Tablets Enalapril

Antihypertensive in clients not taking diuretics.

Initial: 5 mg/day; then, adjust dosage according to response (range: 10-40 mg/day in one to two doses).

Antihypertensive in clients taking diuretics.

Initial: 2.5 mg. Since hypotension may occur following the initiation of enalapril, the diuretic should be discontinued, if possible, for 2-3 days before initiating enalapril. If BP is not maintained with enalapril alone, diuretic therapy may be resumed.

Adjunct with diuretics and digitalis in heart failure. Initial: 2.5 mg 1-2 times/day; then, depending on the response, 5-20 mg/day in two divided doses. Dose should not exceed 40 mg/day. Dosage must be adjusted in clients with renal impairment or hyponatremia.

In clients with impaired renal function.

Initial: 5 mg/day if CCR ranges between 30 and 80 mL/min and serum creatinine is less than 3 mg/dL; 2.5 mg/day if CCR is less than 30 mL/min and serum creatinine is more than 3 mg/dL and in dialysis clients on dialysis days.

Renal impairment or hyponatremia.

Initial: 2.5 mg/day if serum sodium is less than 130 mEq/L and serum creatinine is more than 1.6 mg/dL. The dose may be increased to 2.5 mg b.i.d. and then 5 mg b.i.d. or higher if required; dose is given at intervals of 4 or more days. Maximum daily dose is 40 mg.

Asymptomatic LV dysfunction following MI.

2.5—20 mg/day beginning 72 hr or longer after onset of MI. Therapy is continued for 1 year or longer.

NOTE: Dosage should be decreased in clients with a CCR less than 30 mL/min and a serum creatinine level greater than 3 mg/dL. • IV (Enalaprilat)

Hypertension. 1.25 mg over a 5-min period; repeat q 6 hr.

Antihypertensive in clients taking diuretics.

Initial: 0.625 mg over 5 min; if an adequate response is seen after 1 hr, administer another 0.625-mg dose. Thereafter, 1.25 mg q 6 hr.

Clients with impaired renal function.

Give enalaprit, 1.25 mg q 6 hr for clients with a CCR more than 30 mL/min and an initial dose of 0.625 mg for clients with a CCR less than 30 mL/min. If there is an adequate response, an additional 0.625 mg may be given after 1 hr; thereafter, additional 1.25-mg doses can be given q 6 hr. For dialysis clients, the initial dose is 0.625 mg q 6 hr.

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