Posted cards for study. This board does not prescribe, fill, or replace a visit. Open the board disclaimer

Sephira Med Centres

Scan · enalapril

Does enalapril 20 mg raise potassium?

Last reviewed · 3 min read · Updated

Bone review card, cobalt edge, lime chip: potassium chip up

About one percent of hypertensive patients in Vasotec trials had serum potassium greater than 5.7 mEq/L. Most of those were isolated values that settled while the drug continued. Hyperkalemia led to stopping in 0.28 percent of hypertensive patients. In heart-failure trials the rate was 3.8 percent and was not a listed cause for discontinuation. Mean rise on enalapril alone was about 0.2 mEq/L over up to 48 weeks.

The 0.2 mEq/L mean is a small shift

Hypertensive patients on VASOTEC alone for up to 48 weeks had a mean potassium rise of about 0.2 mEq/L. With a thiazide, the mean change was essentially none. Averages hide the person who went to 6.0.

Diabetes, low GFR, and potassium supplements raise the odds. The patient block says use those stacks cautiously if at all. The salt-substitute scan is the kitchen version.

What the 1 percent figure counted

The cut was greater than 5.7 mEq/L. Isolated bumps often came back down without a stop. That is not permission to ignore a climbing number or a weak, slow pulse. Bring the exact value and the date.

This page stays on potassium. Creatinine has its own scan. The combined lab walk already lives on creatinine and potassium ratings. Link it. Do not clone it.

A loop on the same list pulls the other way

Furosemide wastes potassium. Enalapril can hold it. The net is a lab, not a banana heuristic. See the enalapril panel next to any loop card you already use.

Say the ibuprofen. A dry tank plus an ACE plus an NSAID is how both creatinine and potassium surprise a Friday afternoon. The NSAID scan stays on that squeeze.

No Hypernil cash on a potassium card

This scan will not quote a street price to 'keep the 20 mg going' while you wait on a BMP. Ask the pharmacy that fills generic enalapril if cost is the barrier to the draw.

Chart the INN. Hypernil and Vasotec are names. The ion does not read them.

What a climbing K asks for

Hold and call if the number is high and rising, if you feel wrecked, or if an ECG was already abnormal. Do not stop and restart 20 mg three times before the visit. Bring the salt-sub bottle if you bought one.

Pregnancy is still a stop. A high potassium does not wait for a boxed-warning lecture, but the pregnancy scan remains its own job.

Heart failure saw more high-K reads

3.8 percent in those heart-failure trials. The label says that rate was not a cause for discontinuation in the trial write-up. Your clinic may still hold 20 mg for a number that will not come down.

Potassium-sparing agents should generally not sit with enalapril in heart failure. Spironolactone, triamterene, and amiloride are named. If they are both on the list, someone has to own the frequent draws.

Sources

  1. DailyMed VASOTEC (enalapril maleate) tablets, setid 39631f1f-5d19-43c1-b504-bf56d991ed97
  2. FDA Vasotec / enalapril prescribing information (018998; boxed fetal toxicity, Dosage and Administration)

Checked against the current label and reviewed by Dr. Yuki Tanaka. See Scan, Tag, Board-check, Post.

Board thread

Answers follow the U.S. Vasotec (enalapril) label.

Reid Calder Should I stop 20 mg if K is 5.8?

Board reply

Call the same day. Isolated trial bumps sometimes settled on drug. A 5.8 with weakness or a new spare-K tablet is not a home experiment. Do not restart on your own.

Ben Travers My K was 5.1 on 20 mg. Is that the 1 percent?

Board reply

The trial cut was greater than 5.7 mEq/L. 5.1 is still a number your clinician may want to trend, especially with a salt substitute or a spare-K drug. Bring the exact value.

Hana Seo Can I eat bananas on Hypernil?

Board reply

Diet belongs in the visit, not as a home ban from this page. The labelled stacks that raise K are supplements, salt substitutes, spare-K diuretics, diabetes, and low GFR.