Enalapril is an angiotensin converting enzyme inhibitor (or ACE inhibitor). What this means is that enalapril stops the angiotensin converting enzyme from producing a compound called angiotensin-ll, which is a potent vasoconstrictor.
An anticoagulation effect generally occurs within 24 hours after warfarin administration. However, peak anticoagulant effect may be delayed 72 to 96 hours. The duration of action of a single dose of racemic warfarin is 2 to 5 days. The effects of COUMADIN may become more pronounced as effects of daily maintenance doses overlap.
Reversal of Coumadin anticoagulation may be obtained by discontinuing Coumadin therapy and, if necessary, by administration of oral or parenteral vitamin K 1. The use of vitamin K 1 reduces response to subsequent Coumadin therapy and patients may return to a pretreatment thrombotic status following the rapid reversal of a prolonged INR.