Innovace (enalapril)

- Some people may experience dizziness caused by low blood pressure in the first few days of taking this medicine and in particular the first dose. For this reason, the first dose should preferably be taken at bedtime. Your doctor may want you to take the first dose of this medicine under medical supervision in hospital if you are aged over 70 years, have low blood pressure, low levels of fluids or salt in your blood (eg due to dehydration), severe or unstable heart failure, kidney problems, or are taking high doses of diuretic medicines, multiple diuretic medicines, or certain other medicines that dilate your blood vessels.
- If you feel dizzy during treatment this can be relieved by lying down until the symptoms pass. If affected you should avoid performing potentially hazardous tasks such as driving or operating machinary. If you frequently feel dizzy you should let your doctor know, as your dose of this medicine may need reducing.
- Alcohol may enhance the blood pressure lowering effect of this medicine, which can increase dizziness and may increase the risk of fainting.
- ACE inhibitors can sometimes cause an allergic reaction called angioedema. This is more likely to occur in black patients. Stop taking this medicine and consult your doctor immediately if you experience difficulty breathing or swallowing, or swelling of your face, lips, tongue, throat, hands, feet or ankles while taking this medicine.
- Your blood pressure, kidney function and the amount of potassium in your blood should be regularly monitored while you are taking this medicine.

Use with caution in

- Elderly people
- Children
- Decreased liver function
- Decreased kidney function
- Narrowing of the arteries that supply blood to the kidneys (renal artery stenosis)
- Decreased fluid volume in the body, eg due to diuretic therapy, low salt diet, kidney dialysis, diarrhoea, vomiting, dehydration
- People taking other medicines for high blood pressure, particularly diuretics (see end of factsheet)
- Severe heart failure
- People with hardening of the arteries, eg in the heart (cardiovascular disease), brain (cerebrovascular disease) or legs (peripheral vascular disease)
- Narrowing of the main artery of the body (aortic stenosis)
- Narrowing of one of the valves in the heart (mitral valve stenosis)
- Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)
- Diabetes
- Diseases affecting connective tissue, eg scleroderma, systemic lupus erythematosus (collagen vascular diseases)
- People with kidney failure requiring a certain type of haemodialysis (high-flux membrane)
- People receiving therapy to remove certain types of fat from the blood using a machine (LDL apheresis)
- People undergoing therapy to decrease allergy to bee or wasp stings (desensitisation)
- Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Innovace tablets contain lactose).

Not to be used in

- History of swelling of the lips, face or tongue (angioedema) with no known cause, or caused by previous use of an ACE inhibitor medicine
- Hereditary angioedema
- Pregnancy.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine must not be used during pregnancy, particularly during the second and third trimesters, as it may be harmful to the unborn baby. Seek further medical advice from your doctor. If you get pregnant while taking this medicine, stop taking it and consult your doctor immediately.
- This medicine passes into breast milk in amounts that are probably too small to be harmful to a nursing infant. However, the manufacturer recommends that this medicine should not be used during breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Dizziness
- Blurred vision
- Dry cough
- Feeling of weakness (asthenia)
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Headache
- Depression
- Low blood pressure
- Chest pain
- Increased heart rate (tachycardia)
- Shortness of breath (dyspnoea)
- Alteration in taste
- Rash
- Fatigue
- High blood potassium level (hyperkalaemia)
- Impotence
- Muscle cramps
- Flushing
- Severe swelling of lips, face, tongue or throat (angioedema - see warning above)
- Disorders of the kidney, liver or blood

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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