Acelar

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Acelar

Quick Facts: Acelar (Enalapril Maleate)

Property Description
Active ingredient Enalapril maleate
Form Tablet (Oral formulation)
Pharmacological class Angiotensin-Converting Enzyme (ACE) Inhibitor
General purpose Management of systemic blood pressure
Origin Synthetic compound

What Type of Medicine is Acelar?

Acelar is defined as a synthetic prescription medicine whose active component is Enalapril maleate, classifying it as an Angiotensin-Converting Enzyme (ACE) inhibitor. It is fundamentally recognized as a cardiovascular agent used for managing systemic circulatory stability. Enalapril is characterized as an essential antihypertensive agent with established efficacy. Enalapril is specifically known among the ACE inhibitors for its consistent performance in long-term maintenance of vascular tone, a characteristic clinically recognized for its predictable half-life across diverse patient populations.

Composition, Form, and Origin

The composition of Acelar is based on the single ingredient, Enalapril maleate, a Dicarboxylic acid derivative entirely manufactured as a synthetic compound. Acelar is supplied as an oral formulation in a tablet form for systemic administration. A crucial chemical characteristic is that Enalapril functions as a prodrug, meaning the administered compound is inactive and must undergo metabolic activation in the liver to yield its therapeutic metabolite, Enalaprilat. The drug is a globally approved option for managing cardiovascular health across various patient groups.

General Purpose and Function

The general purpose of this medication is to support the stability and function of the entire cardiovascular system by addressing pressure imbalances within the arteries. The core function is achieved by preventing the conversion of a precursor hormone into Angiotensin II, a chemical known for constricting blood vessels. By interrupting this process, Acelar promotes the relaxation and widening of the blood vessels, resulting in a reduction of peripheral vascular resistance. This action is a fundamental approach to lowering high blood pressure, ultimately working to decrease the mechanical effort required for the heart muscle to circulate blood.

Regulatory References

  1. U.S. National Library of Medicine (NLM)
  2. MedlinePlus

What side effects are possible with Acelar?

Possible side effects and safety information

The official safety profile of Acelar (Enalapril maleate) is structured by classifying possible adverse effects based on their frequency and the body system they impact, as documented by government regulatory bodies.

Frequency-Classified Adverse Reactions

Adverse events are categorized by incidence according to regulatory standards:

  • Very Common (ge 1/10): Cough, Dizziness, Nausea, Blurred vision, Asthenia (lack of energy).
  • Common (ge 1/100, < 1/10): Headache, Hypotension (including orthostatic), Depression, Diarrhoea, Fatigue, Hyperkalaemia (increased serum potassium), and increases in serum creatinine.
  • Uncommon (ge 1/1,000, < 1/100): Anaemia, Angina pectoris, Vomiting, Constipation, Renal dysfunction, Proteinuria, and Impotence.

Serious Adverse Reactions and Safety Constraints

The label formally identifies certain high-consequence adverse reactions. Angioedema (swelling of the face, tongue, and/or throat) is a serious reaction that can occur at any time during treatment. Hepatic failure, a rare syndrome starting with cholestatic jaundice or hepatitis, has also been documented. Blood disorders such as agranulocytosis (severe decrease in white blood cells) are classified as rare.

Regulatory documentation includes specific constraints for high-risk populations. The medication is contraindicated in the second and third trimesters of pregnancy due to an official fetal toxicity risk. There is an increased risk of severe renal insufficiency and hypotension in patients with bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney. Symptomatic hypotension is often more likely to occur after the initial dose in volume-depleted patients. The medication is also contraindicated for use with sacubitril/valsartan due to a significantly increased risk of angioedema.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory documentation identifies that an acute overdosage of Acelar (Enalapril Maleate) primarily results in an exaggerated extension of its therapeutic effect.

