Enalapril Felodipine Brand Name– Lexxel
What is Enalapril Felodipine
Enalapril an angiotensin converting enzyme inhibitor, and felodipine, a calcium-channel blocker are used together in an oral combination as a second-line treatment for hypertension.
The drugs have complimentary mechanisms of action which decrease peripheral resistance and lower blood pressure.
Felodipine is a potent peripheral vasodilator, similar to nifedipine and other members of the dihydropyridine class. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor.
Enalapril is a prodrug that is hydrolyzed by esterases to the active metabolite enalaprilat. Enalapril and enalaprilat lack a sulfhydryl group, which has implications for the safety profile.
Enalapril monotherapy is less effective in black hypertensive patients (a low-renin hypertensive population), and the antihypertensive effects of the combination product are primarily attributed to felodipine in this population. Lexxel® was approved by the FDA in December 1996.
As of July 31, 2008, Lexxel® tablets will be discontinued; AstraZeneca has no plans to further manufacture or distribute Lexxel®.
Indications
- hypertension
For the treatment of hypertension in patients who do not respond to monotherapy
Side Effects
- agranulocytosis
- anaphylactoid reactions
- angina
- angioedema
- aplastic anemia
- arthralgia
- asthenia
- atrial fibrillation
- atrial tachycardia
- azotemia
- blurred vision
- bronchospasm
- cholestasis
- cough
- diaphoresis
- dizziness
- dysgeusia
- dyspnea
- edema
- elevated hepatic enzymes
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fever
- flushing
- gingival hyperplasia
- glomerulonephritis
- gynecomastia
- headache
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hot flashes
- hyperkalemia
- hypotension
- impotence (erectile dysfunction)
- jaundice
- maculopapular rash
- myalgia
- myocardial infarction
- neutropenia
- orthostatic hypotension
- pancreatitis
- pancytopenia
- paresthesias
- pemphigus
- peripheral edema
- peripheral vasodilation
- photosensitivity
- pneumonitis
- pulmonary edema
- renal tubular necrosis
- sinus tachycardia
- Stevens-Johnson syndrome
- stroke
- syncope
- teratogenesis
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vasculitis
- weakness
Monitoring Parameters
- blood pressure
- heart rate
- serum creatinine/BUN
- serum potassium
- serum sodium
Contraindications
- ACE-inhibitor induced angioedema
- acute myocardial infarction
- Angiotensin-converting enzyme inhibitors (ACE inhibitors) hypersensitivity
- aortic stenosis
- autoimmune disease
- Black patients
- bone marrow suppression
- bradycardia
- breast-feeding
- cardiogenic shock
- cardiomyopathy
- cerebrovascular disease
- children
- collagen-vascular disease
- coronary artery disease
- dialysis
- dihydropyridine hypersensitivity
- geriatric
- heart failure
- hepatic disease
- hereditary angioedema
- history of angioedema
- hymenoptera venom (insect sting) allergy desensitization
- hyperkalemia
- hyponatremia
- hypotension
- hypovolemia
- immunosuppression
- low-density lipoprotein apheresis
- pregnancy
- renal artery stenosis
- renal disease
- renal failure
- renal impairment
- surgery
- ventricular dysfunction
Interactions
- Acebutolol
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Pseudoephedrine
- Acrivastine; Pseudoephedrine
- Aldesleukin, IL-2
- Alemtuzumab
- Alfentanil
- Alfuzosin
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Alogliptin; Metformin
- Alpha-glucosidase Inhibitors
- Alprostadil
- Amifostine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Aminolevulinic Acid
- Amiodarone
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Amprenavir
- Amyl Nitrite
- Angiotensin II
- Angiotensin II receptor antagonists
- Apalutamide
- Apomorphine
- Apraclonidine
- Aprepitant, Fosaprepitant
- Aprotinin
- Aripiprazole
- Asenapine
- Atazanavir
- Atazanavir; Cobicistat
- Atenolol
- Atenolol; Chlorthalidone
- Azathioprine
- Azilsartan
- Azilsartan; Chlorthalidone
- Baclofen
- Barbiturates
- Bendroflumethiazide; Nadolol
- Benzonatate
- Benzphetamine
- Betaxolol
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Boceprevir
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- Bosentan
- Brexpiprazole
- Brigatinib
- Brimonidine; Timolol
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Cabergoline
- Calcium Phosphate, Supersaturated
- Canagliflozin; Metformin
- Candesartan
- Candesartan; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
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- Cariprazine
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- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chloroprocaine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Cimetidine
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- Clarithromycin
- Clozapine
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- Delavirdine
