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Pharmacology of enalapril in children: a review

Nori J L Smeets1, Michiel F Schreuder2, Michiel Dalinghaus3

  • 1Department of Pharmacology and Toxicology, Radboud Institute of Health Sciences, Radboudumc, Nijmegen, the Netherlands.

Drug Discovery Today
|August 25, 2020
PubMed

Insights

Pediatric enalapril pharmacokinetics require more research, as current data is insufficient to confirm age-related effects or ensure safe, effective dosing, especially for young children and heart failure patients.

Area of Science:

  • Pharmacology
  • Pediatric Nephrology
  • Pediatric Cardiology

Background:

  • Enalapril, an ACE inhibitor, treats pediatric hypertension, heart failure, and kidney diseases.
  • Adult data cannot be directly extrapolated to children due to differing pharmacokinetics, efficacy, and safety.
  • Understanding pediatric enalapril disposition is crucial for optimizing treatment.

Purpose of the Study:

  • To review and assess the available pediatric enalapril pharmacokinetic data.
  • To identify gaps in evidence regarding enalapril's use in children.
  • To provide insights into age-related pharmacokinetic differences and guide future research.

Main Methods:

  • Systematic literature review of pharmacokinetic studies involving enalapril in pediatric populations.
  • Analysis of data concerning enalapril and its active metabolite, enalaprilat.
  • Evaluation of study designs, patient populations, and reported outcomes.

Main Results:

  • Paediatric enalapril pharmacokinetic data are insufficient to definitively establish age-related effects.
  • Evidence supporting safe and effective enalapril prescribing in children is limited, particularly for infants and those with heart failure.
  • Conflicting results and a lack of studies exist for specific pediatric subgroups.

Conclusions:

  • Current pharmacokinetic data do not adequately support age-specific enalapril dosing in children.
  • Further research is essential to establish evidence-based guidelines for pediatric enalapril use.
  • Specific studies are needed for young children and pediatric heart failure patients to ensure treatment safety and efficacy.

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