaicin and ramipril, Hall J "Predisposition to and late onset of upper airway obstruction following angiotensin-converting enzyme inhibitor therapy. Semple PF "Putative mechanisms of cough after treatment with angiotensin converting capsaicin and ramipril inhibitors.
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