What Vasotec is used for and how to use it
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Vasotec - Consumer Medicine Information

Manufacture: Merck and Co., Inc.
Country: Canada
Condition: Diabetic Kidney Disease (Diabetic Nephropathy), Heart Failure (Congestive Heart Failure), High Blood Pressure (Hypertension), Hypertensive Emergency, Left Ventricular Dysfunction
Class: Angiotensin converting enzyme inhibitors
Form: Tablets
Ingredients: enalapril maleate that appears as enalapril sodium, corn starch, lactose, magnesium stearate, pregelatinized starch, sodium bicarbonate

enalapril tablets

About This Medication

VASOTEC is available only on prescription from your physician.

What the Medication is Used For

VASOTEC is used for:

  • reducing high blood pressure

When blood pressure is high, the workload of the heart and arteries increases so that over time, these organs may not function as they should. In turn, this could lead to damage of the “vital organs”: brain – heart – kidneys, and result in stroke, heart failure, heart attack, blood vessel disease or kidney disease.

VASOTEC is used for:

  • treating patients with heart failure
  • VASOTEC may also be used to treat patients with heart failure. This is a condition where the heart cannot pump adequate amounts of blood to satisfy the needs of the body.

    If your physician has recommended a particular diet, for instance – less salt – follow the diet carefully. This could help your medicine to better control your blood pressure. Your physician may also recommend weight loss. Do follow these suggestions.

    What it Does

    VASOTEC is part of a class of medicines known as angiotensin converting enzyme (ACE) inhibitors. They lower blood pressure by specifically blocking a naturally occurring substance called angiotensin II. Angiotensin II normally tightens your blood vessels. VASOTEC allows them to relax and therefore help lower high blood pressure.

    This medicine does not cure high blood pressure, but does helpcontrol it. So, it is important to continue taking the tablets regularly to keep your blood pressure down. You may have to take high blood pressure medicine for life.

    Keep your regular appointments with your physician, even if you feel well. High blood pressure may not be easily recognized by you, because you may not “feel any symptoms”; but your physician can measure your blood pressure very easily, and check how the medicine is controlling it.

    Read the following information carefully. If you needany explanations, or further information, ask your physician or pharmacist.

    When it Should not be Used

    Do not take VASOTEC if you:

    • are allergic to enalapril or any other component of VASOTEC (see What the important non-medicinal ingredients are).
    • have a history of swelling of the face, lips, tongue, throat, or sudden difficulty breathing or swallowing.
    • have been diagnosed with swelling of the face, lips, tongue, throat, or sudden difficulty breathing or swallowing due to genetic factors or unknown reasons (please refer to Side Effects and What to Do About Them).
    • Are already taking a blood pressure-lowering medicine that contains aliskiren (such as RASILEZ) and you have diabetes or kidney disease.

    What the Medicinal Ingredient is

    Each tablet of VASOTEC is made with enalapril maleate that appears as enalapril sodium in the tablets.

    What the Important Non-medicinal Ingredients are:

    Each tablet of VASOTEC contains the following non-medicinal ingredients: corn starch, lactose, magnesium stearate, pregelatinized starch, sodium bicarbonate. Tablets 10 and 20 mg contain red and/or yellow iron oxides.

    What Dosage Forms it Comes in

    VASOTEC tablet 2.5 mg (white), 5 mg (white), 10 mg (rust red) and 20 mg (peach).

    Warnings and Precautions

    Serious Warnings and Precautions

    VASOTEC should not be used during pregnancy. If you discover that you are pregnant while taking VASOTEC, stop the medication and please contact your physician as soon as possible.

