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enalapril maleate (Epaned)

✓ Approved

Silvergate Pharmaceuticals, Inc. · ACE · Small Molecule

What is enalapril maleate?

enalapril maleate is a small molecule developed by Silvergate Pharmaceuticals, Inc.. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesEpaned
CompanySilvergate Pharmaceuticals, Inc.
Drug ClassSmall Molecule
Molecular TargetACE
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Silvergate Pharmaceuticals, Inc.

Mechanism of Action

Molecular Targets

enalapril maleate acts on 1 molecular target:

ACEangiotensin I converting enzyme (DCP1, ACE1)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

enalapril maleate is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Cardiac disordersCardiac failure✓ Approved
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedBrain injury2026-10-20

Intranasal administration of enalapril confers acute neuroprotection by mitigating mitochondrial dysfunction and apoptosis in a rat model of ischemic stroke.

Sadeghian Nooshin N, Salimpour Azar Saied S, Shadman Javad J, Abedi Ali A et al.

Stroke remains a leading cause of mortality and long-term disability worldwide, with effective treatments hindered by its complex pathophysiology. This study is the first to explore the neuroprotective potential of intranasal enalapril, in mitigating ischemic stroke outcomes through its influence on mitochondrial function. Male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO), followed by the intranasal administration of enalapril (0.03 mg/kg) post-ischemia. Neurological function was evaluated after 24 hours of reperfusion through the modified neurological severity score (mNSS), grip strength, and hot plate tests. Brain infarct volume was quantified via Triphenyltetrazolium chloride staining. Blood- brain barrier (BBB) integrity was evaluated via the Evans Blue extravasation assay. Additionally, we employed immunofluorescence techniques to assess apoptosis through TUNEL staining and evaluated mitochondrial function by examining mitochondrial swelling, succinate dehydrogenase activity, mitochondrial membrane potential and reactive oxygen species production. Intranasal administration of enalapril significantly reduced the infarct volume, preserved BBB integrity, and attenuated sensorimotor deficits in MCAO rats. These protective effects were closely associated with enhanced regional cerebral blood flow, a significant reduction in neuronal apoptosis, and improved mitochondrial function. Intranasal enalapril may provide a novel approach to neuroprotection in ischemic stroke, potentially through mechanisms that enhance mitochondrial function and reduce neuronal apoptosis.

PMID 42897973
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PubMedJournal of cardiology cases2026-10-17

Pediatric restrictive cardiomyopathy with rapid complete atrioventricular block progression.

Ukai Hiromu H, Suzuki Takanori T, Nomura Yoji Y, Yamada Yuya Y et al.

Restrictive cardiomyopathy (RCM) is a rare pediatric cardiomyopathy characterized by ventricular diastolic dysfunction, and poor prognosis that often requires heart transplantation. We report the case of a 7-year-old boy with RCM complicated by complete atrioventricular block (CAVB) in whom pathological examination of the explanted heart demonstrated extensive fibrosis involving the cardiac conduction system. At 1 year and 9 months of age, the patient presented with arrhythmia. Echocardiography revealed marked biatrial enlargement and small ventricles. Cardiac catheterization demonstrated elevated filling pressures confirming RCM. One month after diagnosis, the patient developed severe bradycardia and circulatory collapse, requiring extracorporeal membrane oxygenation. Electrocardiography revealed complete atrioventricular (AV) block, and a permanent pacemaker (PM) was implanted. Despite recurrent heart failure episodes, cardiac function was maintained with medical therapy, including carvedilol and enalapril, without mechanical circulatory support until heart transplantation at 5 years of age. Pathology of the explanted heart revealed extensive interstitial fibrosis involving the conduction system, suggesting that conduction tissue fibrosis caused the CAVB. These findings provide pathological insight into the mechanism of advanced atrioventricular block in pediatric RCM. This case demonstrates that RCM may progress from first-degree AV block to CAVB due to conduction fibrosis. Understanding the clinical and pathological progression of restrictive cardiomyopathy (RCM) complicated by complete atrioventricular block in children is important. This case illustrates that fibrosis of the conduction system can lead to severe bradycardia and circulatory collapse, highlighting the importance of the early detection of conduction abnormalities and timely pacemaker implantation. It has also been demonstrated that appropriate medical therapy combined with pacemaker management can effectively bridge pediatric patients with RCM to heart transplantation.