Category Documented Manifestations and Risks
Primary Clinical Manifestation Severe Hypotension (profound drop in blood pressure) is the most likely sign, potentially accompanied by bradycardia (slow heart rate), dizziness, somnolence, and stupor.
Severe/Life-Threatening Risks Potential progression to circulatory shock, acute renal failure, and critical electrolyte imbalances like hyperkalemia. Myocardial infarction or cerebrovascular events are cited as risks associated with excessive blood pressure reduction.
Emergency Action Required Seek immediate medical attention and contact emergency services or a poison control center immediately upon suspicion of overdose. This action is mandated for any occurrence of profound light-headedness, fainting, or other severe symptoms.

The required management approach is strictly symptomatic and supportive, as no specific antidote is known for this medication. Officially documented interventions include volume repletion via intravenous infusion of normal saline and positioning the patient in the supine position. Monitoring requirements mandate frequent observation of vital signs and electrolytes for at least six hours post-ingestion, with extended hospitalization required if the patient remains symptomatic or hypotensive. The active metabolite of the drug is known to be dialyzable.

Therapeutic Uses of Acelar

Acelar (Enalapril maleate) provides therapeutic support focused on long-term stability and relief within the cardiovascular system, addressing chronic pressure imbalances and compromised heart function. This medication is commonly used to help with high blood pressure and heart failure.

The medication is generally applied in situations involving conditions marked by consistently high arterial pressure or a weakened heart, including chronic hypertension, symptomatic congestive heart failure, and asymptomatic left ventricular dysfunction. Acelar is used to address symptom clusters that arise from these conditions, helping to manage distressing manifestations like dyspnea (shortness of breath) and edema (swelling due to fluid retention).

“Acelar is relevant for easing systemic strain, helping patients cope more steadily with the long-term symptoms associated with chronic cardiovascular issues.”

This therapeutic approach supports general well-being and may assist with maintaining functional stability, which is relevant for managing the long-term stress associated with these conditions. It contributes to improved comfort during periods of heightened symptoms and may assist with managing the risk of the condition worsening, even in high-risk patients who are currently asymptomatic.


Quick Fact: Relief for Cardiovascular Strain Description
Primary Therapeutic Goal Sustained support for chronic pressure imbalances and heart function.
Symptom Management Helps ease physical symptoms like swelling and shortness of breath linked to heart weakness.
Patient Benefit Contributes to improved comfort and assists with maintaining long-term functional stability.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Acelar (Enalapril maleate) eligibility is strictly defined by regulatory authorities based on a patient’s medical status and age. Use is established for adults for all approved indications and for pediatric patients over one month of age for hypertension.

Contraindications and Restrictions

The medicine is contraindicated in patients with a history of angioedema (swelling) related to previous ACE inhibitor treatment or patients with hereditary or idiopathic angioedema.

Category Eligibility Rule
Pregnancy Contraindicated in the second and third trimesters. Discontinuation is advised immediately upon detection of pregnancy.
Concomitant Use Contraindicated with aliskiren in patients with diabetes or renal impairment (GFR <60 mL/min/1.73 m^2).
Renal Impairment Not recommended for children with severe renal impairment (GFR <30 mL/min/1.73 m^2). Use in adults with renal impairment requires caution.
Age Group Not recommended for neonates (infants 1 month of age or less).

Official labeling also advises against use during breastfeeding. Patients with pre-existing conditions like volume depletion or certain valve stenoses require close medical supervision and conditional use.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Regulatory documentation defines this product's interaction profile by formally restricted combinations and agents that affect physiological stability or clearance. Co-administration with Sacubitril/valsartan is contraindicated and requires a 36-hour separation period before or after Acelar use. Aliskiren is also contraindicated in patients with diabetes mellitus or documented renal impairment. Use with high-flux membranes during dialysis procedures is restricted.

A primary pharmacodynamic constraint is the risk of hyperkalaemia. This may result from the concomitant use of Potassium-sparing Diuretics, Potassium Supplements, and Potassium-containing Salt Substitutes. Other agents, including Trimethoprim, Ciclosporin, and Heparin, are noted for increasing this risk.

