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enalapril maleate is indicated for the treatment of hypertension enalapril maleate is effective alone or in combination with other antihypertensive agents especially thiazide type diuretics the blood pressure lowering effects of enalapril maleate and thiazides are approximately additive enalapril maleate is indicated for the treatment of symptomatic congestive heart failure usually in combination with diuretics and digitalis in these patients enalapril maleate improves symptoms increases survival and decreases the frequency of hospitalization see clinical pharmacology heart failure mortality trials for details and limitations of survival trials in clinically stable asymptomatic patients with left ventricular dysfunction ejection fraction 35 percent enalapril maleate decreases the rate of development of overt heart failure and decreases the incidence of hospitalization for heart failure see clinical pharmacology heart failure mortality trials for details and limitations of survival trials in using enalapril maleate consideration should be given to the fact that another angiotensin converting enzyme inhibitor captopril has caused agranulocytosis particularly in patients with renal impairment or collagen vascular disease and that available data are insufficient to show that enalapril maleate does not have a similar risk see warnings in considering use of enalapril maleate it should be noted that in controlled clinical trials ace inhibitors have an effect on blood pressure that is less in black patients than in non blacks in addition it should be noted that black patients receiving ace inhibitors have been reported to have a higher incidence of angioedema compared to non blacks see warnings head and neck angioedema
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