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Generic Name: enalapril and felodipine (e NAL a pril and fe LOE di peen)
Brand Names: Lexxel

What is Lexxel (enalapril and felodipine)?

Enalapril is in a class of drugs called angiotensin-converting-enzyme inhibitors (ACE inhibitors). Enalapril prevents the constriction (narrowing) of blood vessels (veins and arteries).

Felodipine is in a class of drugs called calcium channel blockers. Felodipine relaxes (widens) your blood vessels, which makes it easier for your heart to pump and reduces its workload.

Enalapril and felodipine is used to treat hypertension (high blood pressure).

Enalapril and felodipine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Lexxel (enalapril and felodipine)?

Heavy sweating, vomiting, diarrhea, or other causes of fluid loss may lead to very low blood pressure, dizziness, and fainting during therapy with enalapril and felodipine. Maintain proper fluid intake to prevent dehydration and related adverse effects.

Brush and floss your teeth regularly as directed by your dentist. Rarely, swelling of the gums may occur with felodipine therapy. Proper oral hygiene may alleviate these symptoms.

What should I discuss with my healthcare provider before taking Lexxel (enalapril and felodipine)?

Before taking enalapril and felodipine, tell your doctor if you

• have liver disease;
• have kidney disease;

• have diabetes;

• have a collagen vascular disorder;

• have other diseases of the heart or blood vessels such as heart failure, aortic stenosis, or low blood pressure; or

• are taking salt substitutes, potassium supplements (e.g. K-Dur, Klor-Con), or potassium-sparing diuretics such as amiloride (Midamor), triamterene (Dyrenium, Dyazide, Maxzide), or spironolactone (Aldactone).

You may not be able to take enalapril and felodipine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

How should I take Lexxel (enalapril and felodipine)?

Take enalapril and felodipine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Grapefruit and grapefruit juice may interact with felodipine. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Symptoms of an enalapril and felodipine overdose are not known but might include extreme dizziness, weakness, fainting, fatigue, chest pain, shortness of breath, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

What should I avoid while taking Lexxel (enalapril and felodipine)?

Do not use salt substitutes or potassium supplements while taking enalapril and felodipine except under the supervision of your doctor.

Brush and floss your teeth regularly as directed by your dentist. Rarely, swelling of the gums may occur with felodipine therapy. Proper oral hygiene may alleviate these symptoms.

Heavy sweating, vomiting, diarrhea, or other causes of fluid loss may lead to very low blood pressure, dizziness, and fainting during therapy with enalapril and felodipine. Maintain proper fluid intake to prevent dehydration and related side effects.

Grapefruit and grapefruit juice may interact with felodipine. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Lexxel (enalapril and felodipine) side effects

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• difficulty breathing;

• unusually fast or slow heartbeat;

• jaundice (yellowing of your skin or eyes);

• swelling of your legs, ankles, or face;

• little or no urine;

• chest pain;

• severe dizziness or fainting; or

• a sore throat, fever, or other signs of infection.

Other, less serious side effects may be more likely to occur. Continue to take enalapril and felodipine and talk to your doctor if you experience

• mild dizziness or lightheadedness;

• headache;

• dry, tickling cough;

• numbness or tingling in the hands, feet, arms, or legs;

• insomnia or difficulty sleeping;

• swelling of your gums;

• nausea or diarrhea;

• increased urination;

• muscle or joint discomfort;

• flushing (redness);

• weakness or fatigue; or

• a rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Lexxel (enalapril and felodipine)?

Before taking enalapril and felodipine, tell your doctor if you are taking any of the following drugs:

• a potassium supplement such as K-Dur, Klor-Con, and others;

• salt substitutes that contain potassium;

• the diuretics (water pills) triamterene (Dyrenium, Maxzide, Dyazide), spironolactone (Aldactone), or amiloride (Midamor);

• any other diuretic (water pill) such as hydrochlorothiazide (HCTZ, Hydrodiuril, others), furosemide (Lasix), bumetanide (Bumex), indapamide (Lozol), and others;

• a potassium supplement (K-Dur, Klor-Con, others);

• digoxin (Lanoxin, Lanoxicaps);

• lithium (Lithobid, Eskalith, others);

• cyclosporine (Sandimmune, Neoral);

• cimetidine (Tagamet, Tagamet HB);

• carbamazepine (Tegretol);

• phenobarbital (Luminal, Solfoton); or

• phenytoin (Dilantin).

You may not be able to take enalapril and felodipine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with enalapril and felodipine or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has additional information about enalapril and felodipine written for health professionals that you may read.

What to the pills look like?

Enalapril and felodipine is available with a prescription under the brand name Lexxel. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Lexxel-white, round tablets containing 5 mg each of enalapril and felodipine

• Remember, keep this and all other medicines out of the reach of children. Never share your medicines with others and only use this medication for the condition prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.