-Pharmacotherapeutic group:
Korandil contains an active substance called enalapril maleate. This belongs to the group of
medicines called ACE inhibitors (angiotensin converting enzyme inhibitors).
Korandil is used:  to treat high blood pressure (hypertension

 to treat heart failure (weakening of heart function). It can lower the need to go to hospital
and can help some patients live longer.  to prevent the signs of heart failure. The signs include: shortness of breath, tiredness after light
physical activity such as walking, or swelling of the ankles and feet.
-Therapeutic indications:
This medicine works by widening your blood vessels. This lowers your blood pressure. The
medicine usually starts to work within an hour, and the effect lasts for at least 24 hours. Some
people will require several weeks of treatment until the best effect on your blood pressure is seen

a. Do not take Korandil  if you are allergic (hypersensitive) to enalapril maleate or any of the other ingredients of
Korandil.  if you have ever had an allergic reaction to a type of medicine similar to this medicine called
an ACE inhibitor.  if you have ever had swelling of your face, lips, mouth, tongue or throat which caused
difficulty in swallowing or breathing (angioedema) when the reason why was not known or it
was inherited.  if you have diabetes or impaired kidney function and you are treated with a blood pressure
lowering medicine containing aliskiren.  if you are more than 3 months pregnant (it is also better to avoid Korandil in early pregnancy
– see Pregnancy section).
Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor
or pharmacist before taking this medicine.

b. Take special care with Korandil
Talk to your doctor or pharmacist before taking Korandil  if you have a heart problem.  if you have a condition involving the blood vessels in the brain.  if you have a blood problem such as low or lack of white blood cells
(neutropenia/agranulocytosis), low blood platelet count (thrombocytopenia) or a decreased
number of red blood cells (anaemia).  if you have a liver problem.  if you have a kidney problem (including kidney transplantation). These may lead to higher
levels of potassium in your blood which can be serious. Your doctor may need to adjust your
dose of Korandil or monitor your blood level of potassium.  if you are having dialysis.  if you have been very sick (excessive vomiting) or had bad diarrhoea recently.  if you are on a salt-restricted diet, are taking potassium supplements, potassium-sparing
agents, or potassium-containing salt substitutes.  if you are over 70 years of age.  if you have diabetes. You should monitor your blood for low blood glucose levels, especially
during the first month of treatment. The level of potassium in your blood can also be higher

if you have ever had an allergic reaction with swelling of the face, lips, tongue or throat with
difficulty in swallowing or breathing. You should be aware that black patients are at increased
risk of these types of reactions to ACE inhibitors.  if you have low blood pressure (you may notice this as faintness or dizziness, especially when
standing).  if you have collagen vascular disease (e.g. lupus erythematosus, rheumatoid arthritis or
scleroderma), are on therapy that suppresses your immune system, are taking the drugs
allopurinol or procainamide, or any combinations of these.  if you are taking an mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus: medicines
used to treat certain types of cancer or to prevent the body’s immune system from rejecting a
transplanted organ). You may be at increased risk for an allergic reaction called angioedema.  if you are taking any of the following medicines used to treat high blood pressure:
- an angiotensin II receptor blocker (ARBs) (also known as sartans - for example valsartan,
telmisartan, irbesartan), in particular if you have diabetes-related kidney problems.
- aliskiren.
Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g.
potassium) in your blood at regular intervals.
See also information under the heading “Do not take Korandil’’.
You must tell your doctor if you think you are (or might become) pregnant. This medicine is not
recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant,
as it may cause serious harm to your baby if used at that stage (see Pregnancy section).
You should be aware that this medicine lowers the blood pressure in black patients less effectively
than in non-black patients.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking
Korandil.
If you are about to have a procedure
If you are about to have any of the following, tell your doctor that you are taking Korandil:  any surgery or receive anesthetics (even at the dentist).  a treatment to remove cholesterol from your blood called 'LDL aphaeresis’'.  a desensitization treatment, to lower the effect of an allergy to bee or wasp stings.
If any of the above applies to you, talk to your doctor or dentist before the procedure.
c. Taking other medicines, herbal or dietary supplements
Please tell your doctor, health care provider or pharmacist if you are taking or have recently taken
any other medicines, including medicines obtained without a prescription. This includes herbal
medicines. This is because Korandil can affect the way some medicines work. Also some other
medicines can affect the way Korandil works. Your doctor may need to change your dose and/or
to take other precautions.
In particular tell your doctor or pharmacist if you are taking any of the following medicines  an angiotensin II receptor blocker (ARB) or aliskiren.