PMID 42889934
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PubMedAnais da Academia Brasileira de Ciencias2026-10-15

Exercise training and enalapril mitigate steatotic liver disease and islet disarrangement but diverge in inflammatory modulation in obese mice.

Sepulveda-Fragoso Vinícius V, Proença Ana Beatriz AB, Evangelista Jefferson F JF, Luca Beatriz G DE BG et al.

Metabolic-associated steatotic liver disease (MASLD) is increasingly prevalent worldwide. We previously demonstrated that enalapril and aerobic exercise training (AET) improve steatosis in an obesity model. Here, we investigated the effects of both interventions on pancreatic morphology, oxidative stress, and inflammatory cytokines in the steatotic liver. Male C57BL/6 mice were fed either a standard chow (SC) or a high-fat diet (HF) for 8 weeks. The HF group was divided into enalapril treatment (HF-E, 10 mg/kg/day), AET (HF-T, 300 min/week treadmill running), and both interventions (HF-ET) for 8 additional weeks alongside the HF diet. We measured body mass (BM) gain, plasma cytokines, and pancreatic islet structure. Liver mass, oxidative stress, renin-angiotensin system (RAS), and cytokines were also evaluated. The HF group showed greater BM gain, higher pro-inflammatory cytokines, and hypertrophied pancreatic islets than the SC group. All interventions reduced these parameters, though the HF-E group maintained an enlarged pancreatic islet. In the liver, all interventions improved oxidative stress and reduced RAS overactivation. However, enalapril-treated groups retained elevated IL-6, NFκB, TGF-β, and CD11c protein levels, whereas trained groups exhibited levels comparable to SC. In conclusion, both interventions improved islet structure, oxidative stress, and RAS overactivation, but enalapril failed to reverse the pro-inflammatory cytokine profile in obese mice.

PMID 42879604
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PubMedJournal of Korean medical science2026-10-13

Superior Efficacy of Besifovir in Reducing Hepatocellular Carcinoma Risk Compared to Tenofovir in Chronic Hepatitis B Patients: A Nationwide Cohort Study.

Shin Yoon E YE, Kim Jae Young JY, Kim Hyuk H, Yoo Jeong-Ju JJ et al.

Besifovir dipivoxil maleate (BSV) is a novel therapeutic option for the treatment of chronic hepatitis B (CHB). However, its long-term effectiveness in reducing the risk of hepatocellular carcinoma (HCC) remains unclear. We conducted a retrospective cohort study using the Korean Health Insurance Review and Assessment Service database from 2018 to 2022. A total of 32,383 patients with CHB were included (BSV, n = 2,358; tenofovir disoproxil fumarate [TDF], n = 30,025). Propensity score matching was conducted at a 1:3 ratio to minimize selection bias. The primary outcome was the incidence of HCC, with cirrhosis development as the secondary endpoint. In the overall population, 57 cases of HCC were reported in the BSV group (2,358 individuals, 5,918 person-years), while 1,268 cases of HCC were reported in the TDF group (30,025 individuals, 83,587 person-years). After propensity score matching, the incidence of HCC was significantly lower in the BSV group (9.63 per 1,000 person-years; 95% confidence interval [CI], 7.43-12.49) than in the TDF group (15.36 per 1,000 person-years; 95% CI, 13.72-17.18), with an incidence rate ratio of 1.59 (P = 0.001). This protective effect remained consistent in both cirrhotic (hazard ratio [HR], 1.609; P = 0.028) and non-cirrhotic subgroups (HR, 1.831; P = 0.002). BSV treatment demonstrated superior efficacy in reducing the risk of HCC compared to TDF, regardless of baseline cirrhosis status. These findings suggest that BSV may provide enhanced protection against HCC in patients with CHB.

