USE IN PREGNANCY
When used in pregnancy during the second and third trimesters, ACE inhibitors can cause injury and even death to the developing fetus. When pregnancy is detected, enalapril maleate and hydrochlorothiazide tablets should be discontinued as soon as possible. See
WARNINGS, Pregnancy, Enalapril Maleate, Fetal/Neonatal Morbidity and Mortality.
Enalapril maleate-hydrochlorothiazide combines an angiotensin converting enzyme inhibitor, enalapril maleate, and a diuretic, hydrochlorothiazide.
Enalapril maleate is the maleate salt of enalapril, the ethyl ester of a long-acting angiotensin converting enzyme inhibitor, enalaprilat.
Enalapril maleate and hydrochlorothiazide tablets are indicated for the treatment of hypertension.
This fixed dose combination is not indicated for initial treatment (see
DOSAGE AND ADMINISTRATION).
In using enalapril maleate and hydrochlorothiazide tablets, consideration should be given to the fact that another angiotensin converting enzyme inhibitor, captopril, has caused agranulocytosis, particularly in patients with renal impairment or collagen vascular disease, and that available data are insufficient to show that enalapril does not have a similar risk. (See
In considering use of Enalapril maleate and hydrochlorothiazide tablets, it should be noted that black patients receiving ACE inhibitors have been reported to have a higher incidence of angioedema compared to non-blacks. (See
WARNINGS, Head and Neck Angioedema.)
Media Articles Related to Enalapril and Hydrochlorothiazide (Enalapril / Hydrochlorothiazide)
Hypertension Affects VTE Too
Source: theheart.org | Medscape Cardiology Headlines [2015.11.19]
Dr Goldhaber discusses some changes we may see in the incidence of MI, stroke, DVT, and PE if the medical community were to accept and adopt the new blood pressure targets studied in SPRINT.
theheart.org on Medscape
Hypertension Management After SPRINT: Fast Forward or Pause?
Source: theheart.org | Medscape Cardiology Headlines [2015.11.18]
Dr Clyde Yancy leads a panel discussion on the practice implications of the SPRINT findings suggesting a more stringent blood pressure target with Drs Bittner, Curtis, and O'Gara.
theheart.org on Medscape
Emricasan Shows Benefit in Portal Hypertension (CME/CE)
Source: MedPage Today Gastroenterology [2015.11.18]
(MedPage Today) -- Post-hoc analysis suggests severe disease should be the target
International Conference on Hypertension & Treatment, August 04-06, 2016, Toronto
Source: Conferences News From Medical News Today [2015.11.13]
OMICS International announces the International Conference on Hypertension & Treatment to be held during August 04-06, 2016 at Toronto, Canada, focusing on "Hypertension and Treatment" with a view...
White coat and masked hypertension associated with higher rates of heart and vascular disease
Source: Hypertension News From Medical News Today [2015.11.10]
Patients whose blood pressures spikes in the doctor's office but not at home, and patients whose blood pressure spikes at home but not in the doctor's office, suffer more heart attacks, heart...
Published Studies Related to Enalapril and Hydrochlorothiazide (Enalapril / Hydrochlorothiazide)
Effects of antihypertensive treatment on ultrasound measures of myocardial fibrosis in hypertensive patients with left ventricular hypertrophy: results of a randomized trial comparing the angiotensin receptor antagonist, candesartan and the angiotensin-converting enzyme inhibitor, enalapril. [2009.03]
OBJECTIVE: To compare the effects of the angiotensin II receptor antagonist candesartan with the angiotensin-converting enzyme inhibitor enalapril on myocardial fibrosis evaluated by echoreflectivity analysis... CONCLUSION: In hypertensive patients with left ventricular hypertrophy, both candesartan and enalapril induce a moderate but statistically significant reduction in an echoreflectivity index of myocardial fibrosis.
Blood pressure-lowering efficacy of amiloride versus enalapril as add-on drugs in patients with uncontrolled blood pressure receiving hydrochlorothiazide. [2008.10]
A large proportion of patients with hypertension need a second drug to reach satisfactory control of blood pressure (BP), but there are few well-designed controlled trials comparing the efficacy of drugs added as a second option. In a double-blind randomized clinical trial, 82 patients with uncontrolled BP, receiving hydrochlorothiazide 25 mg daily, were selected to receive amiloride 2.5-5 mg/day (n = 39) or enalapril 10-20 mg/day (n = 43)...
