Enalapril

Dosage

Enalapril is available as a tablet or an oral liquid, while it can also be given as an injection by a veterinarian. Enalapril for dogs comes in tablet sizes of 1 mg, 2.5 mg, 5 mg, 10 mg, and 20 mg.

While dosage amounts can vary, the recommended dosage of enalapril for the treatment of congestive heart failure in dogs is 0.25 to 0.5 mg/kg, orally, once to twice daily. 

Dosage instructions

Enalapril should only be given on the advice of a licensed veterinarian. Dogs can take this medication with or without food. It’s often combined with other medications to treat heart failure or high blood pressure. Your vet may require periodic liver and kidney function tests while your pet is taking this medication.

Closely monitor your dog for any signs of an adverse reaction to enalapril. It’s also important to provide plenty of water for your pet, as enalapril can lead to increased thirst. Finally, make sure to never exceed the recommended dosage amount.

Cost

Generic forms of enalapril tablets cost as little as 15¢ per tablet. The price of compounded forms of enalapril ranges from $25 to $55 depending on the dosage strength and form.

Efficacy

Enalapril for dogs is most commonly used to treat hypertension (high blood pressure) and congestive heart failure. 

Like other ACE inhibitors, enalapril works by blocking the enzyme that constricts blood vessels. This results in reduced blood pressure and allows the heart to function more efficiently. It also ensures increased blood flow to the kidneys, which is why enalapril can also be useful when treating kidney problems.

Enalapril is the most commonly prescribed ACE inhibitor for dogs in the United States.

One study examined the clinical efficacy and safety of enalapril in dogs suffering from moderate or severe heart failure. It found that dogs treated with enalapril achieved significant improvements across 14 clinical variables compared to dogs treated with a placebo.

Anotherstudy of dogs with naturally acquired heart failure showed that dogs treated with enalapril had lower heart rate, arterial blood pressure, and pulmonary arterial blood pressure on average than dogs treated with a placebo. Enalapril has also been shown to modestly delay the onset of congestive heart failure in dogs suffering moderate to severe mitral valve regurgitation.

Finally, the Long-Term Investigation of Veterinary Enalapril (LIVE) Study Group examined the progression of clinical signs of heart disease in dogs with chronic degenerative mitral valvular disease and dilated cardiomyopathy. It found that:

• The mean number of days until treatment failure for dogs with degenerative mitral valvular disease was significantly longer than for dogs treated with a placebo (159.5 vs 86.6 days, respectively).

• The mean number of days until treatment failure for dogs with dilated cardiomyopathy was 142.8 days, compared to 56.5 days for dogs treated with placebo tablets.

Side effects

Enalapril for dogs can produce a number of side effects. Report any potential side effects to your vet or, if necessary, seek emergency veterinary assistance. Signs to keep an eye out for include:

• Vomiting

• Diarrhea

• Loss of appetite

• Lethargy and tiredness

• Dizziness

• Coughing

• Changes in urination

• Kidney dysfunction

• Elevated potassium levels

• Fever

• Collapse

You should also monitor your pet for signs of an allergic reaction to enalapril, such as swelling around the face, difficulty breathing, and hives.

Considerations

Before giving enalapril to your dog, it’s important to be aware whether it’s safe to use with any other medications your dog may be taking as well as any other underlying health problems they may have.

Drug interactions

Enalapril may also interact with a number of other medications, including:

• Non-steroidal anti-inflammatories (aspirin)

• Beta blockers (atenolol)

• Vasodilators (amlodipine, diltiazem, hydralazine)

• Diuretics (spironolactone, furosemide)

• Potassium supplements 

This is not a complete list, so make sure to inform your veterinarian of all medications your dog is currently taking before enalapril is prescribed.

Allergic reactions and sensitivity

Do not use enalapril in dogs who are sensitive or allergic to this medication, pregnant, lactating, or diagnosed with kidney failure. Because enalapril needs to be converted into enalaprilat by the liver, dogs with liver failure will need a different ACE inhibitor that doesn’t require activation.

Frequently asked questions

Can I get enalapril for dogs without a prescription?

No. Enalapril can only be administered with a prescription from a veterinarian.

What should I do if I forget to give my dog a dose of enalapril — can I give a double dose?

No, you should never give your pet a double dose. Instead, continue with the regular dosage schedule when the next dose is due. If in doubt, consult your veterinarian for advice.

What should I do if my dog has an adverse reaction to enalapril or has an overdose?

If your pet has an overdose or suffers an allergic reaction to enalapril, seek veterinary attention immediately.