Enalapril for high blood pressure
This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Name of medicine
Brand names: Ednyt, Innovace
Why is it important for my child to take Enalapril?
Enalapril is one of a group of medicines called ACE inhibitors that help to lower blood pressure.
What is Enalapril available as?
- Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg; these contain small amounts of lactose
- Liquid medicine can be ordered specially from your pharmacist
When should I give Enalapril
- Enalapril is usually given once each day. This is usually in the morning OR the evening.
- Your doctor may tell you to give it twice each day, once in the morning and once in the evening. Ideally these times are 10–12 hours apart, for example some time between 7 and 8 am, and between 7 and 8 pm.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of Enalapril (the dose) that is right for your child. The dose will be shown on the medicine label.
Your doctor will start your child on a low dose of Enalapril. They will check your child’s blood pressure regularly and may increase the dose if your child’s blood pressure is still too high.
It is important that you follow your doctor’s instructions about how much to give.
How should I give Enalapril?
- If you prefer, you can crush the tablet and mix it into a small glass of water (it will make a cloudy mixture but won’t dissolve). Your child should drink it all straight away. Then add some more water to the glass, swirl it round and ask your child to drink it. This makes sure they get all the medicine.
- Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
- You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.
- Shake the medicine well. Measure out the right amount using an oral syringe or a medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount. You can also dilute the medicine (measured with a medicine spoon) in a small amount of water or squash. Make sure your child takes it all straight away.
When should the medicine start working?
Your child’s blood pressure will start to come down after a few days, although you will not see any difference in your child.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of Enalapril, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of Enalapril, do not give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.
What if I forget to give it?
If you usually give it once a day in the morning: Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due.
If you usually give it once a day in the evening: If you remember before bedtime, give the missed dose. You do not need to wake a sleeping child to give a missed dose. You can give the missed dose in the morning, as long as this is at least 12 hours before the evening dose is due.
If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.
Never give a double dose of Enalapril.
What if I give too much?
It may be dangerous to give too much Enalapril because it may make your child’s blood pressure too low.
If you think you may have given your child too much Enalapril, contact your doctor or local NHS services (details at end of leaflet) or take your child to hospital. Have the medicine container or packaging with you, even if it is empty. This will be useful to the doctor.
If you think you may have given your child too much Enalapril, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.
Are there any possible side effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side effects).
Side effects you must do something about
If your child is short of breath or is wheezing, or their face, lips or tongue start to swell, or they develop a rash, they may be allergic to Enalapril. Take your child to hospital or phone for an ambulance straight away.
If your child seems to bruise more easily or bleeding doesn’t stop as quickly as usual, or if their skin or whites of the eyes get a yellow tinge, contact your doctor straight away, as there may be a problem with your child’s blood or liver.
If your child has an irregular or fast heart rate (fluttery or racing), contact your doctor straight away.
Other side-effects you need to know about
Your child may feel dizzy or light-headed when they stand up, or may even faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or lightheaded.
Your child may develop a dry cough that doesn’t go away. If it becomes a problem, contact your doctor for advice, but continue to give Enalapril as normal.
Your child may feel sick or be sick (vomit) when they first start taking Enalapril. Giving the medicine with some food may help. This effect should wear off after a few days as your child’s body gets used to the medicine. If it is still a problem after a week, contact your doctor for advice.
Your child may have constipation (difficulty doing a poo, or doing a poo less often than usual). Encourage them to drink plenty of fluid and to eat foods that contain fibre (e.g. wholemeal foods, fruit and vegetables). If this is still a problem after 2 weeks, contact your doctor.
They may get headaches.
Your child may experience a metallic or bitter taste in their mouth. Eating citrus fruits (e.g. oranges) or sipping water may help.
Your child’s eyesight may be blurred (fuzzy).
Your child’s skin may seem flushed (red) and they may get a rash.
Rarely, your child may get muscle cramps or ringing in their ears.
There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard
Can other medicines be given at the same time as Enalapril?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.
Is there anything else I need to know about this medicine?
- Your doctor will test your child’s blood regularly to check that Enalapril has not affected their kidneys.
- Your doctor will check your child’s blood pressure regularly while they are taking Enalapril.
General advice about medicines
- Try to give medicines at about the same times each day, to help you remember.
- If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
Where should I keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight.
- It does not need to be kept in the fridge.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in.
Who to contact for more information?
Your child’s doctor, pharmacist or nurse will be able to give you more information about Enalapril and about other medicines used to treat high blood pressure.
Version . © NPPG, RCPCH and WellChild, all rights reserved. Review by December 2015.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.