Uses

What is enalapril used for?

Enalapril is commonly used for the following conditions. 

  • To lower high blood pressure (hypertension)
  • To lower the risk of hospitalization and death due to heart failure in people with heart failure
  • To lower the risk of developing heart failure and being hospitalized for heart failure in people whose heart is not pumping blood as well as it should

Enalapril may also be used for other conditions as determined by your healthcare provider.

How does enalapril work (mechanism of action)?

Enalapril blocks the angiotensin-converting enzyme (ACE) from forming a hormone called angiotensin II. When angiotensin II binds to receptors, it causes your blood vessls to constrict. Blocking the formation of angiotensin II helps your blood vessels relax so that blood can move through them more easily. These effects can help your heart work better, lower blood pressure, and may reduce your risk for heart attack and stroke. 

How is enalapril supplied (dosage forms)?

Enalapril is available as Epaned, Vasotec, and generic enalapril in the following dosage forms that are taken by mouth.

  • 1 mg/mL oral solution
  • 2.5 mg oral tablets
  • 5 mg oral tablets
  • 10 mg oral tablets
  • 20 mg oral tablets

How should I store enalapril?

Oral Tablets. Enalapril tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container. Protect from moisture.

Oral Liquid. Epaned (enalapril solution) can either be stored in a refrigerator, between 36 F to 46 F (2 C to 8 C) until the expiration date on the label, or at room temperature, between 68 F to 77 F (20 C to 25 C) for up to 60 days. Do not freeze or expose to excessive heat. Throw away the medicine if it is left out of the refrigerator for more than 60 days. Keep the container tightly closed.

Side Effects

What are the most common side effects of enalapril?

The most common side effects of enalapril are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Tiredness
  • Low blood pressure (see below)
  • Dizziness
  • Cough

There may be other side effects of enalapril that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of enalapril?

While less common, the most serious side effects of enalapril are described below, along with what to do if they happen.

Angioedema. Enalapril may cause a rare reaction called angioedema. The usual symptoms of this reaction include swelling of the lips, face, tongue, or throat. Stop using the medicine and contact your healthcare provider if you have this type of swelling. If you are having trouble breathing, get medical attention right away.

Low Blood Pressure (Hypotension). Enalapril may cause low blood pressure. Low blood pressure is more likely to occur if you have excessive sweating or persistent or severe vomiting or diarrhea. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking enalapril. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Kidney Damage. Kidney damage can happen when taking enalapril. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

High Potassium Level (Hyperkalemia). Enalapril can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your healthcare provider will check your potassium levels, especially if you take certain other medicines. Call your healthcare provider if you have any of the following symptoms of a high potassium level. 

  • Muscle weakness or unusual tiredness
  • Slow heartbeat or feeling of skipped heartbeats
  • Nausea or vomiting
  • Trouble breathing
  • Abnormal heart rhythm

Low Neutrophil Levels (Neutropenia). Enalapril may cause low levels of a type of white blood cell (called neutrophils), which is known as neutropenia. Neutrophils help prevent infection. Having a low level of neutrophils may increase your risk of infection. Tell your healthcare provider if you have any of the following symptoms of low neutrophil levels.

  • Fever, chills, or sweats
  • Tiredness
  • Sore throat, cough, or shortness of breath
  • Mouth or throat sores

Severe Allergic Reactions. Enalapril may cause allergic reactions, which can be serious. Stop using enalapril and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use enalapril?

Allergies to Ingredients. People who are allergic to any of the following should not take enalapril.

  • Vasotec
  • Epaned
  • Enalapril
  • Any other medicine known as an ACE inhibitor
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific enalapril products they stock.

History of Angioedema. Enalapril may cause a rare reaction called angioedema, where there is swelling under the skin. This medicine should not be used if you have had angioedema. 

Drug Interactions. Enalapril should not be taken while you are using certain other medicines. Before taking enalapril, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.  See the Interactions section for more details.

What should I know about enalapril before using it?

Do not take enalapril unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share enalapril with other people, even if they have the same condition as you. It may harm them.

Keep enalapril out of the reach of children. If you keep enalapril oral liquid in the refrigerator, take special precautions to keep it away from children who also use the refrigerator.

Enalapril can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how enalapril affects you.

If you are taking enalapril oral liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

What should I tell my healthcare provider before using enalapril?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if enalapril is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart problems
  • Kidney problems
  • Liver problems
  • Electrolyte imbalance, such as high or low levels of sodium or potassium
  • Persistent or severe vomiting or diarrhea

Pregnancy. Enalapril can cause death or serious harm to an unborn baby if taken during pregnancy. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, stop taking enalapril right away and contact your healthcare provider.

Breastfeeding. Enalapril passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop enalapril.

Interactions

Does enalapril interact with foods or drinks?

There are no known interactions between enalapril and foods or drinks.

It is unknown if drinking alcohol will affect enalapril. The risk of dizziness may be increased if you drink alcohol while taking enalapril.

Does enalapril interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking enalapril.

  • Aliskiren (Tekturna), which is a medicine for high blood pressure
  • Entresto (sacubitril/valsartan), which is a medicine for heart failure 
  • A supplement or salt-substitute containing potassium
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
  • Lithium, which is a medicine for certain mental health conditions
  • An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
  • A medicine such as everolimus (Afinitor, Zortress), sirolimus (Rapamune and others), or temsirolimus (Torisel), which is commonly used to treat cancer or after an organ transplant
  • Any medicine for high blood pressure

This may not be a complete list of medicines that can interact with enalapril. Always check with your healthcare provider.

Does Enalapril interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much enalapril?

If you or someone else has used too much enalapril, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of enalapril?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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