enalaprilat (Vasotec IV)

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Introduction

Enalapril is hepatically hydrolyzed to the active ACE inhibitor enalaprilat. Enalaprilat is available for IV administration.

Indications

Dosage

  • start 1.25 mg IV every 6 hours
  • max 5 mg IV every 6 hours
  • 0.625 mg IV every 6 hours of enalaprilat is approximately equivalent to 2.5 mg PO QD of enalapril.

Use lower initial dose when creatinine clearance < 30 mL/min.

For patients with creatinine > 3 mg/dL or creatinine clearance < 30 mL/min, begin 0.625 mg IV every 6 hours.

Pharmacokinetics

  • IV onset is within 15 minutes
  • duration of action is dose-dependent, usually lasting 4-6 hours
  • < 50% is bound to plasma proteins
  • elimination 1/2life is 35 hours
  • clearance is decreased in CHF, uremia & the elderly

elimination via liver

elimination via kidney

Adverse effects

Drug interactions

Test interactions

Mechanism of action

see ACE inhibitor

More general terms

References

  1. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 120
  2. 2.0 2.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998

Database