Interactions that affect clearance or organ function include the risk of increased serum Lithium concentrations and toxicity due to reduced clearance. Co-administration with NSAIDs may result in deterioration of renal function, a risk specifically heightened for elderly or volume-depleted patients. The risk of angioedema is also officially increased when Acelar is combined with mTOR Inhibitors or DPP-IV Inhibitors. Enalapril absorption is not officially influenced by the presence of food.

Mechanism of Action

Acelar is a prodrug that undergoes rapid hydrolysis in hepatic tissue to its primary active metabolite, enalaprilat. This active metabolite is a competitive inhibitor of the angiotensin-converting enzyme (ACE), which is a component of the renin-angiotensin-aldosterone system (RAAS).

Enalaprilat binds to the active site of ACE, hindering the enzyme's function of converting angiotensin I to the potent vasoconstrictor angiotensin II. The reduction in circulating angiotensin II concentrations leads to a decrease in systemic vascular resistance via arteriole vasodilation. Furthermore, the molecular inhibition of ACE subsequently decreases angiotensin II-mediated aldosterone secretion from the adrenal cortex. This cascade modulates renal handling of sodium and water, promoting their excretion and resulting in a reduction of circulating blood volume. These downstream effects collectively decrease peripheral resistance and circulating volume, producing systemic hemodynamic modulation.

Dosage and Administration Information

Acelar is typically prescribed for the short-term relief of pain and inflammation, such as in conditions affecting the joints and muscles. The precise dosage and duration of treatment must be strictly followed as directed by a qualified healthcare professional. Do not alter the prescribed dose or extend the period of use without consultation.

Administration Guidelines

  • Dosing: The dose is individualized based on the patient's medical condition, response to therapy, and needs. Patients should aim to take the lowest effective dose for the shortest necessary duration to minimize potential risks.
  • Method: The tablet should be swallowed whole with water. It must not be chewed, crushed, or broken. Always refer to the patient information leaflet for specific instructions regarding the form of Acelar you have been prescribed.
  • With Food: It is generally recommended to take Acelar with food or milk to reduce the risk of stomach upset and gastrointestinal irritation, which is a known risk associated with its components, such as non-steroidal anti-inflammatory drugs (NSAIDs).

Important Safety Considerations

To ensure safe use, it is crucial to maintain a regular dosing schedule as advised by your healthcare provider. Avoid consuming alcohol while taking Acelar, as this may increase the risk of serious side effects, including liver damage and excessive drowsiness. Furthermore, do not take any other over-the-counter or prescription medications containing the same active pain-relieving ingredients (such as acetaminophen/paracetamol) without first consulting your prescriber, as this can lead to an accidental overdose. Your doctor may schedule regular monitoring of your kidney function, liver function, and blood component levels during long-term therapy.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Acelar


Evidence for Use in Managing High Blood Pressure (Hypertension)

Research exploring Acelar's use for high blood pressure primarily involves Randomized Controlled Trials (RCTs). These studies were applied in adults with varying degrees of high blood pressure. Research was conducted to observe changes in systemic blood pressure and to measure patterns related to blood pressure evolution over a full day and changes in peripheral vascular resistance.

Studies conducted during defined time intervals reported how blood pressure measurements evolved in the observed populations. Longer-term follow-up studies research examined the measured incidence of major cardiovascular events (e.g., stroke or heart attack) by tracking rates across the study groups. What remains uncertain is the consistency of these patterns across all groups, as studies reported observed changes were less pronounced or varied in certain demographic subgroups, notably in Black patient populations.


Evidence for Use in Treating Symptomatic Heart Failure

Acelar was studied for conditions associated with symptomatic heart failure through large-scale, multi-center Randomized Controlled Trials (RCTs). These studies examined outcomes reflecting daily functioning or activity level, outcomes related to physical discomfort, and outcomes describing episodic or acute changes in patient condition. The research monitored outcomes related to systemic or functional imbalance and outcomes capturing phases of heightened symptom activity within the observed populations.