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- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmedetomidine
- Dexmethylphenidate
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- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Quinidine
- Diazoxide
- Diclofenac
- Diclofenac; Misoprostol
- Diethylpropion
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- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
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- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dorzolamide; Timolol
- Dronedarone
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Duloxetine
- Dutasteride; Tamsulosin
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Tenofovir alafenamide
- Encorafenib
- Enflurane
- Entecavir
- Enzalutamide
- Ephedrine
- Epirubicin
- Eplerenone
- Epoprostenol
- Eprosartan
- Eprosartan; Hydrochlorothiazide, HCTZ
- Ergonovine
- Ertugliflozin; Metformin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esmolol
- Esomeprazole; Naproxen
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etodolac
- Etomidate
- Everolimus
- Famotidine; Ibuprofen
- Fedratinib
- Fenoprofen
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Fluconazole
- Fluorescein
- Fluoxetine
- Fluoxetine; Olanzapine
- Flurbiprofen
- Fluvoxamine
- Fosamprenavir
- Fospropofol
- General anesthetics
- Ginkgo, Ginkgo biloba
- Ginseng, Panax ginseng
- Glipizide; Metformin
- Glyburide; Metformin
- Gold
- grapefruit juice
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Haloperidol
- Halothane
- Heparin
- Hydantoins
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Ibritumomab Tiuxetan
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Icatibant
- Idelalisib
- Iloperidone
- Iloprost
- Imatinib
- Incretin Mimetics
- Indapamide
- Indinavir
- Indomethacin
- Insulins
- Intravenous Lipid Emulsions
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Irbesartan
- Iron Dextran
- Isavuconazonium
- Isocarboxazid
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Isosulfan Blue
- Istradefylline
- Itraconazole
- Ivacaftor
- Ivosidenib
- Kanamycin
- Ketamine
- Ketoconazole
- Ketoprofen
- Ketorolac
- Labetalol
- Lacosamide
- Lanreotide
- Lansoprazole; Naproxen
- Lanthanum Carbonate
- Lapatinib
- Larotrectinib
- Lasmiditan
- Lefamulin
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Levodopa
- Linagliptin; Metformin
- Lisdexamfetamine
- Lithium
- Loop diuretics
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Losartan
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lurasidone
- Magnesium Salts
- Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
- Meclofenamate Sodium
- Mefenamic Acid
- Meglitinides
- Melatonin
- Meloxicam
- Mestranol; Norethindrone
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methamphetamine
- Methohexital
- Methoxsalen
- Methylphenidate
- Methysergide
- Metoprolol
- Mifepristone
- Milrinone
- Mitotane
- Nabumetone
- Nadolol
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Nelfinavir
- Nesiritide, BNP
- Neuromuscular blockers
- Nevirapine
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nitrates
- Nitroglycerin
- Nitroprusside
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Octreotide
- Olanzapine
- Olmesartan
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Osilodrostat
- Oxaprozin
- Oxcarbazepine
- Oxymetazoline
- Palbociclib
- Paliperidone
- Pasireotide
- Pazopanib
- Penbutolol
- Pentoxifylline
- Phenelzine
- Phenylephrine
- Phenylephrine; Promethazine
- Photosensitizing agents (topical)
- Pindolol
- Piroxicam
- Polyethylene Glycol; Electrolytes
- Polyethylene Glycol; Electrolytes; Ascorbic Acid
- Posaconazole
- Potassium
- Potassium Phosphate
- Potassium Phosphate; Sodium Phosphate
- Pramlintide
- Prazosin
- Pregabalin
- Procainamide
- Procaine
- Propofol
- Protease inhibitors
- Pseudoephedrine
- Quinidine
- Rasagiline
- Remifentanil
- Repaglinide
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Risperidone
- Ritonavir
- Rivaroxaban
- Rofecoxib
- Rucaparib
- Sacubitril; Valsartan
- Salicylates
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Selpercatinib
- Sevoflurane
- SGLT2 Inhibitors
- Silodosin
- Simeprevir
- Sincalide
- Sirolimus
- Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sotalol
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Sufentanil
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfonylureas
- Sulindac
- Tacrolimus
- Talazoparib
- Tamsulosin
- Telaprevir
- Telavancin
- Telbivudine
- Telithromycin
- Telmisartan
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- Temsirolimus
- Tenofovir Alafenamide
- Tenofovir Alafenamide
- Tetrabenazine
- Tetracaine
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- Timolol
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- Vasopressin, ADH
- Vemurafenib
- Verteporfin
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- Yohimbine
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