    This medicine may not be suitable for certain people. Tell your physician or pharmacist if you think any of the following applies to you:

    • You have previously taken VASOTEC or other medication of the same type – Angiotensin Converting Enzyme (ACE) inhibitors such as enalapril, lisinopril, captopril, and you were allergic or reacted badly to it, particularly if you experienced swelling of the face, lips, tongue, or throat, or had sudden difficulty breathing or swallowing. These are symptoms of conditions called hereditary angioedema or idiopathic angioedema.
    • Are taking a medicine that contains aliskiren, such as RASILEZ, used to lower high blood pressure. The combination with VASOTEC is not recommended.
    • Are taking an angiotensin receptor blocker (ARB). You can recognize an ARB because its medicinal ingredient ends in “-SARTAN”.
    • Are taking anti-cancer (temsirolimus, everolimus) or anti-rejection (sirolimus) medications. Use of ACE inhibitors, such as VASOTEC, with these drugs may increase the chance of having an allergic reaction (angioedema).
    • You should not take this medicine if you have been diagnosed with hereditary angioedema or idiopathic angioedema (angioedema of unknown cause).
    • Dizziness or drowsiness may occasionally occur when taking medication to lower blood pressure. Therefore, before you perform tasks which may require special attention (driving a car or operating dangerous machinery), wait until you know how you respond to your medicine.
    • You should be aware that black patients are at increased risk of these types of reactions to ACE inhibitors.
    • You are pregnant, breast-feeding or thinking of becoming pregnant. Taking VASOTEC during pregnancy can cause injury and even death to your developing baby. This medicine shouldnot be used during pregnancy. If you become pregnant while taking VASOTEC®, stop the medication and report to your physician as soon as possible. It is possible that VASOTEC passes into breast milk. You should not breast-feed while taking VASOTEC.
    • You suffer from low blood pressure (you may notice this as faintness or dizziness, especially when standing).
    • You are undergoing dialysis.
    • You have any of these conditions:
      • diabetes
      • heart or blood vessel disease
      • liver disease
      • kidney disease
    • You are receiving gold (sodium aurothiomalate) injections.
    • You are taking “water pills” or potassium supplements.
    • You use potassium containing salt substitutes with your food.

    You should also inform your physician or pharmacist if you have recently suffered from excessive vomiting or diarrhea.

    If you have diabetes and are taking oral medicines to treat diabetes or insulin, you should closely monitor for low blood glucose levels, especially during the first month of treatment with VASOTEC.

    If you have to undergo any dental or other surgery, inform the dentist or the physician in charge that you are taking this medicine.

    Remember – This medicine is prescribed for the particular condition that you have. Do not give this medicine to other people, nor use it for any other condition.

    Do not use outdated medicine.

    Interactions With This Medication

    Do not take any other medicines unless you have discussed the matter with your physician or pharmacist. Certain medications tend to increase your blood pressure, for example, non-prescription preparations for appetite control, asthma, colds, coughs, hay fever and sinus problems, or may also react badly with VASOTEC.

    Your physician or pharmacist also needs to know if you are taking any other medication, whether on prescription or otherwise. It is particularly important to inform your physician or pharmacist if you are taking:

    • Diuretics or “water pills”; any other medicines to reduce blood pressure.
    • Diabetes medicine and/or insulin.
    • Blood pressure-lowering drugs, including diuretics (“water pills”), aliskiren-containing products (e.g. RASILEZ), or angiotensin receptor blockers (ARBs).
    • Potassium-containing medicines, potassium supplements.
    • Salt substitutes that contain potassium, as these may lead to increased levels of potassium in the blood which can be serious. In these cases, your physician may need to adjust the dosage of VASOTEC or monitor your blood level of potassium.
    • Lithium (a drug used to treat a certain kind of depression).
    • Certain pain and arthritis medicines, including gold therapy and non-steroidal anti-inflammatory drugs.
    • mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy. Taking these drugs together could increase the risk for an allergic reaction called angioedema.

    Proper Use of This Medication

    Usual Dose

    • Take this medicine exactly as your physician ordered.
    • The absorption of this medicine is not affected by food; so it can be taken with or without a meal.
    • Try to take your medicine every day at the same time. This way it becomes easy to remember your doses.
    • The splitting of VASOTEC tablets is not advised.

