Enalapril and Rheumatoid Arthritis Treatment

In 1985, the drug enalapril was approved by the Food and Drug Administration to treat high blood pressure and congestive heart failure. But enalapril may be contraindicated for those who also have connective-tissue disorders such as lupus, scleroderma, Marfan or Sjogren's Syndrome and rheumatoid arthritis, or RA, according to Drugs.com.

Enalapril

• Enalapril is marketed under the name Vasotec. It is also called an ACE inhibitor drug because it works to inhibit or stop the body's angiotensin converting enzymes, or ACE, according to an online Medicine Net entry on enalapril.

Medication Interractions

• If you have a connective-tissue disease such as rheumatoid arthritis, or RA, ACE inhibitor drugs such as enalapril can cause adverse reactions when combined with other drugs prescribed to treat RA, according to Drugs.com. One such drug whose use is contraindicated with ACE inhibitors, according to the FDA, is sodium aurothiomalate---a solution of injectable gold used to treat RA.

"Nitritoid Reaction"

• For patients with high blood pressure and/or heart disease, as well as rheumatoid arthritis, caution should be used in using enalapril, according to the FDA. Combining medications such as sodium aurothiomalate with enalapril can trigger what is known as a "nitritoid reaction," according to Medicine Net.

Symptoms

• Symptoms of a "nitritoid reaction" include overall redness or flushing of the face, nausea, vomiting and hypotension---also known as low blood pressure, according to Medicine Net. If you experience this type of reaction, you should see your doctor immediately.

FDA Labeling

• As of February 9, 1988, the FDA mandated the addition of a warning to Vasotec's label about the danger of a "nitritoid reaction" when combining sodium aurothiomalate with an ACE inhbitor. This warning was given in accord with section 505(o)(4) of the Federal Drug and Cosmetics Act, according to the online FDA drug-safety information on Vasotec.