Enalapril | Side Effects, Dosage, Uses & More
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Generic Name:

enalapril, Oral tablet

All Brands

  • Vasotec
SECTION 1 of 5

Highlights for enalapril

Oral tablet
1

Enalapril is an oral drug that’s used to treat high blood pressure, heart failure, and asymptomatic left ventricular dysfunction.

2

The dosage for adults with high blood pressure is 5 mg taken by mouth once per day. The dosage for adults with heart failure or left ventricular dysfunction starts at 2.5 mg taken by mouth two times per day.

3

Common side effects include dizziness, weakness, skin rash, and cough.

4

This drug may cause low blood pressure. Tell your doctor if you feel lightheaded or faint.
You shouldn’t take this drug if you’re pregnant or plan to become pregnant. Enalapril can harm or be fatal to your unborn child.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to effects that may be dangerous.

Use during pregnancy warning. You shouldn’t take this drug if you’re pregnant or plan to become pregnant. Enalapril can harm or be fatal to your unborn child. You should stop taking this drug right away if you get pregnant.

Swelling

Enalapril can cause sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines (angioedema). This is serious and can sometimes be fatal. Tell your doctor right away if you have swelling or stomach pain. Your doctor will have you stop taking this drug, and you may be given medication to reduce the swelling. Your risk of swelling may be higher if you’ve had this problem before while taking a drug similar to enalapril (angiotensin-converting enzyme or ACE inhibitor).

Low blood pressure

Enalapril can cause low blood pressure. Tell your doctor if you feel lightheaded or have any fainting spells. You may have a higher risk of low blood pressure if you:

  • aren’t drinking enough fluids
  • sweat heavily
  • have diarrhea or are vomiting
  • have heart failure
  • are on dialysis
  • take diuretics

Dry cough

Enalapril may cause a dry cough. This will go away once you stop taking the medication.

What is enalapril?

Enalapril is a prescription drug. It’s available as an oral tablet and oral solution.

Enalapril is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

Enalapril may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

Enalapril is used to treat high blood pressure, heart failure, and asymptomatic left ventricular dysfunction.

How it works

Enalapril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors.

More Details

How it works

Enalapril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Enalapril helps your blood vessels relax and widen. This lowers your blood pressure.

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SECTION 2 of 5

enalapril Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with enalapril include:

  • dizziness

  • weakness

  • skin rash

  • cough

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • breathing problems. Symptoms include:

    • trouble breathing or swallowing
    • hoarseness
  • liver problems. Symptoms include:

    • yellowing of your skin or the whites of your eyes
  • central nervous system problems, such as:

    • lightheadedness
    • fainting
  • swelling (angioedema) of your face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

  • infection. Symptoms include:

    • fever
    • sore throat
    • chills
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Enalapril does not cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

enalapril May Interact with Other Medications

Oral tablet

Enalapril can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food interactions

You shouldn’t use salt substitutes containing potassium. This can increase your risk of high potassium levels in your body.

Medications that might interact with this drug

Pain drugs

These drugs can increase your risk of kidney problems when taken with enalapril.

These drugs include:

  • non-steroidal anti-inflammatory drugs (NSAIDs), such as:
    • diclofenac
    • ibuprofen
    • indomethacin
    • keoprofen
    • ketorolac
    • meloxicam
    • nabumetone
    • naproxen
    • piroxicam
  • COX-2 inhibitors, such as:
    • celecoxib

Heart and blood pressure drugs

Taking these medications with enalapril can increase your risk of kidney problems, low blood pressure, and/or high blood potassium.

These drugs include:

  • angiotensin-converting enzyme (ACE) inhibitors, such as:  
    • benazepril
    • captopril
    • clizapril
    • enalapril
    • enalaprilat
    • fosniopril
    • imidapril
    • moexipril
    • perindopril
    • qunapril
    • ramipril
    • trandolapril
  • angiotensin receptor blockers (ARBs), such as:
    • irbesartan
    • losartan
    • olmesartan
    • telmisatan
    • valsartan
  • beta blockers, such as:
    • acebutolol
    • arotinolol
    • atenolol
    • betaxolol
    • bisoprolol
    • esmolol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • timolol (systemic)
  • calcium channel blockers, such as:
    • amlodipine
    • felodipine
    • nicardipine
    • nifedipine
  • loop diuretics, such as:
    • bumetanide
    • furosemide
    • indapamide
    • torsemide
  • potassium-sparing diuretics, such as:
    • eplerenone
    • spironolactone
    • triamterene
    • amiloride
  • thiazide diuretics, such as:
    • chlorthiazide
    • chlorthalidone
    • hydrochlorothiazide
    • methylclothiazide
    • metolazone

Potassium-sparing diuretics, potassium supplements, and potassium-containing salt substitutes

These medications increase your risk of high potassium levels in your blood when taken with enalapril.

These drugs include:

  • spironolactone
  • triamterene
  • amiloride

Lithium

Enalapril may increase the lithium levels in your body. This may make you have more side effects.

Gold

Using injectable gold with enalapril may increase your risk of a nitritoid reaction. Nitritoid reactions affect the constriction or dilation of your blood vessels. Symptoms include:

  • warmth and reddening of your face and cheeks (flushing)
  • nausea
  • vomiting
  • low blood pressure

Drugs used to prevent rejection of an organ transplant

These medications increase your risk of sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines (angioedema) when taken with enalapril.

