enalapril + isradipine + propranolol

This is a combination of three antihypertensive agents: - **Enalapril** is an angiotensin-converting enzyme (ACE) inhibitor prodrug that, once converted to its active form enalaprilat, inhibits ACE and reduces the production of angiotensin II. This leads to vasodilation and decreased blood pressure[2][4]. - **Isradipine** is a dihydropyridine calcium channel blocker that inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle, resulting in vasodilation and reduced blood pressure[4]. - **Propranolol** is a non-selective beta-adrenergic receptor antagonist (beta blocker) that decreases heart rate, myocardial contractility, and renin release from the kidneys. This results in lower cardiac output and reduced blood pressure[1][5][6]. The combination targets multiple mechanisms involved in hypertension management—renin-angiotensin system inhibition (enalapril), peripheral vasodilation via calcium channel blockade (isradipine), and sympathetic nervous system inhibition (propranolol). Such combinations may be used for patients with difficult-to-control hypertension or specific cardiovascular comorbidities.