PMID 42865284
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PubMedRevista peruana de medicina experimental y salud publica2026-10-13

Hampi Tariki Kit: thin-layer chromatography for semiquantitative screening of solid oral medicines in Peru.

Mónico-Rosales Gladys M GM, Mostacero-Rodríguez Fredy R FR, Quispe-Paitán B Rosa BR, Rodríguez-Calzado E Javier EJ et al.

To develop and validate rapid thin-layer chromatography (TLC) methods integrated into the Hampi Tariki kit for the semiquantitative screening of active pharmaceutical ingredients (APIs) in oral solid medications marketed in Peru. Eight TLC methods were developed and validated for tablets and capsules containing acyclovir, dicloxacillin, dimenhydrinate, ibuprofen, diclofenac sodium, paracetamol, norfloxacin, phenazopyridine hydrochloride, chlorphenamine maleate, and phenylephrine hydrochloride. Fifty-seven commercial samples available in the national market, from different manufacturing laboratories, including branded and generic products previously verified as compliant by official methods at the Centro Nacional de Control de Calidad (CNCC) of the Instituto Nacional de Salud (INS), were evaluated. Silica gel 60 F254 plates, reference standards, and analytical grade solvents were used. Validation was performed according to ICH Q2(R1) guideline, evaluating selectivity, linearity, precision, accuracy, visual detection limit, and robustness. The methods allowed for visual and densitometric differentiation of levels equivalent to 80%, 100%, and 120% of the declared content. Retention factor (Rf ) values were between 0.20 and 0.85, and multicomponent formulations presented chromatographic resolution ≥1.0. Correlation coefficients were greater than 0.99 for system and method linearity; repeatability showed coefficients of variation less than 3.0%, intermediate precision less than 5.0%, and bias against high-performance liquid chromatography (HPLC) remained within the ±3.00% range. Deliberate variations evaluated in robustness did not produce significant changes in Rf values. The developed methods demonstrated adequate analytical performance as rapid semiquantitative screening tests. Integrated into the Hampi Tariki kit, they constitute a proposal with potential to support the preliminary identification of suspicious samples and prioritize their confirmation by HPLC or other official methods.

PMID 42867952
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PubMedBulletin of environmental contamination and toxicology2026-10-12

Biochemical, Genotoxic and Somatic responses of Oreochromis Niloticus Exposed to Enalapril Maleate in Water.

da Silva Allana Kiara Peretti AKP, Colaço Otávio Augusto Wolff OAW, Mannes Yorrannys Y, Ramsdorf Wanessa Algarte WA

Pharmaceutical residues are increasingly detected in aquatic environments; however, information regarding the ecotoxicological effects of antihypertensive drugs such as enalapril maleate remains limited, particularly in fish. This study aimed to evaluate the effects of aqueous exposure to EM on somatic, biochemical, and genotoxic biomarkers in Oreochromis niloticus under controlled laboratory conditions. A 21-day subchronic bioassay was conducted using fish exposed to EM-contaminated water at nominal concentrations of 100, 500, 1000, and 2000 µg/L, alongside a control group. Genotoxic effects were evaluated using the comet assay and micronucleus test, while biochemical biomarkers - including acetylcholinesterase, catalase, glutathione S-transferase, and lipid peroxidation - were assessed to investigate oxidative stress and potential neurotoxicity. Somatic condition was also analyzed as an indicator of overall organism health. The results demonstrated genotoxic effects, evidenced by DNA damage. Biochemical analyses revealed alterations consistent with oxidative stress and potential neurotoxic responses, while somatic indices showed minor but detectable health changes. Although the observed damage levels were relatively low, these findings indicate that continuous exposure to EM and its byproducts can induce sublethal physiological disturbances with potential long-term consequences for aquatic organisms. Overall, this study highlights the relevance of ecotoxicological monitoring of EM in aquatic systems. The observed biological responses underscore its potential ecological risk, and future studies should incorporate preliminary stability assessments and evaluate long-term effects and degradation products to better understand the environmental impact of this antihypertensive drug.

PMID 42862340
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