Enalapril, the active ingredient of Korandil, belongs to the group of medicines called Angiotensin Converting Enzyme (ACE) inhibitors. These medicines are mostly prescribed to treat all grades of essential hypertension. Korandil works by widening your blood vessels. This lowers your blood pressure. This medicine usually starts to work within an hour, and the effect lasts for at least 24 hours. Some people will require several weeks of treatment until the best effect on your blood pressure is seen.
Korandil is indicated for the treatment of hypertension (high blood pressure), the treatment of heart failure by lowering the need to go to hospital and can helping some patients live longer and for preventing the signs of heart failure. The signs include: shortness of breath, tiredness after light physical activity such as walking, or swelling of the ankle and feet.
What should you know before you take Korandil
Do not take Korandil if
- You are allergic (hypersensitive) to enalapril maleate or any of the other ingredients of Korandil.
- Yu have ever had an allergic reaction to a type of medicine similar to Korandil called an ACE inhibitor.
- You have ever had swelling of your face, lips, mouth, tongue or throat which caused difficulty in swallowing or breathing (angioedema) when the reason why was not known or it was inherited.
- You are more than 3 months pregnant (it also better to avoid Korandil in early pregnancy)
- Do take Korandil if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking Korandil.
Be particularly careful with Korandil.
Inform your doctor or pharmacist if:
- You have a heart problem
- You have a condition involving the blood vessels in the brain
- You have a blood problem such as low or lack of white blood cells (neutropenia/agranulocytosis), low blood platelet count (thrombocytopenia) or a decreased number of red blood cells (anaemia).
- You have a liver problem
- You have a kidney problem (including kidney transplantation). These may lead to higher levels of potassium in your blood which can be serious. Your doctor may need to adjust your dose of Korandil or monitor your blood level of potassium.
- You are having dialysis
- You have been very sick (excessive vomiting) or had bad diarrhea recently.
- You are on a self-restricted diet, are taking potassium supplements, potassium-sparing agents, or potassium-containing salt substitutes.
- You are over 70 years of age
- You have diabetes. You should monitor your blood for low blood glucose levels, especially during the first month of treatment. The level of potassium in your blood can also be higher.
- You have ever had an allergic reaction with swelling of the face, lips, tongue or throat with difficulty in swallowing or breathing. You should be aware that black patients are at increased risk of these type of reactions to ACE inhibitors
- You have low blood pressure (you may notice this as faintness or dizziness, especially when standing).
- You have collagen vascular disease (e.g. lupus erthematosus, rheumatoid arthritis or scleroderma), are on therapy that suppresses your immune system, and are taking the drugs allopurinol or procaine, or any combination of these.
- You think you are (or might become) pregnant. Korandil is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage.
- Yu are breastfeeding or about to start breast-feeding.
You should be aware that Korandil lowers the blood pressure in black patients less effectively that in non-black patients.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Korandil.
If you are about to have a procedure
If you are about to have any of the following, tell your doctor that you are taking Korandil:
- Any surgery or receive anesthetics (even at the dentist).
- Treatment to remove cholesterol from your blood called ‘LDL alpharesis’
- A desensitization treatment, to lower the effect of an allergy to bee or wasp stings
If any of the above applies to you, talk to your doctor or dentist before the procedure.
If you are about to take Korandil it is important to inform your doctor or pharmacist of any other medicines, including medicinal medicines obtained without a prescription. This includes herbal medicines. This is because Korandil can affect the way some medicines work. Also some other medicines can affect the way Korandil works. Tell your doctor or pharmacist if you are taking particularly any of the following medicines: other medicines to lower blood pressure, such as beta-blocker or water tablets (diuretics), medicines containing potassium (including dietary salt substitutes), medicines for diabetes (including oral antidiabetic medicines and insulin), lithium (a medicine used to treat a certain kind of depression), tricyclic antidepressants, antipsychotics, certain cough and cold medicines and weight reducing medicines which contain something called a ‘sympathomimetic agent’, certain pain or arthritis medicines including gold therapy, non-steroidal anti-inflammatory drugs, aspirin, medicines used to dissolve blood clots (thrombolytic) and alcohol.
Taking Korandil with food or drink
Korandil can be taken with or without food. Most people take Korandil with a drink of water.
Pregnancy and breast-feeding
Pregnancy: you must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advice you to stop taking Korandil before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Korandil
Korandil is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.
Consult your doctor or your pharmacist before taking any medicine.
Breast-feeding: tell your doctor if you are breast-feeding or about to start breast-feeding.
Breast-feeding newborn babies (first few weeks after birth), and especially premature babies is not recommended whilst taking Korandil.
In case of an older baby you doctor should advise you on the benefits and risks of taking Korandil whilst breast-feeding, compared with other treatments.
Ability to drive or operate machinery
When driving or operating machinery it should be taken into an account that occasionally dizziness or sleepiness may occur. If this happens do not drive or use any tools or machines.
How you should take Korandil
Follow your doctor’s instructions. You should check with your doctor or pharmacist if you are not sure. It is very important to continue taking Korandil for as long as your doctor prescribes it.
Do not take more tablets than prescribed.
Hypertension: the initial dose is 5mg to 20mg given once daily. Some patients may need a lower starting dose. The usual long term dose is 20mg taken once a day. The maximum long term dose is 40mg taken once a day.
Heart failure: the initial dose is 2.5mg taken once a day. Your doctor will raise this amount step by step until the dose that is right for you, has been achieved. The usual long term dose is 20mg taken in one or two doses. The maximal long term dose is 40mg each day divided in two doses.
Patients with kidney problems: your dose of medicine will be changed depending on how well your kidneys are working:
- Moderate kidney problems-5mg to 10mg each day
- Severe kidney problems-2.5mg each day
- If you are having dialysis, your dose may be changed depending on how low your blood pressure is
Elderly patients: your dose will be decided by your doctor and will be based on how well your kidneys are working
Children: experience in the use of Korandil in children with high blood pressure is limited. If the child can swallow tablets, the dose will be worked out using the child’s weight and blood pressure. The usual starting doses are
- Between 20kg and 50kg-2.5mg each day
- More than 50kg-5mg each day
The dose can be changed according to the needs of the child
- A maximum of 20mg daily can be used in children who are between 20kg and 50kg
- A maximum of 40mg daily can be used in children who are more than 50kg
Korandil is not recommended in newborn babies (first few weeks after birth) and in children with kidney problems.
If you receive a dose of Korandil longer than normal
In case you take a dose larger than normal, stop taking the medicine and contact your doctor or go to a hospital immediately. The following effects may happen: feeling of light-headed or dizziness. This is due to a sudden or excessive drop in blood pressure.
If you forget to take Korandil
If you have to take your medicine continuously and you missed a dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose to make up for a forgotten dose.
Possible undesirable effects
As with all medicines, Korandil can cause undesirable effects, although not everybody gets them. The following side effects may happen with this medicine:
Stop taking Korandil and talk to a doctor straight away, if you notice any of the following:
- Swelling of your face, lips, tongue or throat which may cause difficulty in breathing or swallong.
- Swelling of your hands, feet or ankles.
- If you develop a raised red skin rash (hives).
You should be aware that black patients are at increased risk of these types of reactions. If any of the above happen, stop taking Korandil and talk to a doctor straight away.
When you start taking Korandil you may feel faint or dizzy. If this happens, it will help to lie down. This is caused by your blood pressure lowering. It should improve as you continue to take the medicine. If you are worried, please talk to your doctor.