    For Patients With High Blood Pressure

    Adults

    Your physician may adjust the dose according to your blood pressure response. The usual dose range is 10 mg to 40 mg per day given in a single dose or two divided doses. The maximum daily dose for VASOTEC oral administration is 40 mg.

    Children (Less Than 16 Years)

    The usual starting dose is up to 5 mg once daily. Doses above 40 mg have not been studied.

    For Patients With Congestive Heart Failure:

    The initial dose is 2.5 mg taken once a day. Your physician will closely monitor you to determine the initial effect on your blood pressure. The usual daily dose is 5 mg to 20 mg given in a single dose or two divided doses. The maximum daily dose is 40 mg.

    Overdose:

    • In case of an overdose, contact your physician, hospital emergency department or regional Poison Control Center immediately, even if there are no symptoms. The most likely symptom would be a feeling of lightheadedness or dizziness due to a sudden or excessive drop in blood pressure.

    Missed Dose:

    • If you miss a dose of this medicine, take it as soon as possible. However, if no more than six hours have elapsed since the missed dose, you may take that day’s dose of medication and then go back to your regular dosing schedule. Do not take a double dose.

    Side Effects and What to Do About Them

    Along with its intended action, any medication, including VASOTEC, may cause side effects. Most people do not experience any problem when taking these medicines; but if you notice any of the following, have other side effects or if the condition persists or worsens, seek medical attention.

    • Dry cough, sore throat.
    • The initial dose may cause a greater fall in blood pressure than will occur following continued treatment. You may notice this as faintness or dizziness and it may help to lie down. If concerned, please consult your physician or pharmacist.

    Serious Side Effects, How Often They Happen and What to Do About Them

    Symptom/effectTalk with your physician or pharmacistStop taking drug and call your physician or pharmacist
    Only if severeIn all cases
    CommonFatigue
    Dizziness/Fainting/
    Lightheadedness, especially following exercise, and/or when it is hot and you have lost a lot of water by sweating
    Low blood pressure
    Headache
    Rash/Itching
    Nausea/Vomiting/
    Diarrhea
    Lasting cough
    Chest pain
    Shortness of breath
    UncommonAllergic reactions/
    Angioedema (sudden difficulty in breathing or swallowing, swelling of face, eyes, lips, tongue and/or throat, hands or feet)
    Flu-like symptoms (fever, malaise, muscle pain, rash, itching, abdominal pain, nausea, vomiting, diarrhea, jaundice, loss of appetite)
    Liver impairment such as jaundice, dark/brown urine
    Abdominal pain
    Low blood sugars in diabetic patients
    Loss of appetite

    This is not a complete list of side effects. For any unexpected effects while taking VASOTEC contact your physician or pharmacist.

    How to Store it

    Store your tablets at 15°C–30°C, in a tightly closed container, away from heat and direct light, and out of damp places, such as the bathroom or kitchen.

    Discard remaining tablets six months after opening the bottle.

    Keep all medicines out of the reach of children.

    Reporting Side Effects

    You can help improve the safe use of health products for Canadians by reporting serious and unexpected side effects to Health Canada. Your report may help to identify new side effects and change the product safety information.

    3 ways to report:

    • Online at MedEffect;
    • By calling 1-866-234-2345 (toll-free);
    • By completing a Consumer Side Effect Reporting Form and sending it by:
      • Fax to 1-866-678-6789 (toll-free), or
      • Mail to: Canada Vigilance Program
        Health Canada, Postal Locator 0701E
        Ottawa, ON
        K1A 0K9

    Postage paid labels and the Consumer Side Effect Reporting Form are available at MedEffect.

    NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

    More Information

    If you want more information about VASOTEC:

    • Talk to your healthcare professional
    • Find the full product monograph that is prepared for healthcare professionals and includes this Consumer Information by visiting the Health Canada website or Merck Canada web site www.merck.ca or by calling Merck Canada at 1-800-567-2594

    To report an adverse event related to VASOTEC, please contact 1-800-567-2594.