Enalapril Maleate

Enalapril Maleate

Hypertension

Oral

• Initial: 2.5-5 mg PO qDay
• Maintenance: 10-40 mg/day PO qDay or divided q12hr

IV

• 1.25 mg/dose IV over 5 minutes q6hr; doses up to 5 mg/dose IV q6hr have been administered

Left Ventricular Dysfunction

Initial: 2.5 mg PO q12hr

May titrate up to 20 mg/day

Congestive Heart Failure

Initial: 2.5 mg PO qDay or q12hr

Maintenance: 5-40 mg/Day PO divided q12hr; titrate slowly q2Weeks

IV: 1.25-5 mg q6hr; avoid IV administration in unstable heart failure or acute myocardial infarction

Conversion from IV to oral dosage form

If not concurrently receiving diuretics, initiate enalapril 5 mg PO qDay; if concurrently receiving diuretics and responding to 0.625 mg IV q6hr, initiate at 2.5 mg PO qDay; titrate upwards as necessary

Dosage Modifications

Hepatic impairment: No dosage adjustment required

Renal impairment

• CrCl <30 mL/min: (PO) Initiate 2.5 mg; titrate to response; not to exceed 40 mg
• Dialysis: 2.5 mg PO on day of dialysis; adjust dose on nondialysis days according to BP
• CrCl <30 mL/min: (IV) Initiate 0.625 mg q6hr; titrate based on response
• CrCl ≥30 mL/min: (PO) Initiate 5 mg/day; titrate to maximum of 40 mg
• CrCl ≥30 mL/min: (IV) 1.25 mg q6hr; titrate based on response