Enalapril - an ACE inhibitor

About enalapril

Enalapril belongs to a class of medicines called مثبطات الإنزيم المحول للأنجيوتنسين (ACE). You may have been prescribed it to reduce high blood pressure (hypertension), or to prevent (or treat) فشل القلب. Heart failure is a condition where your heart does not work as well as it should.

ACE inhibitors like enalapril prevent your body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme. This widens your blood vessels and helps to reduce the amount of water put back into your blood by your kidneys. These actions help to decrease blood pressure. Although people with high blood pressure often do not feel unwell, if left untreated, high blood pressure can harm the heart and damage blood vessels, leading to a heart attack or stroke. Enalapril can be used on its own or alongside other medicines which reduce blood pressure. A combination brand called Innozide® (which contains enalapril with another medicine called hydrochlorothiazide) can help to reduce the total number of tablets people with high blood pressure need to take each day.

In heart failure, there can be too much circulating fluid in your blood vessels because your heart is not working as efficiently as it once did. Enalapril helps to reduce this. It also appears to have a protective effect on the heart and slows the progression of the heart failure.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking enalapril it is important that your doctor knows:

• إذا كنت حاملاً أو مرضعة.

• إذا كان لديك أي مشاكل في طريقة عمل الكلى لديك، أو أي مشاكل في طريقة عمل الكبد لديك.

• إذا كنت تعاني من نقص في السوائل في الجسم (الجفاف) - على سبيل المثال، إذا كنت قد أصبت بالإسهال أو المرض مؤخرًا.

• إذا قيل لك أن لديك تراكمًا للترسبات الدهنية على جدران شرايينك، وهي حالة تُسمى تصلب الشرايين.

• إذا كنت تعاني من نوع معين من ضعف الدورة الدموية يسمى مرض الشرايين المحيطية.

• If you have collagen vascular disease - this includes conditions such as systemic lupus erythematosus (SLE) and scleroderma.

• إذا قيل لك أنك تعاني من مرض عضلة القلب (اعتلال عضلة القلب)، أو تضيق في الوعاء الدموي الرئيسي من قلبك (تضيق الأبهر).

• إذا كنت قد تعرضت في أي وقت مضى لرد فعل حيث يتورم وجهك أو لسانك أو حلقك (وذمة وعائية).

• إذا كنت تتلقى علاجًا لإزالة التحسس للحماية من لسعات النحل والدبابير.

• إذا كنت تتلقى علاج غسيل الكلى، أو علاج لإزالة الكوليسترول من دمك بواسطة جهاز (فصل الدهون منخفضة الكثافة).

• إذا كنت تتناول أي أدوية أخرى. يشمل ذلك أي أدوية تتناولها والتي يمكن شراؤها بدون وصفة طبية، بالإضافة إلى الأدوية العشبية والمكملات الغذائية.

• If you have ever had an allergic or unusual reaction to any other ACE inhibitor (such as captopril, ramipril or perindopril), or to any other medicine.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about enalapril and will provide you with a full list of side-effects which you could experience from taking it.

• Take the tablets exactly as your doctor tells you to.

• If you are being treated for high blood pressure: enalapril is taken once a day. You will be advised to take your very first dose at bedtime. This is because you can feel quite dizzy when you first start taking it. After the first dose, you can generally take enalapril at a time of day you find easy to remember. For most people this will be in the morning.

• If you are being treated for heart failure: your doctor will give you a small once-daily dose to begin with, and then your dose will be increased gradually over a few weeks. Once the dose has been increased, enalapril is commonly taken as two doses a day, one taken in the morning and the other in the evening. Increasing your dose slowly like this helps to avoid unwanted side-effects, such as dizziness.

• Try to take your doses at the same time(s) of day each day as this will help you to remember to take your doses regularly. You can take enalapril tablets either with or without food. It is best to swallow the tablet with a drink of water.

• There are several strengths of enalapril tablet. Your doctor will prescribe the strength which is suitable for your condition. Each time you collect a new supply, check to make sure the tablets are the strength that you are expecting.

• If you forget to take a dose at your usual time, take it as soon as you remember (unless it is nearly time for your next dose, in which case do not take the forgotten dose but take the next dose when it is due). Do not take two doses together to make up for a missed dose.

• حاول الحفاظ على مواعيدك المنتظمة مع طبيبك. هذا لضمان متابعة تقدمك. سيرغب طبيبك في إجراء بعض اختبارات الدم لك من وقت لآخر للتأكد من أن كليتيك تعملان بشكل جيد.

• من المهم جدًا أن تتبع أي نصائح غذائية ونمط حياة تم تقديمها لك من قبل طبيبك. قد يشمل ذلك نصائح حول تناول نظام غذائي صحي، وعدم التدخين، وممارسة التمارين الرياضية بانتظام.

• If you buy any medicines, check with a pharmacist that they are suitable to take with enalapril. This is because some medicines (such as anti-inflammatory painkillers and indigestion remedies) can interfere with your treatment.

• It is likely that your doctor will advise that you do not use salt substitutes while you are taking enalapril. These products have a high content of potassium which could be harmful for you.

• If you drink alcohol, ask your doctor for advice about drinking alcohol while you are on enalapril. Alcoholic drinks can make you feel light-headed or dizzy, and they may not be advisable for you.

• If you have diabetes you may need to check your blood glucose more frequently, as the tablets can lower the levels of sugar in your blood. Your doctor will advise you about this.

• If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking enalapril. This is because some anaesthetics could cause your blood pressure to drop too low.

• Treatment with enalapril is often long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise.

إذا كنت تتناول هيدروكلوروثيازيد أيضًا مع هذا الدواء

• أشارت الدراسات إلى أن تناول جرعات أعلى من هيدروكلوروثيازيد لفترات طويلة قد يزيد من خطر الإصابة بأنواع معينة من سرطان الجلد.

• أخبر طبيبك إذا كنت قد تلقيت علاجًا لسرطان الجلد من قبل.

• أخبر طبيبك عن أي شامات جديدة أو متغيرة أو علامات مقلقة على جلدك.

• استخدم واقي الشمس في ضوء الشمس القوي. لا تستخدم أجهزة التسمير.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with enalapril. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

مهم: if you experience any of the following potentially serious symptoms, stop taking enalapril and contact your doctor for advice straightaway:

• أي صعوبة في التنفس، أو تورم في وجهك، فمك، لسانك أو حلقك. هذه علامات على رد فعل تحسسي.

• Any yellowing of your skin or the whites of your eyes. These may be signs of a liver problem called jaundice, which is a rare side-effect.

• A severe skin rash.

إذا شعرت بأي أعراض أخرى تعتقد أنها قد تكون بسبب الأقراص، تحدث مع طبيبك أو الصيدلي للحصول على مزيد من النصائح.

• احفظ جميع الأدوية بعيدًا عن متناول ورؤية الأطفال.

• احفظه في مكان بارد وجاف، بعيدًا عن الحرارة المباشرة والضوء.