* The dose should be individualized 

* Hypertension

– Adults: the initial dose of Enalapril is 2.5 – 5mg/day. Dosage should be adjusted according to blood pressure response.

– The usual dose is 10 to 20 mg per day, once a day. Maximum tolerated dosage for adults: 40 mg/day

– In patients currently receiving diuretic therapy. If possible, diuretic therapy should be discontinued for 1–3 days prior to initiation of therapy with Enalapril 5 mg. It is necessary to use small initial doses, 5 mg or less in 24 hour. The dose is titrated upward, depending on clinical response.

* Heart Failure: (usually in combination with diuretics)

– The recommended initial dose is 2.5 mg/day in the first three days

– In the next four days: 5 mg/day in two divided doses. 

– The dose should be increased gradually to the usual maintenance dose of 20 mg, given in a single dose or two divided doses, as tolerated by the patient. 

* Asymptomatic Left Ventricular Dysfunction

– The initial dose of Enalapril maleate is 2.5 mg and it should be administered under close medical supervision to determine the initial effect on the blood pressure. In the absence of, or after effective management of, symptomatic hypotension following initiation of therapy, the dose should be increased gradually to the usual maintenance dose of 20 mg, given in divided doses twice daily. Blood pressure and renal function should be monitored closely both before and after starting treatment.

* Precautions: 

– In patients with renal impairment, the intervals between the administration of Enalapril should be prolonged and/or the dosage reduced