The certainty remains low regarding the direct applicability of some influential survival data, as these landmark trials were conducted before the widespread adoption of certain other heart failure medications in standard clinical practice. Furthermore, evidence is limited for use in patients whose heart failure is characterized by a preserved or non-reduced ejection fraction.


Evidence for Preventing Progression of Asymptomatic Heart Dysfunction

Specific Randomized Controlled Trials (RCTs) was studied for conditions characterized by functional limitations in high-risk patients who had heart damage but did not yet exhibit symptoms of heart failure. The research examined outcomes describing episodic or acute changes and outcomes reflecting daily functioning or activity level in the study populations. Studies report how symptoms evolved in the observed populations, noting patterns related to the time until onset of clinical symptoms and the measured rate of condition change.

What the Scientific Literature Indicates as Uncertain or Under-Researched

The certainty remains low in several specific areas. The data for certain groups, such as very young infants or patients with different underlying causes of heart failure (like non-reduced ejection fraction), remain insufficient for detailed conclusions. Evidence quality varies across studies, and while some findings indicate patterns related to outcomes linked to physiological strain, long-term effects on specific outcomes are not fully established in all populations, such as in pediatric patients.

Key Studies & References

  1. Studies of Left Ventricular Dysfunction (SOLVD) – NCT00000516 (Prevention and Treatment Trials)

Frequently Asked Questions (FAQ)

Common questions about Acelar (FAQ)


Q: Is Acelar intended for short-term or long-term use?

A: Acelar is approved by regulatory bodies for the long-term management of chronic cardiovascular conditions, including heart failure and high blood pressure. However, its use is also described in official product information for the short-term treatment of other conditions, depending on the specific prescribed form. The determination of therapeutic duration is generally made by a healthcare provider.


Q: How long does the effect of one dose of Acelar typically last?

A: According to official product information, the active form of the medicine typically reaches its highest level in the bloodstream within three to four hours. The blood pressure-lowering effect is commonly described as lasting for about 24 hours. This sustained action is consistent with the drug's approved dosing schedules.


Q: Are there any known foods or beverages that should be avoided when taking Acelar?

A: Official labeling includes a warning against alcohol consumption, which may increase the risk of serious side effects, including liver damage. Furthermore, official documents advise caution regarding products with high amounts of potassium, such as potassium supplements and salt substitutes. The regulatory concern is an unsafe increase in the potassium level (hyperkalaemia) in the blood.


Q: What is the usual duration of treatment with Acelar?

A: For the management of chronic conditions such as heart failure and hypertension, regulatory information indicates that Acelar treatment is typically long-term. This continuous use is needed to maintain a consistent therapeutic effect on the body's systems. The duration of therapy is determined based on the specific condition being addressed.


Q: Are the side effects of Acelar generally worse when treatment is first started?

A: Regulatory warnings indicate that the risk of symptomatic hypotension (a drop in blood pressure) is often higher right after taking the initial dose of the medicine. This is particularly relevant for individuals who may be volume-depleted or dehydrated, as described in the official warnings.


Q: Can Acelar be taken with common over-the-counter pain relievers?

A: Official drug information advises caution when taking Acelar with certain common over-the-counter medicines. Specifically, non-steroidal anti-inflammatory drugs (NSAIDs) and products containing acetaminophen (paracetamol) are noted. Regulatory documents suggest that combining these medicines may be associated with an increased risk of adverse events, including a deterioration of kidney function.


Q: Can people with kidney or liver issues take Acelar?

A: Regulatory guidance imposes specific restrictions for people with severe kidney or liver issues. The medicine is contraindicated in certain cases of severe kidney impairment and for patients with conditions like bilateral renal artery stenosis. Regulatory guidance states that monitoring of kidney and liver function is generally warranted during therapy, as rare cases of hepatic failure have been documented.


