Medicine Information

Ace

Injection10 mg/mLAntihypertensiveATC: C09AA02

Generic Name

Enalaprilat 10 mg Injection

Manufacturer

Example Pharmaceutical Co. Ltd.

Country

Bangladesh

Loading images...

Price Details

Current market pricing information

Variant	Unit Price	Strip Price
ace 10 mg injection	৳ 150.00	N/A

Description

Overview of the medicine

Enalaprilat is an intravenous (IV) angiotensin-converting enzyme (ACE) inhibitor used for the treatment of hypertension, especially when oral therapy is not feasible. It is the active metabolite of enalapril and provides a rapid and effective way to lower blood pressure.

Uses & Indications

Hypertensive emergencies where rapid blood pressure control is required.

Hypertension when oral therapy is not practical or feasible.

Management of congestive heart failure in specific situations (off-label use in some regions).

Dosage

Adults

Initial dose 1.25 mg IV administered over 5 minutes, every 6 hours. May be increased up to 5 mg every 6 hours depending on patient response and clinical status.

Elderly

Initial dose of 0.625 mg IV administered over 5 minutes, every 6 hours, due to potential for reduced renal function and increased sensitivity.

Renal_impairment

For creatinine clearance < 30 mL/min, initial dose is 0.625 mg IV every 6 hours. Dosage should be adjusted based on renal function and blood pressure response.

How to Take

Enalaprilat is administered by slow intravenous injection over at least 5 minutes. It can also be diluted in 50 mL of 5% Dextrose Injection, 0.9% Sodium Chloride Injection, or 5% Dextrose and 0.9% Sodium Chloride Injection and infused.

Mechanism of Action

Enalaprilat inhibits angiotensin-converting enzyme (ACE), which prevents the conversion of angiotensin I to the potent vasoconstrictor angiotensin II. This leads to decreased vasoconstriction, reduced aldosterone secretion, and consequently, a reduction in blood pressure and systemic vascular resistance.

Pharmacokinetics

Onset

Within 5-15 minutes of IV administration.

Excretion

Primarily excreted unchanged in the urine, mainly by glomerular filtration and tubular secretion.

Half life

Effective half-life is about 1.5 to 12 hours, with accumulation in renal insufficiency.

Absorption

Rapidly and completely absorbed after intravenous administration, as it is the active form.

Metabolism

Enalaprilat is the active drug and is not metabolized further.

Side Effects

Contraindications

Hypersensitivity to enalaprilat, enalapril, or any other ACE inhibitor.
History of angioedema related to previous ACE inhibitor therapy.
Hereditary or idiopathic angioedema.
Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m²).

Drug Interactions

Lithium

Increased serum lithium levels and symptoms of lithium toxicity.

Aliskiren

Contraindicated in patients with diabetes or renal impairment.

Diuretics

Increased risk of excessive blood pressure reduction.

mTOR inhibitors (e.g., sirolimus, everolimus)

Increased risk of angioedema.

Non-steroidal anti-inflammatory drugs (NSAIDs)

May reduce the antihypertensive effect and increase the risk of renal function deterioration.

Potassium-sparing diuretics/Potassium supplements

Increased risk of hyperkalemia.

Storage

Store at controlled room temperature (20°C to 25°C). Protect from light. Do not freeze. Discard any unused portion.

Overdose

Symptoms of overdose include marked hypotension and electrolyte disturbances. Treatment involves discontinuing the drug, establishing intravenous access, and administering intravenous fluid infusion to restore blood pressure. Hemodialysis can effectively remove enalaprilat from the systemic circulation.

Pregnancy & Lactation

Pregnancy Category D (due to fetal toxicity). Enalaprilat should not be used during pregnancy. It is also not recommended during breastfeeding, as enalapril (the active form of which enalaprilat is a prodrug) is excreted in human milk.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1.25 mg/mL solution in 2 mL vial

Shelf Life

Varies by manufacturer, usually 24-36 months when stored under recommended conditions.

Availability

Hospitals, Clinics, Pharmacies (with prescription)

Approval Status

Approved by regulatory authorities

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have established the efficacy and safety of enalaprilat in managing hypertension, including hypertensive emergencies. Studies have also evaluated its use in heart failure.

Lab Monitoring

Blood pressure monitoring (continuous during infusion or frequently otherwise).
Renal function tests (BUN, serum creatinine) before and during therapy.
Serum electrolyte levels (especially potassium) regularly.
Complete blood count (CBC) periodically, especially in patients with renal impairment or collagen vascular disease.

Doctor Notes

Closely monitor blood pressure, renal function, and serum potassium during enalaprilat therapy, especially in high-risk patients.
Be vigilant for signs of angioedema, particularly in the initial treatment period. Have epinephrine and airway management readily available.
Transition to oral ACE inhibitor therapy (e.g., enalapril maleate) as soon as the patient's condition allows.

Patient Guidelines

Patients should report any symptoms of swelling of the face, lips, tongue, or throat (angioedema) immediately to their healthcare provider.
Patients should be informed about the risk of fetal harm if they become pregnant while on this medication.
Avoid sudden changes in body position to minimize the risk of dizziness or lightheadedness upon standing.
Report any signs of infection (e.g., fever, sore throat) as this medicine can affect white blood cells.

Missed Dose Advice

Enalaprilat injection is typically administered in a hospital or clinic setting under medical supervision. If a scheduled dose is missed, it will be administered by the healthcare professional as soon as possible. Do not self-administer or adjust doses.

Driving Precautions

Enalaprilat injection may cause dizziness or lightheadedness, especially after the first dose or with dose adjustments. Patients should be advised to avoid driving or operating machinery until they know how the medication affects them.

Lifestyle Advice

Follow a diet low in sodium as recommended by the doctor to help manage blood pressure.
Regular physical activity, if medically appropriate, can contribute to overall cardiovascular health.
Avoid excessive alcohol consumption, as it can worsen hypotension.