Enalaprilat
Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect.
Drug | Enalaprilat |
Brand names | Vasotec IV ® |
Indications | Hypertension and hypertensive emergency. Acute left ventricular failure. |
Mechanism of action | Enalaprilat is the active metabolite (ester) of enalapril, an angiotensin-converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. |
Effects | • The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat, and may cause severe hypotension. |
Time to onset of action | 15 to 30 minutes. |
Peak effect | Within hours. |
Duration of effect | 8 to 24 hours |
Delivery | IV |
Dose | Initial dose: 1.25 mg iv. Increase as necessary. Maximum dose: 5 mg iv every six hours. |
Adverse effects | Severe hypotension. |
Contraindications | • Contraindicated in pregnancy, severe renal artery stenosis, severe hyperkalemia. • Avoid in acute heart failure and acute myocardial infarction. |