Q: How is Acelar described to interact with high blood pressure medications?

A: Regulatory documents list several important interactions with other medicines used to manage blood pressure. Acelar is explicitly contraindicated for use with Sacubitril/valsartan and with Aliskiren in patients with diabetes or kidney impairment. Furthermore, combining Acelar with diuretics may increase the risk of symptomatic hypotension (low blood pressure).


Q: Can Acelar be used by people who have diabetes?

A: Official labeling states that Acelar is contraindicated (advised against) for use in patients with diabetes who are simultaneously taking the medicine Aliskiren. However, regulatory documents describe the use of Acelar in patients with diabetes who are not taking Aliskiren under routine medical supervision.


Q: Is there published long-term safety data available for Acelar?

A: Yes, research supporting Acelar's long-term use includes studies that track patients over extended periods to examine the incidence of major cardiovascular events. Additionally, long-term safety data is continuously gathered from ongoing post-marketing surveillance and classified by frequency in regulatory documents.


Q: How does the published evidence for Acelar compare to older medicines used for the same purpose?

A: Regulatory documentation and research overviews provide context for Acelar's evidence, often noting that some influential studies were conducted before the widespread use of certain other heart failure medications. Official sources describe the available evidence for its approved uses but do not make direct claims about whether Acelar is superior to older medicines.


Q: Does Acelar build up in the body over time?

A: Studies on the pharmacokinetics of Acelar indicate that its active component, Enalaprilat, has an effective accumulation half-life of approximately 11 hours. With continuous daily use, the medicine will reach a steady therapeutic level in the body. Achieving this steady state is understood to be important for consistent therapeutic effects.


Q: Why does Acelar need to be taken consistently as described in the product information?

A: Consistent use is required to maintain a steady concentration of the medicine's active component in the body. This steady level is necessary for the continuous therapeutic inhibition of the ACE enzyme, which is the mechanism used to provide sustained blood pressure control. Regulatory documents reinforce the importance of consistent scheduling to maintain therapeutic stability.


Q: What is the recommended response if a dose of Acelar is missed?

A: Official patient guidance for Acelar generally advises patients to take the next dose at the regularly scheduled time if a dose is missed. Regulatory information explicitly warns against taking a double dose to compensate for a missed one. Specific guidance is provided in the patient information leaflet.


Q: Is Acelar available in different strengths or formulations?

A: Yes, regulatory product information states that Acelar (Enalapril maleate) is available in multiple tablet strengths, typically ranging from 2.5 mg up to 20 mg. The availability of different strengths allows for flexibility in the prescribed therapeutic amount.


Q: Do patients need to avoid specific activities while taking Acelar?

A: Due to common side effects like dizziness and fatigue that are noted in the official safety profile, regulatory warnings advise patients to use caution when participating in activities that require high levels of concentration. This includes tasks such as driving or operating heavy machinery until the individual's reaction to the medicine is understood.


Q: How quickly does Acelar start to show its effects after the first dose?

A: According to official clinical pharmacology data, the onset of the blood pressure lowering effect is typically observable within one hour after taking the tablet. The maximum effect of that single dose generally occurs within four to six hours.


Q: Can Acelar lose effectiveness the longer a person takes it?

A: Official clinical studies indicate that the therapeutic effects of Acelar are maintained during long-term therapy. Regulatory documents suggest there is no evidence of the medicine diminishing in effectiveness over extended periods of use for its approved indications.


Q: Is Acelar commonly prescribed alongside other treatments for the condition?

A: Regulatory guidelines state that for the management of certain chronic conditions, such as heart failure, Acelar is frequently prescribed as part of a combination regimen with other medications, such as diuretics or beta-blockers, to achieve optimal therapeutic management.


Q: Does Acelar have known effects on body weight (gain or loss)?

