Enalapril is used for:

Treating high blood pressure, heart failure, and other heart problems. It may be used alone or with other medicines. It may also be used for other conditions as determined by your doctor.

Enalapril is an angiotensin-converting enzyme (ACE) inhibitor. It works by helping to relax blood vessels. This helps to lower blood pressure.

Do NOT use Enalapril if:

• you are allergic to any ingredient in Enalapril or similar medicines (eg, captopril, lisinopril)
• you are pregnant
• you are taking dextran sulfate or potassium-sparing diuretics (eg, amiloride)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Enalapril :

Some medical conditions may interact with Enalapril. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have or have ever had liver or kidney problems or kidney transplantation
• if you are receiving dialysis
• if you have bone marrow suppression, low blood counts, low blood sodium, high blood potassium, porphyria (a blood disease), giant hives, systemic lupus erythematosus (SLE or lupus), scleroderma, or a collagen vascular disease
• if you have narrowing or hardening of the arteries of the brain or heart, chest pain, or discomfort known as angina

Some MEDICINES MAY INTERACT with Enalapril. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Diuretics (eg, furosemide, hydrochlorothiazide) because excessive decreases in blood pressure may occur, which may cause dizziness, especially upon standing, or fainting
• Dextran sulfate because it may increase the risk of allergic reaction (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue) and lightheadedness upon standing
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, aspirin, indomethacin) because the effectiveness of Enalapril may be decreased and the risk of kidney damage may be increased
• Lithium or thiopurines (eg, azathioprine) because the risk of serious side effects may be increased by Enalapril
• Oral diabetes medicine (eg, glyburide) because side effects, including a low blood sugar level (eg, hunger, shakiness or weakness, dizziness, headache, sweating), may be increased by Enalapril
• Potassium supplements or potassium-sparing diuretics (eg, amiloride) may cause high blood potassium levels (eg, listlessness, confusion, abnormal skin sensations of the arms and legs, heaviness of the limbs, slow or irregular heartbeat, or stopping of the heart) when used with Enalapril

This may not be a complete list of all interactions that may occur. Ask your health care provider if Enalapril may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Enalapril :

Use Enalapril as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Enalapril may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• If you miss a dose of Enalapril , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Enalapril.

Important safety information:

• Enalapril may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Enalapril with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Check with your doctor before you use a salt substitute or a product that has potassium in it.
• If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
• Enalapril may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.
• Enalapril may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Enalapril. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Tell your doctor or dentist that you take Enalapril before you receive any medical or dental care, emergency care, or surgery.
• LAB TESTS, including liver function, kidney function, and complete blood counts, may be performed while you use Enalapril. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: Do not take Enalapril after the third month of pregnancy. It may cause injury or death to the fetus. If you become pregnant, contact your doctor right away. Enalapril is found in breast milk. If you are or will be breast-feeding while you use Enalapril , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Enalapril :

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome: Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness or lightheadedness when sitting up or standing; headache; nausea; persistent, dry cough; tiredness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; hoarseness; infection (fever, sore throat); irregular or slow heartbeat; unusual stomach pain; yellowing of the skin or eyes.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Radiation: 1. Rays of energy. Gamma rays and X-rays are two of the types of energy waves often used in medicine. 2. The use of energy waves to diagnose or treat disease.

Replantation: 1. Literally, the act of planting again. 2. In surgery, the restoration of any part of the body to its original site. Also known as reimplantation.

The Chinese surgeon Zhong Wei Chen (1929-2004) was the "father of replantation." Dr. Chen was the first to reattach a severed hand with success which he did in 1963. Dr. Chen also developed many microsurgical procedures including techniques for preserving severed extremities, reattaching amputated fingers and thumbs, reconstructing muscles and repairing nerves and blood vessels.

Rheumatism: Rheumatism is an older term, used to describe any of a number of painful conditions of muscles, tendons, joints, and bones.

Rheumatism conditions have been classified as either localized, regional, or generalized. Localized rheumatism conditions include bursitis and tendinitis. Regional rheumatism conditions include chest wall pain, temporomandibular joint pain, and myofascial pain syndromes. Generalized rheumatism conditions include fibromyalgia.

Another category of rheumatism is psychogenic rheumatism. With this term it is understood that the patient is reporting inconsistent pains of muscles and joints that do not correspond to true anatomy and physiology. The patient is felt to have underlying psychological causes for the symptoms.

Rheumatology: A subspecialty of internal medicine that involves the non-surgical evaluation and treatment of the rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system. Many of the rheumatic diseases and conditions feature immune system abnormalities. Therefore, rheumatology also involves the study of the immune system. Classical rheumatology training includes 4 years of medical school, 1 year of internship in internal medicine, 2 years of internal medicine residency, and 2 years of rheumatology fellowship. There is a subspecialty board for rheumatology certification. The American College of Rheumatology is the official organization acting on behalf of the field of rheumatology in the United States.

T cell: A type of white blood cell that is of key importance to the immune system and is at the core of adaptive immunity, the system that tailors the body's immune response to specific pathogens. The T cells are like soldiers who search out and destroy the targeted invaders.

Immature T cells (termed T-stem cells) migrate to the thymus gland in the neck, where they mature and differentiate into various types of mature T cells and become active in the immune system in response to a hormone called thymosin and other factors. T-cells that are potentially activated against the body's own tissues are normally killed or changed ("down-regulated") during this maturational process.

There are several different types of mature T cells. Not all of their functions are known. T cells can produce substances called cytokines such as the interleukins which further stimulate the immune response. T-cell activation is measured as a way to assess the health of patients with HIV/AIDS and less frequently in other disorders.

T cell are also known as T lymphocytes. The "T" stands for "thymus" -- the organ in which these cells mature. As opposed to B cells which mature in the bone marrow.

Teleology: The study of the ultimate purpose of the design of something in nature.

For example, "what is the true purpose of the nose?" is a teleological question and, to say that all evolutionary changes occur for a definite purpose is a teleological explanation of evolution.

"Teleology" comes from ancient Greek roots but it (and teleological) did not enter English until the 18th century. It is a compound of the Greek "tele-, telos," meaning "end or purpose" + the ending "logos" meaning "the science or study of" = the study of the ends or purposes.

Testosterone: A "male hormone" -- a sex hormone produced by the testes that encourages the development of male sexual characteristics, stimulates the activity of the male secondary sex characteristics, and prevents changes in them following castration. Chemically, testosterone is 17-beta-hydroxy-4-androstene-3-one.

Testosterone is the most potent of the naturally occurring androgens. The androgens cause the development of male sex characteristics, such as a deep voice and a beard; they also strengthen muscle tone and bone mass.

High levels of testosterone appear to promote good health in men, for example, lowering the risks of high blood pressure and heart attack. High testosterone levels also correlate with risky behavior, however, including increased aggressiveness and smoking, which may cancel out these health benefits.

Testosterone may be given to treat medical conditions, including female (but not male) breast cancer, hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).