Efficacy and safety of lercanidipine versus hydrochlorothiazide as add-on to enalapril in diabetic populations with uncontrolled hypertension. [2006.01]
OBJECTIVE: Angiotensin-converting enzyme inhibitors plus dihydropyridine calcium channel blockers or low-dose thiazide diuretics are considered first-line therapies in hypertensive diabetic patients as glucose metabolism is not relevantly affected. Most diabetic patients require at least two different drug classes to achieve the recommended target blood pressure of 130/85 mmHg. This controlled clinical trial investigated the calcium channel blocker lercanidipine versus hydrochlorothiazide (HCTZ) as add-on in diabetic patients with uncontrolled hypertension on enalapril monotherapy... CONCLUSION: Lercanidipine add-on showed comparable efficacy to HCTZ add-on in diabetic patients with hypertension badly controlled on angiotensin-converting enzyme inhibitor monotherapy. The blood pressure response rates seemed to be somewhat higher following enalapril plus lercanidipine than enalapril plus HCTZ.
Rationale for the use of a fixed-dose combination in the management of hypertension: efficacy and tolerability of lercanidipine/enalapril. 
Hypertension, a significant factor in the development of cerebrovascular disorders, heart disease and renal failure, is a common disorder worldwide. Despite the availability of a wide range of antihypertensive agents, almost two-thirds of hypertensive patients have poorly controlled blood pressure (BP)...
Pharmacodynamics of kardos administered as monotherapy and in combination with hypothiazide and enalapril in grade I-II arterial hypertension. [2009.08]
Therapy with kardos produced an antiihypertensve effect in patients with grade I-II arterial hypertension. This antiihypertensve effect was considerably potentiated, when kardos was administered in combination with enalapril..
Clinical Trials Related to Enalapril and Hydrochlorothiazide (Enalapril / Hydrochlorothiazide)
Relative Bioavailability Study With Enalapril in Healthy Volunteers [Active, not recruiting]
Phase I study in healthy adult male and female volunteers to compare the bioavailability of
enalapril administered in orodispersible Minitablets with or without water in comparison to
the standard galenic tablet formulation of enalapril. The standard pharmacokinetic
parameters will be calculated from the bioanalytical results for enalapril and enalaprilat
and compared in a descriptive statistical analysis.
A Fixed Dose Combination Amlodipine + Enalapril Bioavailability Study [Completed]
The study is designed to estimate the bioavailability of amlodipine and enalapril maleate
fixed dose combination (FDC) relative to co-administration of amlodipine and enalapril
maleate tablets. The rational for this study is to provide a more convenient dosing regimen
for patients. This is an open-label, randomized, single dose, two-way crossover study, in
which 16 healthy adult male and female subjects will be enrolled and dosed under fasting
conditions. Each subject will participate in two treatment periods of 7 days each. There
will be at least 14 days of wash out period between the two dosing periods and a follow-up
period of up to 21 days after treatment period 2. The total duration of study will be
approximately 35 days from the start of the first treatment.
Comparison of the Antihypertensive Efficacy of Valsartan and Enalapril After Missing One Dose [Completed]
This study was designed in order to evaluate the blood pressure lowering effect of valsartan
compared to enalapril over 24 hours after skipping one daily dose. Both drugs act on the
renin-angiotensin-aldosterone system (RAAS) and are widely use for the treatment of
hypertension. Previous studies had a significant limitation: the effect of a missing dose
was not evaluated after the whole 24 hours post missing dose period (48 hours after last
taken dose), and as a result, it does not imitate the real life situation of a missing dose.
China Stroke Primary Prevention Trial [Completed]
The purpose of this trial is to confirm that enalapril maleate and folic acid tablets is
more effective in preventing stroke among the patients with primary hypertension when
compared to enalapril maleate.
Enalapril Maleate and Doxorubicin Hydrochloride in Treating Women With Breast Cancer [Active, not recruiting]
RATIONALE: Drugs used in chemotherapy, such as doxorubicin hydrochloride, work in different
ways to stop the growth of tumor cells, either by killing the cells or by stopping them from
dividing. Enalapril maleate may help protect heart cells from the side effects of
chemotherapy. It is not yet known whether giving enalapril maleate before or after
doxorubicin hydrochloride is more effective in treating women with breast cancer.
PURPOSE: This randomized clinical trial is studying giving enalapril maleate together with
doxorubicin hydrochloride to see how well it works in treating women with breast cancer.
Page last updated: 2015-11-19