Enalapril (Enalaprilat)

What is this medication for?

• CHF (vasodilator, with furosemide/pimobendan), protein in the urine/glomerular disease, adjunct high blood pressure
• CHF adjunct (HCM), high blood pressure (2nd-line — ACE inhibitors alone often inadequate), proteinuric CKD

How is it given?

Give exactly as your veterinarian prescribed — never change the dose or stop on your own unless your veterinarian has told you to.

• Do not stop abruptly — taper/transition under veterinary guidance.

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• stomach/intestinal distress (loss of appetite, vomiting, diarrhea) (Most common)
• Lethargy, inappetence (Reported)
• Azotemia, low blood pressure, hyperkalemia (Possible, especially with concurrent diuretics)

Worth a phone call to your veterinarian

• Cough (Common in humans, rare in dogs/cats)

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• Trouble breathing, collapse, seizures, severe vomiting or diarrhea, facial swelling, or pale gums

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: ACE inhibitor hypersensitivity; discontinue in pregnancy
• has or has had: Renal insufficiency (dose caution — nearly all renally cleared, unlike benazepril's dual clearance), hyponatremia, coronary/cerebrovascular insufficiency

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • Furosemide/other diuretics
  • Potassium-sparing diuretics (spironolactone)
  • NSAIDs
  • Potassium supplements

Storage and handling

<30°C, tight container. Compounded suspensions stable 60 days; degrades faster above pH 5.

Good to know

• Unlike benazepril, enalaprilat is cleared almost entirely renally (~95% in dogs) — this matters more in patients with significant renal impairment; benazepril's dual hepatic/renal clearance may be preferable there.
• ACE inhibitors alone are generally inadequate to control high blood pressure in cats — used as part of a stepped approach, typically after amlodipine.
• Do not stop abruptly — taper/transition under veterinary guidance.