other medicines to lower blood pressure, such as beta-blockers or water tablets (diuretics).  medicines containing potassium (including dietary salt substitutes).  medicines for diabetes (including oral antidiabetic medicines and insulin).  lithium (a medicine used to treat a certain kind of depression).  medicines for depression called tricyclic antidepressants.  medicines for mental problems called antipsychotics.  certain cough and cold medicines and weight reducing medicines which contain something
called a ‘sympathomimetic agent'.  certain pain or arthritis medicines including gold therapy.  an mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus; medicines used to treat certain
types of cancer or to prevent the body’s immune system from rejecting a transplanted organ).  non-steroidal anti-inflammatory drugs including COX-2-inhibitors (medicines that reduce
inflammation, and can be used to help relieve pain).  aspirin (acetyl salicylic acid).  medicines used to dissolve blood clots (thrombolytics).  alcohol.
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before
taking Korandil.
d. Taking Korandil with food and drink
Korandil can be taken with or without food. Most people take Korandil with a drink of water.
e. Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby,
ask your doctor for advice before taking this medicine.
Pregnancy
Your doctor will normally advise you to stop taking Korandil before you become pregnant or as
soon as you know you are pregnant and will advise you to take another medicine instead of
Korandil. Korandil is not recommended in early pregnancy, and must not be taken when more than
3 months pregnant, as it may cause serious harm to your baby if used after the third month of
pregnancy.
Breast-feeding
Tell your doctor if you are breast-feeding or about to start breast-feeding. Breast-feeding newborn
babies (first few weeks after birth), and especially premature babies, is not recommended whilst
taking Korandil. In case of an older baby your doctor should advice you on the benefits and risks
of taking Korandil whilst breast-feeding, compared with other treatments.
Ask your doctor or pharmacist for advice before taking any medicine.
f. Driving and using machines
You may feel dizzy or sleepy while taking this medicine. If this happens do not drive or use any
tools or machines.
g. Important information about some of the ingredients of Korandil

Korandil 20 mg tablets contain lactose.
If you have been told by your doctor that you have an intolerance to some sugars, contact your
doctor before taking this medicinal product.
Korandil 20 mg tablets contain Ponceau 4R E124, which may cause allergic reactions

Always take Korandil exactly as our doctor or health care provider has told you. You should check
with your doctor, health care provider or pharmacist if you are not sure.
 It is very important to continue taking this medicine for as long as your doctor prescribes it.
 Do not take more tablets than prescribed.
 The tablet can be divided into equal doses.
High blood pressure:  the usual starting dose ranges from 5 mg to 20 mg taken once a day.  some patients may need a lower starting dose.  the usual long term dose is 20 mg taken once a day.  the maximal long term dose is 40 mg taken once a day.
Heart failure:  the usual starting dose is 2.5 mg taken once a day.  your doctor will raise this amount step by step until the dose that is right for you has been
achieved.  the usual long term dose is 20 mg each day, taken in one or two doses.  the maximal long term dose is 40 mg each day, divided in two doses.
Patients with kidney problems:
Your dose of medicine will be changed depending on how well your kidneys are working:  moderate kidney problems - 5 mg to 10 mg each day.  severe kidney problems - 2.5 mg each day.  if you are having dialysis - 2.5 mg each day. On days you are not having dialysis your dose
may be changed depending on how low your blood pressure is.
Elderly patients:
Your dose will be decided by your doctor, and will be based on how well your kidneys are working.
Use in children:
Experience in the use of Korandil in children with high blood pressure is limited. If the child can
swallow tablets, the dose will be worked out using the child’s weight and blood pressure. The
usual starting doses are:  between 20 kg and 50 kg – 2.5 mg each day.  more than 50 kg – 5 mg each day.

