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What is enalapril?
Enalapril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Enalapril is used to treat high blood pressure (hypertension), congestive heart failure, kidney problems caused by diabetes, and to improve survival after a heart attack. Enalapril may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of enalapril?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• feeling light-headed, fainting;

• urinating more or less than usual, or not at all;

• fever, chills, body aches, flu symptoms;

• pale skin, easy bruising or bleeding;

• fast, pounding, or uneven heartbeats;

• chest pain; or

• swelling, rapid weight gain.

Less serious side effects may be more likely to occur, such as:

• cough;

• loss of taste sensation, loss of appetite;

• dizziness, drowsiness, headache;

• sleep problems (insomnia);

• dry mouth;

• nausea, vomiting, diarrhea; or

• mild skin itching or rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take enalapril?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Take each dose with a full glass of water. Enalapril can be taken with or without food. Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking enalapril. Drink plenty of water each while you are taking this medication.

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What is the most important information I should know about enalapril?
Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Enalapril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking enalapril. Drink plenty of water each day while you are taking this medication.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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What other drugs will affect enalapril?
Before taking enalapril, tell your doctor if you are taking any of the following drugs: lithium (Lithobid, Eskalith); a potassium supplement such as K-Dur, Klor-Con; salt substitutes that contain potassium; aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or a diuretic (water pill). If you are using any of these drugs, you may not be able to use enalapril or you may need dosage adjustments or special tests during treatment.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Enalapril has been assigned to pregnancy category D by the FDA for use during the second and third trimesters and to category C during the first trimester. Animal and human data have revealed evidence of embryolethality and teratogenicity associated with ACE inhibitors. There are no controlled data in human pregnancy. Congenital malformations have been reported with the use of ACE inhibitors during the first trimester of pregnancy, while fetal and neonatal toxicity, death, and congenital anomalies have been reported with the use of ACE inhibitors during the second and third trimesters of pregnancy. If the patient becomes pregnant, enalapril should be discontinued as soon as possible. Enalapril is considered contraindicated during pregnancy.

Drugs that act directly on the renin-angiotensin system can cause fetal and neonatal morbidity and death when administered during pregnancy. A committee of the National Institutes of Health has recommended that these drugs be avoided during pregnancy. Limited data have shown an association between major congenital malformations and the use of ACE inhibitors during the first trimester. In addition, the use of drugs that act directly on the renin-angiotensin system during the second and third trimesters of pregnancy has been associated with fetal and neonatal injury, including hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death. Oligohydramnios has also been reported, presumably resulting from decreased fetal limb contractures, craniofacial deformation, and hypoplastic lung development. Prematurity, intrauterine growth retardation, and patent ductus arteriosus have also been reported, although it is not clear whether these occurrences were due to exposure to the drug. Mothers whose embryos and fetuses are exposed to an ACE inhibitor during the first trimester should be informed of the risks. When pregnancy is detected or expected, enalapril should be discontinued as soon as possible. A 30-year-old woman G3P2 with hypertension received enalapril and furosemide throughout gestation. At 20 weeks' gestation, oligohydramnios, multicystic fetal kidneys, and a small fetal thorax were detected. At 37 weeks' gestation, when the mother developed proteinuria and dyspnea at rest, uncomplicated labor was induced with prostaglandins. She delivered a live 2.8 kg male who died at 10 minutes of life due to respiratory failure. A limited autopsy revealed low set ears, small epicanthic folds, bilateral talipes, a markedly bell-shaped thorax, severe renal cystic dysplasia, and a normal karyotype.

Enalapril and enalaprilat, the active metabolite, are excreted into human milk in small amounts. Data regarding the effects of this drug on the nursing infant are unavailable, but, based on milk enalapril and enalaprilat concentrations, adverse effects in the nursing infant are unlikely. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

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Who should NOT use this medication?

• Known hypersensitivity (e.g. history of angioedema) to enalapril, enalaprilat, or another ACE inhibitor of any ingredient in the formulation. History of hereditary or idiopathic angioedema.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an enalapril overdose may include feeling extremely dizzy or light-headed, or fainting.

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What should I discuss with my healthcare provider before taking enalapril?
Do not use this medication if you are allergic to enalapril or to any other ACE inhibitor, such as benazopril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik). Before using enalapril, tell your doctor if you are allergic to any drugs, or if you have: kidney disease (or if you are on dialysis); liver disease; heart disease or congestive heart failure;

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Can I stop taking the medication if I feel better?
Even though you may feel better you should not stop taking your high blood pressure medication without first checking with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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