Enalaprilat

ACE Inhibitor PeptidomimeticRx: PrescriptionCompound: Approved

Also known as: Enalapril diacid, Enalaprilat, Enalaprilate, MK-422, Vasotec IV

Educational Only — Not medical advice. Consult a qualified clinician before using any peptide.

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Summary

Enalaprilat is the active diacid metabolite of enalapril; administered intravenously for acute hypertension and heart failure. It lowers blood pressure by inhibiting ACE.

Mechanism of Action

Competitive inhibition of angiotensin‑converting enzyme, preventing conversion of angiotensin I to angiotensin II and reducing aldosterone secretion

Routes of Administration

Intravenous

Goals & Uses

  • Heart failureCardiovascularHigh
  • Acute renal protectionRenalModerate
  • HypertensionCardiovascularHigh
  • Reduction of proteinuria in renal diseaseRenalModerate
  • Hypertensive emergency/urgency managementCardiovascularHigh
  • Heart failure management (acute)CardiovascularModerate
  • Blood pressure control in hospitalized patientsCardiovascularHigh

Contraindications

  • History of angioedema related to ACE inhibitorsImmunologicHigh
  • Hereditary or idiopathic angioedemaImmunologic/AllergicHigh
  • Hypersensitivity to enalaprilat or any ACE inhibitorHypersensitivityHigh
  • PregnancyPopulationHighPotential fetal risk or insufficient safety data
  • Pregnancy (2nd and 3rd trimester)ObstetricHigh
  • Concomitant use with sacubitril/valsartanDrug InteractionHigh
  • History of ACE inhibitor-induced angioedemaImmunologic/AllergicHigh
  • Bilateral renal artery stenosisVascular/RenalHigh
  • Severe bilateral renal artery stenosisRenalHigh

Adverse Effects

  • Injection site reactionsLocalUncommon
  • CoughRespiratoryCommonPersistent or episodic cough
  • Acute kidney injuryRenalUncommonSudden decline in kidney function
  • HypotensionCardiovascularCommonLow blood pressure
  • Renal impairmentRenalUncommon
  • Headache / dizzinessNeurologicalCommon
  • HyperkalemiaElectrolyte ImbalanceCommon
  • AngioedemaImmunologicRare

Drug Interactions

  • Non‑steroidal anti‑inflammatory drugs (NSAIDs)Moderate
  • Potassium-sparing diuretics / potassium supplementsModerate
  • Diuretics (loop/thiazide)Moderate
  • Sacubitril/valsartan (Entresto)High
  • Potassium‑sparing diuretics (e.g., spironolactone)Moderate
  • AliskirenHigh
  • NSAIDsModerateMay increase renal risk in susceptible patients
  • LithiumHigh

Population Constraints

  • PregnancyReproductive SafetyAbsolute
  • Bilateral renal artery stenosis or single functioning kidney with renal artery stenosisRenalAbsolute
  • Renal impairmentOrgan ImpairmentRelative
  • Pediatric patientsAgeRelative
  • Elderly patientsAgeRelative
  • Pregnant womenReproductiveAbsolute
  • Neonates and infants (premature/newborn)PediatricAbsolute
  • Severe renal impairment (eGFR <30 mL/min)RenalRelative

Regulatory Status

  • European UnionApprovedApproved: Hypertensive emergencies, Heart failureApproved for IV use; same indications as US
  • United StatesApprovedApproved: Acute hypertension, Acute decompensated heart failureIV formulation (Enalaprilat) approved; oral enalapril is the prodrug
  • United KingdomApprovedApproved: Hypertensive emergencies, Acute heart failureAvailable under prescription as Enalaprilat injection

Not orally bioavailable; approved for intravenous use only in most jurisdictions.

Evidence & Sources

No sources recorded yet.

Frequently Asked Questions

What is Enalaprilat?

Enalaprilat is the active diacid metabolite of enalapril; administered intravenously for acute hypertension and heart failure. It lowers blood pressure by inhibiting ACE.

What is Enalaprilat used for?

Enalaprilat is educationally associated with: Heart failure, Acute renal protection, Hypertension, Reduction of proteinuria in renal disease, Hypertensive emergency/urgency management, Heart failure management (acute), Blood pressure control in hospitalized patients. Educational only — not medical advice.

How is Enalaprilat administered?

Recorded routes of administration: Intravenous.

What are the potential side effects of Enalaprilat?

Reported adverse effects include: Injection site reactions, Cough, Acute kidney injury, Hypotension, Renal impairment, Headache / dizziness, Hyperkalemia, Angioedema. This list is not exhaustive — consult a qualified clinician.

Who should avoid Enalaprilat?

Recorded contraindications: History of angioedema related to ACE inhibitors, Hereditary or idiopathic angioedema, Hypersensitivity to enalaprilat or any ACE inhibitor, Pregnancy, Pregnancy (2nd and 3rd trimester), Concomitant use with sacubitril/valsartan, History of ACE inhibitor-induced angioedema, Bilateral renal artery stenosis, Severe bilateral renal artery stenosis. Consult a qualified clinician before use.