These drugs include:

  • temsirolimus
  • sirolimus
  • everolimus

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Enalapril warnings
swelling (angioedema)
People with swelling (angioedema)

If you have swelling throughout your body, this drug can make it worse. If you have a history of swelling throughout your body, you shouldn’t take enalapril.

low blood pressure
People with low blood pressure

Enalapril can make your blood pressure lower. Tell your doctor if you already have low blood pressure. They may change your dose, especially if you have heart or kidney problems, or diabetes.

heart problems
People with heart problems

Use this drug with caution if you have ischemic heart disease. Enalapril may increase your risk of low blood pressure.

surgery
People who plan to have surgery/anesthesia

You may experience low blood pressure while having major surgery or during anesthesia.

pregnant women
Pregnant women

Enalapril is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should only be used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breastfeeding
Women who are breast-feeding

Enalapril may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

for children
For children

For high blood pressure: Enalapril shouldn’t be used in infants and children with severe kidney disease.

For heart failure: The use of this medicine to treat heart failure hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

For asymptomatic left ventricular dysfunction: The use of this medicine to treat asymptomatic left ventricular dysfunction hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

allergies
Allergies

Enalapril can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take enalapril (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

High blood pressure

Brand: Vasotec

Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg

Brand: Epaned

Form: Oral solution
Strengths: 1 mg/mL

Generic: enalapril

Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg
Adult dosage (ages 18 years and older)

The starting dose is 5 mg taken by mouth once per day. Your doctor may increase your dose depending on your blood pressure goals. They’ll decide if you take the drug once or twice per day. The maximum dose is 40 mg per day. If you’re using enalapril with a diuretic, your starting dose should be 2.5 mg taken by mouth once per day.

Child dosage (ages 1 month–17 years)

The starting dose is 0.08 mg/kg of body weight taken by mouth once per day (up to 5 mg once per day). Your doctor may increase your dose depending on your blood pressure goals. The maximum dose is 0.58 mg/kg taken by mouth once per day (40 mg once per day).

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Special considerations

Kidney problems:

  • Normal or mild kidney problems: (>30 mL/min): 5 mg taken once per day
  • Moderate to severe kidney problems (≤30 mL/min): 2.5 mg taken once per day
  • People on dialysis: 2.5 mg taken once per day on dialysis days. On the days that you don’t have dialysis, your doctor will change your dose based on your blood pressure.

Heart failure

Brand: Vasotec

Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg

Brand: Epaned

Form: Oral solution
Strengths: 1 mg/mL

Generic: enalapril

Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg
Adult dosage (ages 18 years and older)

The starting dose is 2.5 mg taken by mouth twice per day. The usual dose is 2.5–20 mg taken twice per day. Your doctor may increase your dose over a period of a few days or weeks. The maximum dose is 40 mg per day taken in divided doses.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children for heart failure and shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Special considerations

Kidney problems:

Serum creatinine >1.6 mg/dL: The starting dose: 2.5 mg taken once per day. Your doctor may increase your dose every 4 days to 2.5 mg taken twice per day. They may increase it again to 5 mg taken twice per day. The maximum dose is 40 mg per day.

Low sodium:

Serum sodium <130 mEq/L: The starting dose: 2.5 mg taken once per day. Your doctor may increase your dose every 4 days to 2.5 mg taken twice per day. They may increase it again to 5 mg taken twice per day. The maximum dose is 40 mg per day.

Asymptomatic left ventricular dysfunction

Brand: Vasotec

Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg

Brand: Epaned

Form: Oral solution
Strengths: 1 mg/mL

Generic: enalapril

Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg
Adult dosage (ages 18 years and older)

The starting dose is 2.5 mg taken by mouth twice per day. Your doctor may increase your dose up to a maximum of 10 mg taken twice per day.

Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children for asymptomatic left ventricular dysfunction and shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Enalapril comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all

  • For high blood pressure: Your blood pressure may get worse. This increases your risk for heart attack and stroke. 
  • For heart failure: Your heart failure may get worse. This condition can be fatal.
  • For asymptomatic left ventricular dysfunction: Your condition can worsen and progress to heart failure.

If you stop taking it suddenly

Don’t stop taking this drug without talking to your doctor first.

  • For high blood pressure: Your blood pressure may suddenly increase. This can cause anxiety, sweating, and a fast heart rate.
  • For heart failure: You may have chest pain, shortness of breath, and swelling of your limbs.
  • For asymptomatic left ventricular dysfunction: You may not feel any different, but your condition may get worse and can lead to heart failure.

If you don’t take it on schedule

  • For high blood pressure: Your blood pressure may get worse. This increases your risk for heart attack and stroke.
  • For heart failure: Your heart failure may get worse. This condition can be fatal.
  • For asymptomatic left ventricular dysfunction: Your condition can worsen and progress to heart failure.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

If you take too much

You may have more side effects caused by this medication. You may have the following symptoms:

  • low blood pressure
  • loss of consciousness
  • kidney failure

If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room.

How to tell this drug is working

  • For high blood pressure: You may be able to tell if this drug is working if your blood pressure goes down.
  • For heart failure: You may be able to tell if this drug is working if your symptoms of heart failure, such as shortness of breath, get better.
  • For asymptomatic left ventricular dysfunction: If this drug is working, you should have fewer episodes of chest pain.

Enalapril is used for long-term treatment.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

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How Much Does enalapril Cost?

Oral tablet

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Lowest price for enalapril

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These prices represent the lowest priced national pharmacies for enalapril on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on February 17, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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