Generic name: Enalapril maleate, FelodipineBrand names: Lexxel
Lexxel is used to treat high blood pressure. It combines two blood pressure drugs: an ACE inhibitor and a calcium channel blocker. The ACE inhibitor (enalapril) lowers blood pressure by preventing a chemical in your blood called angiotensin I from converting to a more potent form that narrows the blood vessels and increases salt and water retention. The calcium channel blocker (felodipine) also works to keep the blood vessels open, and eases the heart's workload by reducing the force and rate of your heartbeat.
Lexxel can be prescribed alone or in combination with other blood pressure medicines, especially water pills (diuretics) such as hydrochlorothiazide.
Doctors usually prescribe Lexxel for patients who have been taking one of its components—enalapril or extended-release felodipine—without showing improvement. Like other blood pressure medications, Lexxel must be taken regularly for it to be effective. Since blood pressure declines gradually, it may be 1 or 2 weeks before you get the full benefit of Lexxel; and you must continue taking it even if you are feeling well. Lexxel does not cure high blood pressure; it merely keeps it under control.
Lexxel can be taken with a light meal or without food. Remember, however, that a high-fat meal can reduce its effectiveness, and that grapefruit juice increases its impact.
Swallow Lexxel tablets whole. Do not crush, divide, or chew them.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lexxel.
Avoid Lexxel if you have ever had an allergic reaction to it, or have ever developed a swollen throat and difficulty swallowing (angioedema) while taking similar drugs such as captopril, enalapril, or lisinopril. Make sure your doctor is aware of the incident.
Call your doctor immediately if you begin to suffer angioedema while taking Lexxel. Warning signs include swelling of the face, lips, tongue, or throat; swelling of the arms and legs; and difficulty swallowing or breathing.
Bee or wasp venom given to prevent an allergic reaction to stings may cause a severe allergic reaction to Lexxel. Kidney dialysis can also prompt an allergic reaction to the drug.
Lexxel sometimes causes a severe drop in blood pressure. The danger is especially great if you have been taking water pills (diuretics), or if you have heart disease, kidney disease, or a potassium or salt imbalance. Excessive sweating, severe diarrhea, and vomiting are also a threat. They can rob the body of water, causing a dangerous drop in blood pressure. If you feel light-headed or faint, have chest pain, or feel your heart racing, contact your doctor immediately.
Because another of the ACE inhibitors, captopril, has been known to cause serious blood disorders, your doctor will check your blood regularly while you are taking Lexxel. If you develop signs of infection such as a sore throat or a fever, you should contact your doctor at once—an infection could be a signal of blood abnormalities.
Lexxel may also affect the liver; and your doctor will need to adjust your dosage with extra care if you are over 65 or have liver disease. Report these symptoms of liver problems to your doctor immediately: a generally run-down feeling, pain in the upper right abdomen, or yellowing of the skin or the whites of your eyes.
If you suffer from heart failure or kidney disease, make certain that your doctor knows about it. Lexxel should be used with caution under these circumstances.
Some people taking Lexxel develop a dry, nagging cough. This will go away when you stop taking the drug. Others are troubled by swollen gums. Good dental hygiene makes this less likely.
If Lexxel is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lexxel with the following:CimetidineDiuretics such as furosemide or hydrochlorothiazideDiuretics that leave potassium in the body, such as amiloride, spironolactone, and triamtereneEpilepsy medications such as carbamazepine, phenobarbital, and phenytoinErythromycinGrapefruit juiceHigh-fat mealsItraconazoleLithiumPotassium supplements
Because Lexxel tends to increase your potassium level, avoid potassium-containing salt substitutes unless your doctor approves.
Do not take Lexxel during pregnancy. When taken during the final 6 months, the ACE inhibitor in Lexxel can cause birth defects, prematurity, and death in the developing or newborn baby. If you are pregnant, inform your doctor immediately.
Lexxel may appear in breast milk and could affect a nursing infant. If Lexxel is essential to your health, your doctor may advise you to stop breastfeeding.
Lexxel is available in two strengths. Lexxel 5-2.5 contains 5 milligrams of enalapril and 2.5 milligrams of felodipine. Lexxel 5-5 contains 5 milligrams of each.
The usual starting dose is 1 tablet of Lexxel 5-5 once a day. If there is no change in your blood pressure after 1 or 2 weeks, the doctor may increase your dose to 2 tablets once a day. If your blood pressure still remains too high, the dose may be increased to 4 tablets of Lexxel once a day. The doctor may also add a water pill (containing a thiazide) to your regimen.
The safety and effectiveness of Lexxel in children have not been established.
If you are over 65, your doctor may have to monitor your blood pressure closely at the beginning of treatment, and adjust your dose with care.
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.