What are the precautions or contraindications for using enalapril?
Along the same lines, enalapril should not be used in patients with existing acute kidney injuries. There is the risk that it could make the damage worse.
Plus, dogs and cats with acute heart failure should also not take enalapril since enalapril can cause a sharp decrease in blood flow to the kidneys. Since it takes a few days for enalapril to be helpful to the heart, the veterinarian will wait to start it once a congestive heart failure patient stabilizes.
It is fairly common that dogs with chronic heart failure will end up on enalapril plus a diuretic (i.e. water pill) like furosemide. The combination of these two medications can decrease blood flow to the kidneys as a side effect of helping to take the burden off the heart. For this reason, the vet will monitor your dog’s kidney values carefully when using enalapril and furosemide (Lasix®) together.
Veterinarians will also commonly use enalapril with other heart medications like pimobendan (i.e. Vetmedin®) as combination therapy for heart failure.
When a dog takes enalapril, the liver metabolizes it into the active form called enalaprilat. In cases of liver disease in dogs or liver damage, the liver many not be able to metabolize the enalapril. Also, in rare instances, enalapril may cause acute liver damage. The reason for this is unknown.
Enalapril should be used with caution in pets who are dehydrated and in pets who have already have an increased blood potassium level (i.e. hyperkalemia). Enalapril can further increase blood potassium levels, which may lead to a life-threatening heart arrhythmia. Using enalapril with a potassium-sparing diuretic like spironolactone intensifies that risk.
Because enalapril can lower blood pressure, it should not be given prior to undergoing anesthesia. The combination of enalapril, and sedatives or anesthetics (which can also lower blood pressure) can lead to a dangerously low blood pressure.
Pregnant dogs should not take enalapril. Enalapril can reduce fetal kidney function and increase the risk of fetal death.
Before prescribing enalapril, your vet will also want to know the names of any other medications and supplements your dog is taking. This is important information that can hopefully prevent negative drug interactions.
Depending on the medication, the combination of the two drugs can increase the risk of adverse effects like vomiting and diarrhea. Or it may negatively impact the way the body metabolizes enalapril. The following list of medications, while not comprehensive, should be used carefully (or not at all) when receiving enalapril:
Side Effects of Enalapril for Dogs
As with any medication, side effects may occur while your dog is on enalapril. Possible gastrointestinal side effects include:
Less commonly, dogs may develop weakness, low blood pressure, kidney dysfunction, and elevated potassium levels (which could negatively affect the heart). Contact your veterinarian if your dog is showing side effects from enalapril—they may want to adjust the dose or switch to a different medication.
The recommended dosage of enalapril for dogs falls within a wide range. Most dogs are dosed at 0.25 to 1 milligram per kilogram of body mass every 12–24 hours. Enalapril is given orally as a pill and is only available with a prescription from your veterinarian. Your vets office may carry enalapril, but you can also purchase it from a human pharmacy.
Enalapril overdose may occur if you accidentally give your dog too much or if your dog gets into the pill container. Toxicity usually occurs after extreme overdoses—about 10 times the recommended dose. The biggest concern after an overdose is low blood pressure which can lead to weakness, lethargy, collapse, and kidney failure.
Contact your vet if your dog gets more enalapril than recommended (even if it does not seem like a lot). Be sure to tell them how much was ingested and how long ago, if known. You may need to induce vomiting or seek out emergency veterinary services.
Your veterinarian will need to monitor your dog periodically during enalapril treatment. This may include exams, lab work, and blood pressure checks. Although enalapril can help dogs with kidney disease, it should be used with caution in dogs with severe kidney failure.
In addition, there are several medications that should be avoided or used carefully in conjunction with enalapril. Be sure to tell your vet about all medications and supplements your dog gets.
What is enalapril?
Enalapril (brand names: Enacard®, Vasotec®, Glioten®, Lotrial®, Pres®, Renitec®, Reniten®, Xanef®, Epaned®) is an ACE inhibitor used to treat heart failure, high blood pressure, or proteinuria (protein in the urine). It is also used in the treatment of chronic kidney disease.
Its use in cats, dogs, ferrets, and birds to treat certain conditions is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their direction may be significantly different from those on the label.
Enalapril is given by mouth in the form of a tablet or liquid. It may also be given in the form of an injection into the vein in the hospital setting. The tablets or oral liquid may be given with or without food, but if vomiting occurs after dosing on an empty stomach, give future doses with food or a treat. Measure liquid doses carefully. While your pet is on this medication, make sure there is always plenty of clean water available. Do not stop this medication abruptly unless instructed by your veterinarian.
This medication should take effect within 1 to 2 hours; however, effects may not be visibly noticeable and therefore laboratory tests may need to be done to evaluate this medication’s effectiveness.
What Every Pet Owner Should Know About The Use Of Enalapril In Dogs [ Side Effects Of Enacard ]
Enalapril (trade name Enacard or Vasotec) is used in dogs to treat some kinds of heart disease, and some forms of kidney disease. As with many drugs, it can have a few side effects.