Anapril Dosage/Direction for Use

Essential Hypertension: The initial dose is 10-20 mg, depending on the degree of hypertension, and is given once daily. In mild hypertension, the recommended initial dose is 10 mg daily. For other degrees of hypertension the initial dose is 20 mg daily. The usual maintenance dose is one 20 mg tab taken once daily. The dosage should be adjusted according to the patient to a maximum of 40 mg daily.
Renovascular Hypertension: Since blood pressure and renal function in such patients may be particularly sensitive to ACE inhibitor, therapy should be initiated with a lower starting dose (eg. 5 mg or less). The dosage should then be adjusted according to the needs of the patient. Most patients may be expected to respond to one 20 mg tab taken once daily. For patients with hypertension who have been treated recently with diuretics, caution is recommended.
Concomitant Diuretic Therapy in Hypertension: Symptomatic hypotension may occur following the initial dose of Anapril, this is more likely in patients who are being treated currently with diuretics. Caution is recommended, therefore, since these patients may be volume or salt depleted. The diuretic therapy should be discontinued for 2-3 days prior to initiation of therapy with Anapril. If this is not possible, the initial dose of Anapril should be low (5 mg or less) to determine the initial effect on the blood pressure. Dosage should then be adjusted according to the needs of the patient.
Dosage in Renal Insufficiency: Generally, the intervals between the administration of enalapril should be prolonged and/or the dosage reduced.
Heart Failure: The initial dose of Anapril in patients with heart failure 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 with Anapril in heart failure, the dose should be increased gradually to the usual maintenance dose of 20 mg, given in a single dose or 2 divided doses, as tolerated by the patient. This dose titration may be performed over 2-4 week period or more rapidly if indicated by the presence of residual signs and symptoms of heart failure. This dosage regimen was effective in reducing mortality. Blood pressure and renal function should be monitored closely both before and after starting treatment with Anaprill because hypotension and (more rarely) consequent renal failure have been reported. If possible, the dose of diuretic should be reduced before beginning treatment. The appearance of hypotension after the initial dose of Anapril dose not imply that hypotension will recur during chronic therapy with Anapril and dose not preclude continued use of the drug. Serum potassium also should be monitored.
Administration: Since absorption of Anapril tablet is not affected by food, tablets may be administered before, during or after meals.