ACE inhibitor

Enalapril maleate

Brand names: Innovace

Adult dose

Dose: Hypertension: start 5mg OD; up-titrate to 20mg OD (max 40mg). HF: start 2.5mg BD; titrate to target 10–20mg BD

Route: Oral

Frequency: OD–BD

Clinical pearls

NICE NG106 HF, NG136 hypertension
ESC HF guidelines: target dose where tolerated
Renal function and potassium check 1–2 weeks after initiation/up-titration

Contraindications

Pregnancy (all trimesters)
Bilateral renal artery stenosis
Hereditary or idiopathic angioedema
Concomitant aliskiren in DM/CKD
Hypersensitivity

Side effects

Cough
Hyperkalaemia
First-dose hypotension
Renal impairment
Angioedema
Hyponatraemia

Interactions

Potassium-sparing diuretics
NSAIDs ("triple whammy" AKI)
Lithium
ARB combination (avoid)
Sacubitril-valsartan (washout 36h)

Monitoring

U&E (baseline, 1–2 weeks after change, annually)
BP
Cough/angioedema

Reference: BNF; NICE NG136; NICE NG106; ESC HF guidelines; https://bnf.nice.org.uk/drugs/enalapril-maleate/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

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