Enalapril/Felodipine, Oral

What are other names for this medicine?

Type of medicine: calcium channel blocker; ACE inhibitor

Generic and brand names: enalapril and felodipine, oral; Lexxel

What is this medicine used for?

This medicine is taken by mouth to treat and control high blood pressure. It contains both a calcium channel blocker and an ACE inhibitor.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• an autoimmune disease such as lupus, or any other immune system problem
• heart disease or irregular heartbeat
• hyperkalemia (too much potassium in the blood)
• hyponatremia (too little sodium in the blood)
• kidney or liver problems
• low blood pressure

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How should I take it?

Take this medicine exactly as your healthcare provider prescribes. Take it regularly every day, even if you begin to feel better. You may take this medicine with or without food. You may need to take it for a long time to control your blood pressure.

This medicine is usually taken once a day. Take it with a full glass of water. Swallow the medicine without crushing, breaking, or chewing it.

If you miss a dose one day, do not take a double dose the next day. If you are not sure about what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What should I watch out for?

You may develop a cough when you take this medicine. This is usually a dry cough that does not produce mucus. Do not treat yourself for coughs or colds while you are taking this medicine without asking your healthcare provider for advice. Talk to your provider if the cough continues.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may cause a sudden drop in blood pressure, especially when you first start taking it. You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. If you feel dizzy or faint while you are standing, lie down for a while and then get up slowly, Also, drinking alcohol may make it worse. Do not drink alcohol unless your healthcare provider approves.

You need to check your blood pressure regularly while taking this medicine. You may need to have blood tests to see how this medicine affects you. Keep all appointments.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Check with your healthcare provider if you have severe diarrhea, nausea and vomiting, or if you sweat a lot. The loss of body fluid can make it dangerous to take this medicine.

You may get infections more easily when you are taking this medicine. If you have any sign of infection, such as a sore throat or fever, contact your healthcare provider.

Do not use salt substitutes or potassium supplements unless your healthcare provider approves.

This medicine may cause your gums to swell. Careful and regular flossing and brushing may prevent mouth problems. Contact your healthcare provider or dentist if your gums get swollen and painful.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot contact your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (swelling of your tongue, throat, lips, or face; trouble swallowing; hives; itching; tightness or pain in your chest; trouble breathing); severe dizziness or fainting; fast or irregular heartbeat; severe abdominal pain.

Serious: Yellowing of skin or eyes, unexplained weight gain, swelling in hands or feet, change in how much you urinate, sore throat, fever.

Other: Cough, headache, trouble sleeping, nervousness, flushing, dry mouth, constipation, diarrhea, nausea, stomach pain, dizziness, tiredness, stuffy nose, swelling or pain in the gums, change in sexual ability or desire.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• allopurinol (Zyloprim)
• antibiotics such as erythromycin (Ery-Tabs, E.E.S., Eryc), ciprofloxacin (Cipro), and clarithromycin (Biaxin)
• antifungals such as clotrimazole (Mycelex), itraconazole (Sporanox), and ketoconazole (Nizoral)
• anti-HIV medicines such as indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), delavirdine (Rescriptor), ritonavir (Norvir), and saquinavir (Fortovase, Invirase)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, primidone (Mysoline), and phenytoin (Dilantin)
• bronchodilators such as aminophylline (Truphylline), dyphylline (Dilor, Lufyllin), oxtriphylline (Choledyl SA), and theophylline
• cimetidine (Tagamet)
• diuretics (water pills) such as furosemide (Lasix), chlorothiazide (Diuril), hydrochlorothiazide (Oretic, Microzide), spironolactone (Aldactone), amiloride (Midamor), bumetanide (Bumex), torsemide (Demadex), and triamterene (Dyrenium, Maxzide, Dyazide)
• imatinib (Gleevec)
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenolate mofetil (CellCept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• lithium (Lithobid, Eskalith)
• medicines to treat erectile dysfunction such as vardenafil (Levitra), sildenafil (Viagra), and tadalafil (Cialis)
• medicines to treat irregular heartbeat such as amiodarone (Cordarone, Pacerone), procainamide (Pronestyl), disopyramide (Norpace, Norpace CR), quinidine, sotalol (Betapace), dofetilide (Tikosyn), flecainide (Tambocor), lidocaine (Xylocaine), digoxin (Lanoxin, Lanoxicaps, Digitek), and tocainide (Tonocard)
• natural remedies such as dong quai, yohimbe, ginseng, and garlic
• nonsteroidal anti-inflammatory drugs such as diclofenac sodium (Voltaren), diclofenac potassium (Cataflam), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin, Nuprin), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), meclofenamate (Meclomen), mefenamic acid (Ponstel), naproxen (Naprosyn), naproxen sodium (Anaprox), oxaprozin, piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin)
• potassium supplements such as Kaon-Cl, Slow-K, K-Tab, K-Lyte/Cl, Klorvess, Micro-K, and K-Dur
• rifampin (Rifadin).

The effects of this medicine may be increased if you take it with grapefruit juice. Discuss this with your healthcare provider.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.