Enalapril

Enalapril belongs to a group of drugs called ACE inhibitors. They are used in children with heart problems to lower blood pressure and help reduce the workload of the heart. This information sheet describes how this medicine is given and some of its possible side effects.Children starting on enalapril will need their blood pressure checking to make sure the dose is tolerated. Enalapril works by causing the small arteries to relax, reducing blood pressure and allowing the heart to work more effectively.

Enalapril is usually given once or twice a day. It is available as tablets in the following strengths: 2.5mg, 5mg, 10mg and 20mg. Tablets can be crushed and dispersed in water to give to younger children using the oral syringe provided.

People with the following conditions should discuss taking enalapril with their doctor:

• pregnant or could be pregnant, planning to become pregnant or breast-feeding
• hereditary angioedema, a condition that causes inflammation and swelling of various parts of the body such as the lips, tongue, skin, intestines
• kidney disease

Enalapril is usually well tolerated. It can cause:

• Low blood pressure: dizziness sometimes occurs when starting the medicine or after the dose has been increased. If your child feels dizzy, lying down will help.
• Skin rashes
• Changes in sense of taste (usually only for a short time)
• Dry cough
• Nausea (feeling sick)
• Low white cell count
• Potassium levels in the blood can be affected. This will need to be checked routinely along with kidney function.

Some medicines can interact with enalapril. Always check with your prescriber or pharmacist before giving your child any other medicines, including herbal or complementary medicines. The following medicines are known to react with enalapril:

• Furosemide, digoxin, amiloride, spironolactone and potassium supplements: These medicines are often prescribed alongside enalapril. They affect the potassium level in the body so a blood test to check the potassium level may be needed if a medicine is added, increased or stopped.
• Medicines that lower the blood pressure, such as calcium channel blockers angiotensin II blockers and beta-blockers: These are sometimes prescribed alongside enalapril. They have an additional effect on the blood pressure. If dizziness or fainting occurs, please tell us.
• Non-steroidal anti-inflammatory drugs such diclofenac and ibuprofen: Kidney function will need to be monitored if these medicines are taken with enalapril.
• Lithium: lithium levels in the body may be increased if taken with enalapril

• Keep medicines in a safe place where children cannot reach them.
• Keep medicines in a cool, dry place out of direct sunlight and away from heat.
• If your doctor decides to stop treatment with enalapril, return any unused medicine to the pharmacist. Do not flush down the toilet or throw it away.
• If you forget to give your child a dose, give it as soon as you remember. Do not give a double dose.
• If you child vomits after taking the medicine, do not give a double dose.
• Your family doctor (GP) will need to give you a repeat prescription for enalapril. Some medicines will need to be ordered by your community pharmacy (chemist) so arrange this in plenty of time.