Before taking enalapril

Before taking enalapril make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from kidney or liver problems.
• If you are on a salt restricted diet or use salt substitutes which contain potassium.
• If you have dialysis treatment.
• If you are dehydrated (for example if you have had diarrhoea and sickness very recently).
• If you have atherosclerosis (the build-up of fatty deposits on the walls of arteries).
• If you suffer from peripheral vascular disease (a particular type of poor circulation).
• If you suffer from a collagen vascular disease, such as systemic lupus erythematosus (SLE) or scleroderma.
• If you have cardiomyopathy (cardiac muscle disease) or aortic stenosis (narrowing of the blood vessel from the heart).
• If you have a history of angioedema (where the face, tongue and throat swell).
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic or unusual reaction to any other ACE inhibitor (this includes ramipril, lisinopril and perindopril), a type of medicine called sulphonamides (if you have been prescribed Innozide®) or to any other medicine.

How to take enalapril

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Take your medication exactly as directed by your doctor.
• It is not important whether you take your dose before or after food.
• Enalapril is usually taken once a day. Try to take enalapril at the same time each day to avoid missing any doses.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.

Getting the most from your treatment

• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
• Keep your regular doctor's appointment so your progress can be monitored.
• If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.
• Treatment with enalapril is usually life-long.
• Do not take indigestion remedies at the same time as enalapril. If you need to take an indigestion remedy, leave at least two hours before or after your dose of enalapril.
• Enalapril may cause dizziness or lightheadedness, especially the first time you take it. Make sure you know how you react to this medicine before you drive, operate machinery or do other jobs that could be dangerous if you were not fully alert.
• If you have been prescribed Innozide®, the hydrochlorothiazide contained in this product may cause a positive reaction to 'anti-doping' tests used in sport.

Can enalapril cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• Difficulty breathing, swelling of the face, mouth, tongue or throat
• Jaundice (yellowing of the skin and whites of the eyes)
• Chest pain

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store enalapril

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Innovace® tablets, Merck Sharp & Dohme Limited, electronic Medicines Compendium. Dated May 2010, accessed October 2010.
• Manufacturer's PIL, Innozide ® tablets, Merck Sharp & Dohme Limited. electronic Medicines Compendium. Dated May 2008, accessed October 2010.
• British National Formulary; 60th Edition (September 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)