A: Official drug labels do not list weight change as a common or very common side effect. However, regulatory documents acknowledge that the medicine's effects on fluid balance and metabolism, or the use of concurrent medications, could indirectly lead to changes in body weight.


Q: Does Acelar interact with hormonal birth control methods?

A: Official product labels and regulatory sources generally do not cite specific interactions between Acelar (an ACE inhibitor) and hormonal birth control methods. This indicates that there is no formal warning on the product label regarding a reduction in the efficacy of hormonal contraceptives.


Q: What is the expected timeline for feeling the maximum benefit of Acelar?

A: While the initial effect on blood pressure occurs within hours, the full expected clinical benefits for the management of chronic conditions typically require a longer period. Official clinical studies suggest that the achievement of the full therapeutic benefit for chronic conditions typically requires continuous therapy over several weeks.


Q: Is Acelar considered a newly approved medicine by regulatory bodies?

A: The active ingredient in Acelar, Enalapril maleate, is an established medicine that has been approved by regulatory bodies globally for several decades. It is recognized as a key treatment within its pharmacological class.


Q: Does Acelar have a risk of dependence, as described in official sources?

A: Regulatory documentation, including sections on drug abuse and dependence, does not classify Acelar (Enalapril maleate) as a medicine with a risk for dependence or abuse. This information is consistent across official drug labels.


Q: What should be done if someone experiences an unusual symptom after taking Acelar?

A: Official patient guidance states that any unusual or severe symptoms, especially signs of angioedema (swelling of the face, tongue, and throat), warrant immediate attention from a healthcare professional or emergency services. This is a crucial safety warning described in regulatory documentation.


Q: Is Acelar a controlled substance?

A: According to official classification by the US Drug Enforcement Administration and equivalent international bodies, Acelar (Enalapril maleate) is not classified as a scheduled or controlled substance.


Q: How often did people experience side effects in clinical studies for Acelar?

A: Regulatory documents classify side effects by their documented incidence rate in clinical studies. For example, a "Common" side effect is reported to occur in at least 1 out of every 100 people but fewer than 1 out of 10 people. The full safety profile is structured using these frequency standards.


Q: Are there any supplements or vitamins known to interact with Acelar?

A: Official documentation lists certain supplements and products that may interact with Acelar. The most prominent example is potassium supplements, as the combination can increase the risk of hyperkalaemia (an unsafe rise in potassium levels). The antibiotic Trimethoprim is also noted for increasing this risk.


Q: How often do people experience side effects with Acelar?

A: To provide clarity on its safety profile, regulatory documents classify all known adverse effects based on how often they occurred in clinical trials. This classification, such as 'Very Common' or 'Uncommon,' allows patients to understand the documented rate of side effects for the medicine.


Q: Can Acelar be used by people who have diabetes?

A: Official labeling states that Acelar is contraindicated (advised against) for use in patients with diabetes who are simultaneously taking the medicine Aliskiren. However, regulatory documents describe the use of Acelar in patients with diabetes who are not taking Aliskiren under routine medical supervision.

How should Acelar be stored and disposed of?

How to Store and Dispose of Acelar

Acelar (Enalapril maleate) tablets must be stored according to specific environmental and container requirements to maintain stability and effectiveness.

Storage Conditions

The medication requires storage at controlled room temperature, generally between 20 C to 25 C (68 F to 77 F). The product must be protected from moisture and heat by keeping the container tightly closed and in the original packaging. It is mandatory to store Acelar out of the sight and reach of children.

Storage Restriction Requirement
Temperature Controlled Room Temperature
Environmental Protect from Moisture and Heat
Prohibited Do Not Freeze

Disposal Instructions

Unused or expired Acelar should be disposed of through a dedicated drug take-back program. If a take-back program is unavailable, the tablets must be mixed with an undesirable substance and sealed in a container before being placed in household trash. To prevent environmental release, the medication must not be flushed down a toilet or poured down a sink.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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