By Rania Gollakner, BS, DVM, MPH

What is enalapril?

Enalapril (brand names: Enacard®, Vasotec®, Glioten®, Lotrial®, Pres®, Renitec®, Reniten®, Xanef®, Epaned®) is an ACE inhibitor used to treat heart failure, high blood pressure, or proteinuria (protein in the urine). It is also used in the treatment of chronic kidney disease.

Its use in cats, dogs, ferrets, and birds to treat certain conditions is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their direction may be significantly different from those on the label.

How is enalapril given?

Enalapril is given by mouth in the form of a tablet or liquid. It may also be given in the form of an injection into the vein in the hospital setting. The tablets or oral liquid may be given with or without food, but if vomiting occurs after dosing on an empty stomach, give future doses with food or a treat. Measure liquid doses carefully. While your pet is on this medication, make sure there is always plenty of clean water available. Do not stop this medication abruptly unless instructed by your veterinarian.

This medication should take effect within 1 to 2 hours; however, effects may not be visibly noticeable and therefore laboratory tests may need to be done to evaluate this medication’s effectiveness.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Common side effects of enalapril include loss of appetite, vomiting, diarrhea, and tiredness. In cats, lethargy and loss of appetite are most common. Serious side effects include signs of infection (fever), rash, collapse, weakness, low blood pressure, kidney dysfunction, and elevated potassium levels.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Enalapril should not be used in pets that are allergic to it or that have an acute kidney injury or certain heart conditions. It should be used cautiously in pets with kidney disease, liver disease, and heart failure with the dosages adjusted as needed. Enalapril should be used cautiously in pets with dehydration, low sodium levels, blood abnormalities, collagen vascular disease, or pets undergoing gas anesthesia. Extreme caution should be taken if administering enalapril to pregnant or lactating pets.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with enalapril: anesthetics, antacids, antihypertensive agents, vasodilators, baclofen, buspirone, cabergoline, cimetidine, corticosteroids, erythropoietin, digoxin, diphenhydramine, disopyramide, diuretics, doxepin, glycerin, heparins, NSAIDs, opioids, potassium, potassium sparing diuretics, probenecid, sildenafil, and vasodilators.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Electrolytes, kidney values, and urine protein levels should be monitored, initially 1-2 weeks after starting the medication and then every 3 months once your pet is stable. Complete blood counts and blood pressure should also be monitored depending on the reason for using this medication. Your veterinarian will also monitor your pet to be sure that the medication is working.

At home, monitor your pet for signs of congestive heart failure (difficulty breathing, increased breathing rate, cough) or serious side effects.

How do I store enalapril?

Store this medication at room temperature less than 30°C (86°F) away from moisture and light.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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