Angioedema, including laryngeal edema, may occur at any time during treatment with angiotensin converting enzyme inhibitors, including Co-Enatec. Patients should be so advised and told to report immediately any signs or symptoms suggesting angioedema (swelling of face, extremities, eyes, lips, tongue, difficulty in swallowing or breathing) and to take no more drug until they have consulted with the prescribing physician.
Discontinue as soon as possible when pregnancy is detected; affects renin-angiotensin system, causing oligohydramnios, which may result in fetal injury and/or death.
This medication contains Co-Enatec. Do not take Co-Enatecat, Epaned, Vasotec, or Vasotec IV if you are allergic to Co-Enatec or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
Can Co-Enatec cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with Co-Enatec. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
Dry hacking nonproductive cough may occur within few months of treatment; consider other causes of cough prior to discontinuation.
See "What Are Side Effects Associated with Using Co-Enatec?”
What Are Side Effects Associated with Using Co-Enatec?
Common side effects of Co-Enatec include:
Other side effects of Co-Enatec include:
Serious side effects of Co-Enatec include:
- Symptoms of high potassium blood level (such as muscle weakness, slow/irregular heartbeat)
- Signs of infection (such as fever, chills, persistent sore throat)
- Changes in the amount of urine
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
Q: About two weeks ago, while undergoing tests for allergies, I had an allergic reaction - swelling in my lips. I usually take Co-Enatec and I took 20 mg doing that time. It didn't seem to work to help lower my blood pressure, which rose to 183/121. Anyhow, since then I've been careful to avoid anything with any type of nuts since the reaction was caused by almonds. However, I noticed yesterday under my lower lip a funny feeling and I eventually looked in the mirror. I saw redness and one small spot of swelling on the skin. I was baffled as to what could have caused it. I later remember it hadn't been long since I'd taken a dose of Co-Enatec. Could this now be causing the angioedema? I never had problems like this with the Co-Enatec and I've been taking it at least five years. I do feel I have "plateaued" on it. I've been taking the maximum dose for more than a year and it doesn't seem to have the same effects as before. Second question - I can only take ACE Inhibitors and ARBs to lower my BP because of other medical conditions, including CHF. Should I get another ACE Inhibitor? My BP is around 140/90 when I take Co-Enatec only, and I was supposed to have a second med, but which one? I've had trouble with some of the others including clonidine, Nifedipine, Norvasc, metoprolol and propanolol, and they all had to be stopped.
A: Angioedema is an uncommon side effect with Co-Enatec and usually occurs in the first month of treatment. Although it is possible to have this condition occur later in treatment, it is more common in African-American patients, women and people who have a history of drug or seasonal allergies. The exact prevalence and incidence of ARB-induced angioedema are not known, but are thought to be significantly lower than the ACE inhibitors. For patients who cannot take any other alternatives, ARBs seem the way to go for people who have had this issue with ACE inhibitors, although careful monitoring is recommended for the physician. There are no clear cut ways to distinguish which medication would be best in this case for your condition, but it has been shown that losartan (Cozaar) seems to show the most cases with angioedema, if it happens at all, with the ARBs. Lori Mendoza, PharmD Poulin, PharmD
¿Dónde puedo obtener más información?
Su farmacéutico le puede dar más información acerca Co-Enatec.
Mechanism Of Action
Co-Enatec, after hydrolysis to Co-Enatecat, inhibits angiotensin-converting enzyme (ACE) in human subjects and animals. ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. The beneficial effects of Co-Enatec in hypertension and heart failure appear to result primarily from suppression of the renin-angiotensin-aldosterone system. Inhibition of ACE results in decreased plasma angiotensin II, which leads to decreased vasopressor activity and to decreased aldosterone secretion. Although the latter decrease is small, it results in small increases of serum potassium. In hypertensive patients treated with VASOTEC alone for up to 48 weeks, mean increases in serum potassium of approximately 0.2 mEq/L were observed. In patients treated with VASOTEC plus a thiazide diuretic, there was essentially no change in serum potassium (see PRECAUTIONS). Removal of angiotensin II negative feedback on renin secretion leads to increased plasma renin activity.
ACE is identical to kininase, an enzyme that degrades bradykinin. Whether increased levels of bradykinin, a potent vasodepressor peptide, play a role in the therapeutic effects of VASOTEC remains to be elucidated.
While the mechanism through which VASOTEC lowers blood pressure is believed to be primarily suppression of the renin-angiotensin-aldosterone system, VASOTEC is antihypertensive even in patients with low-renin hypertension. Although VASOTEC was antihypertensive in all races studied, black hypertensive patients (usually a low-renin hypertensive population) had a smaller average response to Co-Enatec monotherapy than non-black patients.
Important: if you experience any of the following potentially serious symptoms, stop taking Co-Enatec and contact your doctor for advice straightaway:
- Any difficulty breathing, or swelling of your face, mouth, tongue or throat. These are signs of an allergic reaction.
- Any yellowing of your skin or the whites of your eyes. These may be signs of a liver problem called jaundice, which is a rare side-effect.
- A severe skin rash.
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
¿Qué otras drogas afectarán a Co-Enatec?
Dígale a su médico acerca de todas las medicinas que usted esté usando, comience a usar, o deje de usar durante su tratamiento con Co-Enatec, especialmente:
- un diurético o "pastilla para eliminar el agua";
- inyecciones de oro para el tratamiento de la artritis; o
- antiinflamatorios no esteroides (AINE, NSAID por sus siglas en inglés) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, y otras.
Esta lista no está completa. Otras drogas pueden interactuar con Co-Enatec, incluyendo medicinas que se obtienen con o sin receta, vitaminas, y productos herbarios. No todas las interacciones posibles aparecen en esta guía del medicamento.