The dose can be changed according to the needs of the child:  a maximum of 20 mg daily can be used in children who are between 20 kg and 50 kg.  a maximum of 40 mg daily can be used in children who are more than 50 kg.
This medicine is not recommended in newborn babies (first few weeks after birth) and in children
with kidney problems.
a. If you take more Korandil than you should
If you take more Korandil than you should, talk to your doctor or go to a hospital straight away.
Take the medicine pack with you. The following effects may happen: feeling of light-headed or
dizziness. This is due to a sudden or excessive drop in blood pressure.
b. If you forget to take Korandil  if you forget to take a tablet, skip the missed dose.  take the next dose as usual.  do not take a double dose to make up for a forgotten dose.
c. If you stop taking Korandil
Do not stop taking your medicine unless your doctor tells you to.
If you have any further questions on the use of this product, ask your doctor, health care provider
or pharmacist

Like all medicines, Korandil can cause side effects, although not everybody gets them. The
following side effects may happen with this medicine:
Other side effects include:
Very Common (affects more than 1 in 10 people)  feeling dizzy, weak or sick.  blurred vision.  cough.
Common (affects less than 1 in 10 people)  light-headedness due to low blood pressure, changes in heart rhythm, fast heartbeat, angina or
chest pain.  headache, depression, fainting (syncope), change in sense of taste.  shortness of breath.  diarrhea, abdominal pain.  tiredness (fatigue).  rash, allergic reactions with swelling of the face, lips, tongue or throat with difficulty in
swallowing or breathing.  high levels of potassium in the blood, increased levels of creatinine in your blood (both are
usually detected by a test).

Uncommon (affects less than 1 in 100 people)

 flushing.  sudden fall in blood pressure.  fast or uneven heart beats (palpitations.)  heart attack (possibly due to very low blood pressure in certain high-risk patients, including
those with blood flow problems of the heart or brain).  stroke (possibly due to very low blood pressure in high-risk patients).  anaemia (including aplastic and haemolytic).  confusion, sleeplessness or sleepiness, nervousness.  feeling your skin prickling or being numb.  vertigo (spinning sensation).  ringing in your ears (tinnitus).  runny nose, sore throat or hoarseness.  asthma - associated tightness in chest.  slow movement of food through your intestine (ileus), inflammation of your pancreas.  being sick (vomiting), indigestion, constipation, anorexia.  irritated stomach (gastric irritations), dry mouth, ulcer.  muscle cramps.  impaired kidney function, kidney failure.  increased sweating.  itching or nettle rash.  hair loss.  generally feeling unwell (malaise), high temperature (fever).  impotence.  high level of proteins in your urine (measured in a test).  low level of blood sugar or sodium, high level of blood urea (all measured in a blood test).
Rare (affects less than 1 in 1,000 people)  ‘Raynaud’s phenomenon’ where your hands and feet may become very cold and white due to
low blood flow.  changes in blood values such as a lower number of white and red blood cells, lower
hemoglobin, lower number of blood platelets.  bone marrow depression.  swollen glands in neck, armpit or groin.  autoimmune diseases.  strange dreams or sleep problems.  accumulation of fluid or other substances in the lungs (as seen on X-rays).  inflammation of your nose.  inflammation of the lungs causing difficulty breathing (pneumonia).  inflammation of the cheeks, gums, tongue, lips, throat.  reduced amount of urine.  rash that looks like targets (erythema multiforme).  ‘Stevens-Johnson syndrome’ and “toxic epidermal necrolysis” (serious skin condition where
you have reddening and scaling of your skin, blistering or raw sores), exfoliative

dermatitis/erythroderma (severe skin rash with flaking or peeling of the skin), pemphigus
(small fluid-filled bumps on the skin)  liver problems such as lower liver function, inflammation of your liver, jaundice (yellowing
of the skin or eyes), higher levels of liver enzymes or bilirubin (measured in a blood test).  enlargement of the breasts in males (gynaecomastia).
Very Rare (affects less than 1 in 10,000 people)  swelling in your intestine (intestinal angioedema).
Not known (frequency cannot be estimated from the available data)  overproduction of antidiuretic hormone, which causes fluid retention, resulting in weakness,
tiredness or confusion.  a symptom complex has been reported which may include some or all of the following:
fever, inflammation of the blood vessels (serositis/vasculitis), muscle pain
(myalgia/myositis), joint pain (arthralgia/arthritis). Rash, photosensitivity or other skin
manifestations may occur.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist

Keep out of the reach and sight of children.
Do not store above 30 oC. Protected from light and moisture. Store in the original carton.
Do not use Korandil after the expiry date which is stated on the carton after “EXP”. The expiry
date refers to the last day of the month.