Envas (Enalapril Maleate)
Also sold as: Envas, BQL, Enam, Vasotec
Pregnancy
Cat D
Lactation
Caution
Schedule
H
Forms
Tablet 2.5/5/10/20mg
Indications
- HTN
- Heart failure (HFrEF)
- Post-MI LV dysfunction
- Diabetic nephropathy
Adult Dosing
HTN
Start 5 mg PO OD; titrate to 10-40 mg/day in 1-2 doses
HF
Start 2.5 mg BD; titrate every 1-2 weeks to target 10-20 mg BD
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 30 | Standard dosing |
| CrCl 10-30 | Start 2.5 mg, titrate slowly |
| CrCl < 10 | 2.5 mg on dialysis days |
Pregnancy & Lactation
Pregnancy: Category D
CONTRAINDICATED — fetal renal damage, oligohydramnios
Lactation: Caution
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| NSAIDs | Reduced effect, AKI ("triple whammy") | Major |
| K+ sparing diuretics, K+ | Hyperkalemia | Major |
| Lithium | Lithium toxicity | Major |
| ARBs | AVOID combination (ONTARGET trial) | Major |
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Side Effects
Common
- Dry cough (10-20%)
- Dizziness
- Hyperkalemia
- First-dose hypotension
Serious / Discontinue If
- Angioedema (especially in Black patients, idiosyncratic)
- AKI in renal artery stenosis
- Hyperkalemia
Contraindications
- Pregnancy
- Bilateral renal artery stenosis
- History of ACEi-induced angioedema
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Envas 5 | Cadila | 10 tab ₹35 |
| BQL 5 | Wyeth | 10 tab ₹45 |
| Enam 5 | Dr Reddy's | 10 tab ₹38 |
Monitoring Required
- BP, K+, creatinine within 1-2 weeks of start, then 3-6 monthly
Patient Counseling Points
- Take same time daily
- Stop if pregnant
- Cough → switch to ARB
- Report facial swelling immediately
- Avoid OTC NSAIDs
Stop Googling drug references mid-consultation
EasyClinic auto-flags Envas interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)
Disclaimer: This information is for clinical reference only. It is not exhaustive and does not substitute clinical judgement. Always verify current dosing against the manufacturer's prescribing information and current treatment guidelines. Drug prices are approximate and may vary.