1. Enalapril oral tablet is available as both a generic and brand-name drug. Brand name: Vasotec.
  2. Enalapril comes as an oral tablet and an oral solution.
  3. Enalapril oral tablet is used to treat high blood pressure, heart failure, and asymptomatic left ventricular dysfunction.

Enalapril oral tablet is a prescription drug that’s available as the brand-name drug Vasotec. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Enalapril also comes as a prescription oral solution.

Why it’s used

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

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

How it works

Enalapril belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

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

Enalapril can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Enalapril. This list does not include all possible side effects.

For more information on the possible side effects of Enalapril, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects that can 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

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Breathing problems. Symptoms include:
    • trouble breathing or swallowing
    • hoarseness
    • tightness in your chest
  • Liver problems. Symptoms include:
    • yellowing of your skin or the whites of your eyes
  • Central nervous system problems, such as:
    • lightheadedness
    • fainting
  • Kidney problems. Symptoms include:
    • inability to pass urine
    • change in the amount of urine you pass
    • blood in your urine
    • weight gain
  • High potassium levels. Symptoms include:
    • weakness
    • lightheadedness or dizziness
    • numbness or tingling
    • shortness of breath
    • irregular heartbeat
  • Swelling (angioedema) of your face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Infection. Symptoms include:
    • fever
    • sore throat
    • chills

The enalapril dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using enalapril to treat
  • your age
  • the form of enalapril you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

This dosage information is for enalapril oral tablet. All possible dosages and forms may not be included here.

Forms and strengths

Brand: Vasotec

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

Generic: enalapril

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

Dosage for high blood pressure

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. The usual dosage range is 10 to 40 mg per day. Your doctor will 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 dosage considerations

For people with kidney problems:

  • Normal or mild kidney problems: 5 mg taken once per day
  • Moderate to severe kidney problems: 2.5 mg taken once per day. Children with moderate to severe kidney problems should not take enalapril.
  • 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.

Dosage for heart failure

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 medication hasn’t been studied in children with heart failure. It shouldn’t be used to treat this condition 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: If your blood serum creatinine level is greater than 1.6 mg/dL, the starting dose is 2.5 mg, taken once per day. Your doctor may increase your dose to 2.5 mg twice daily, and then to 5 mg twice daily and higher as needed. The changes will likely be made at intervals of 4 days or more. The maximum dose is 40 mg per day.

Low sodium: If your blood serum sodium level is less than 130 mEq/L, the starting dose is 2.5 mg, taken once per day. Your doctor may increase your dose to 2.5 mg twice daily, and then to 5 mg twice daily and higher as needed. The changes will likely be made at intervals of 4 days or more. The maximum dose is 40 mg per day.

Dosage for asymptomatic left ventricular dysfunction

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 medication hasn’t been studied in children for asymptomatic left ventricular dysfunction. It shouldn’t be used to treat this condition 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.

Enalapril oral tablet is used for long-term treatment. It 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 dangerous 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: Your blood pressure should go down.
  • For heart failure: Your symptoms of heart failure, such as shortness of breath, should get better.
  • For asymptomatic left ventricular dysfunction: You should have fewer episodes of chest pain.

Enalapril oral tablet comes with several warnings.

Swelling warning

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

Low blood pressure warning

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

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

Allergy warning

Enalapril can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • wheezing
  • swelling of your face, lips, tongue, or throat
  • hives

Call 911 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).

Food interactions

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

Warnings for people with certain health conditions

For 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.

For 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.

For people with heart problems: Use this drug with caution if you have ischemic heart disease. Enalapril may increase your risk for low blood pressure.

For people with moderate to severe kidney damage: Your doctor may lower your dosage of enalapril.

For people who plan to have surgery or an anesthetic: You may experience low blood pressure while having major surgery or during anesthesia.

Warnings for other groups

For pregnant women: This drug can have a negative effect on the development of a fetus. Enalapril 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.

For women who are breastfeeding: Enalapril may pass into breast milk and may cause side effects in a child who’s breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

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: Enalapril shouldn’t be used to treat high blood pressure in infants and children with severe kidney disease. The use of this medication to treat heart failure or asymptomatic left ventricular dysfunction hasn’t been studied in children. This drug shouldn’t be used to treat these conditions in people younger than 18 years.

Enalapril can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with enalapril. This list does not contain all drugs that may interact with enalapril.

Before taking enalapril, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Examples of drugs that can cause interactions with enalapril are listed below.

Pain drugs

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

Examples of these drugs include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • aspirin
    • diclofenac
    • etodolac
    • ibuprofen
    • indomethacin
    • ketoprofen
    • ketorolac
    • meloxicam
    • nabumetone
    • naproxen
    • piroxicam
    • sulindac
  • COX-2 inhibitors, such as:
    • celecoxib

Heart and blood pressure drugs

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

Examples of these drugs include:

  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril
    • captopril
    • enalapril
    • fosinopril
    • moexipril
    • perindopril
    • quinapril
    • ramipril
    • trandolapril
  • angiotensin receptor blockers (ARBs), such as:
    • azilsartan
    • candesartan
    • irbesartan
    • losartan
    • olmesartan
    • telmisartan
    • valsartan
  • renin inhibitor:
    • aliskiren
  • beta blockers, such as:
    • acebutolol
    • 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:
    • chlorothiazide
    • chlorthalidone
    • hydrochlorothiazide
    • metolazone

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

These medications increase your risk for high potassium levels in your blood when taken with enalapril. Examples of these drugs include:

  • spironolactone
  • triamterene
  • amiloride
  • eplerenone

Lithium

Taking lithium with 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 for 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 for angioedema (sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines) when taken with enalapril.

Examples of these drugs include:

  • temsirolimus
  • sirolimus
  • everolimus

Drugs called neprilysin inhibitors

These drugs are used to treat heart failure. They should not be used with enalapril. Do not use enalapril within 36 hours of switching to or from a neprilysin inhibitor.

Using these drugs together raises your risk for angioedema (sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines).

An example of this drug class includes:

  • sacubitril/ valsartan

Keep these considerations in mind if your doctor prescribes enalapril oral tablet for you.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You may need to check your blood pressure and heart rate at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

Clinical monitoring

Before starting and during your treatment with this drug, your doctor will check your:

  • kidney function
  • electrolyte levels
  • blood pressure

Sun sensitivity

This drug may make your skin more sensitive to sunlight. You may get severe sunburn even if you’re in the sun for a short period of time. You should:

  • Wear sunscreen and protective clothing when you’re out in the sun.
  • Avoid tanning booths.
  • Avoid being in the sun for long periods of time.

Hidden costs

You may need to purchase a blood pressure monitor to check your blood pressure at home.

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about other drug options that may work for you.

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.