Enalaprilat

Diuretic therapy may cause excessive reduction of blood pressure after enalaprilat initiation. Risk is higher when diuretic therapy was recently instituted.

Lithium toxicity has been reported in patients receiving lithium concomitantly with enalapril. Monitor serum lithium levels frequently; toxicity is reversible upon discontinuation of both drugs.

Nitritoid reactions (facial flushing, nausea, vomiting, hypotension) have been reported rarely with injectable gold and concomitant ACE inhibitor therapy.

Potassium-sparing diuretic may lead to significant increases in serum potassium when used concomitantly with enalaprilat. Use with caution and monitor serum potassium frequently.

NSAIDs may diminish the antihypertensive effect of enalaprilat. In patients with compromised renal function, may result in further deterioration of renal function.

May lead to significant increases in serum potassium when used with enalaprilat. Use with caution and monitor serum potassium frequently.

Potassium-sparing diuretic may lead to significant increases in serum potassium when used concomitantly with enalaprilat. Use with caution and monitor serum potassium frequently.

NSAIDs may diminish the antihypertensive effect of enalaprilat. In patients with compromised renal function, may result in further deterioration of renal function.

Potassium-sparing diuretic may lead to significant increases in serum potassium when used concomitantly with enalaprilat. Use with caution and monitor serum potassium frequently.

Drug Interactions Hypotension-Patients on Diuretic Therapy : Patients on diuretics and especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with enalaprilat. The possibility of hypotensive effects with enalaprilat can be minimized by administration of an intravenous infusion of normal saline, discontinuing the diuretic or increasing the salt intake prior to initiation of treatment with enalaprilat. If it is necessary to continue the diuretic, provide close medical supervision for at least one hour after the initial dose of enalaprilat (see WARNINGS ).

Other Cardiovascular Agents: Enalaprilat injection has been used concomitantly with digitalis, beta adrenergic-blocking agents, methyldopa, nitrates, calcium-blocking agents, hydralazine and prazosin without evidence of clinically significant adverse interactions.