Enalapril

Enalapril (e NAL a pril) is prescribed for high blood pressure and heart failure. Enalapril belongs to a group of drugs called angiotensin converting enzyme inhibitors.

Medically reviewed by Victor Nguyen, PharmD, MBA on May 14, 2023
Written by Helen Marshall, BPharm, MRPharmS

Introduction

This article describes enalapril’s uses, side effects, and more. Below you’ll find some coupon options to help save on the cost of enalapril.

Boxed warning: Risk of fetal harm

Enalapril has a boxed warning about the risk of fetal harm. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for enalapril” section below.

Side effects of enalapril

Enalapril may cause mild or serious side effects (also known as adverse effects). More common mild side effects of enalapril and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about enalapril’s side effects, ask your doctor or pharmacist. You can also read the prescribing information* for enalapril.

* To view enalapril’s prescribing information, see the “Article resources” section below.

Mild side effects

More common mild side effects reported with enalapril are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about enalapril’s side effects based on the form, see the prescribing information* for enalapril.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Enalapril’s mild side effects include:

• low energy or weakness
• dizziness, especially when getting up
• ongoing dry cough
• rash
• mild allergic reaction†

* To view enalapril’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for enalapril” section below.

Serious side effects

Serious side effects of enalapril are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about enalapril’s side effects based on the form, see the prescribing information* for enalapril.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, enalapril’s serious side effects include:

• low blood pressure
• high level of potassium in the blood
• kidney problems, such as acute (sudden) kidney failure
• liver problems, such as liver failure
• boxed warning: risk of fetal harm†
• severe allergic reaction†

* To view enalapril’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for enalapril” section below.

Common questions about enalapril

Below you’ll find answers to a few commonly asked questions about enalapril.

Can enalapril be used in dogs?

Yes, veterinarians may sometimes prescribe enalapril for use in dogs. Note that drugs for animal use are approved by the Center for Veterinary Medicine. This is completely separate from the approval process of drugs for human use, which is done by the Food and Drug Administration (FDA).

To be safe, do not give medications to a pet without first talking with a veterinarian. Some medications could be dangerous or cause harm to pets.

To learn more about enalapril’s use in dogs, talk with your pet’s veterinarian.

How does enalapril compare with other similar drugs, such as losartan, captopril, and ramipril?

Enalapril is a type of drug called an angiotensin converting enzyme (ACE) inhibitor. Other ACE inhibitors include captopril and ramipril (Altace). Losartan (Cozaar) belongs to a similar group of drugs called angiotensin II receptor blockers (ARBs).

These drugs have similar uses. They’re all prescribed for hypertension (high blood pressure) and heart failure, although heart failure is an off-label use for losartan. (Off-label use is when a drug is prescribed for a condition it has not been approved to treat.) They’re also used for kidney disease in people with diabetes, but this is an off-label use for enalapril and ramipril.

These drugs can cause similar side effects. However, ARBs such as losartan are less likely to cause a cough, which is a common side effect of ACE inhibitors. They’re also less likely than ACE inhibitors to cause angioedema (an allergic reaction that causes swelling).

To learn more about how enalapril compares with other similar drugs, talk with your doctor. They can recommend the best choice of medication for you.

Is enalapril a beta-blocker?

No, enalapril is not a beta-blocker. It belongs to a group of drugs called angiotensin converting enzyme (ACE) inhibitors. Both beta-blockers and ACE inhibitors are used to treat high blood pressure and heart failure. But they work in different ways and can cause different side effects.

If you’re wondering whether a beta-blocker might be a good treatment option for your condition, talk with your doctor or pharmacist.

How does enalapril work? And how long does it take to start working?

Enalapril works by stopping your body from making a hormone called angiotensin II. This hormone usually tightens and narrows your blood vessels. With less of this hormone in your body, your blood vessels relax and widen. This lowers your blood pressure and makes it easier for your heart to pump blood around your body.

Enalapril starts working to lower your blood pressure within a few hours. If you take it for high blood pressure or left ventricular dysfunction,* you’re unlikely to notice it working. That’s because these conditions don’t usually cause symptoms. If you take it for heart failure, it may take a few weeks for your symptoms to ease.

Enalapril has a half-life of about 11 hours. (A drug’s half-life is how long it takes for your body to remove half of a dose of the drug from your system.) It usually takes about five half-lives for your body to clear a drug from your system.

For more information about how enalapril works, talk with your doctor or pharmacist.

* With left ventricular dysfunction, the left side of your heart is weak and doesn’t pump out blood as effectively as usual.

Am I able to take potassium supplements with enalapril?

No, you should not take potassium supplements with enalapril. Enalapril can increase the level of potassium in your blood. Taking potassium supplements with enalapril can make your potassium level too high, which can be dangerous.

While you’re taking enalapril, you should not use salt substitutes that contain potassium for the same reason.

To find out whether other supplements you may take are safe to use with enalapril, talk with your doctor or pharmacist.

Dosage of enalapril

The dosage of enalapril your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking enalapril

Enalapril oral tablets and oral solution are taken by mouth, with or without food.

Your doctor will talk with you about how to take enalapril. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Overdose of enalapril

You should not take more enalapril than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much enalapril, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Uses of enalapril

The Food and Drug Administration (FDA) approves prescription drugs such as enalapril for certain conditions. Approved uses for enalapril are described below.

Use for certain cardiovascular (heart and blood vessel) problems

Doctors may prescribe enalapril oral tablets and oral solution to:

• treat hypertension (high blood pressure)
• treat heart failure that’s causing symptoms
• treat left ventricular dysfunction that’s not causing symptoms

Enalapril is used for these purposes in adults. It’s also used for treating high blood pressure in children ages 1 month and older. It’s usually prescribed as a long-term treatment.

With high blood pressure, you don’t usually have symptoms. But having high blood pressure increases your risk of heart attack or stroke. Enalapril lowers your blood pressure, which reduces this risk.

With heart failure, your heart is weak and can’t pump blood around your body as easily as usual. This can cause symptoms such as breathlessness, low energy, and swollen ankles. Enalapril makes it easier for your heart to pump blood around your body, which reduces heart failure symptoms. It also lowers the risk of being hospitalized and dying from heart failure.

With left ventricular dysfunction, the left side of your heart is weak and doesn’t pump out blood as effectively as usual. If not treated, this problem can develop into heart failure. Enalapril makes it easier for your heart to pump blood, which helps prevent heart failure. It also reduces your risk of being hospitalized with heart failure.

Enalapril is usually prescribed together with diuretics and digoxin (Lanoxin) for heart failure. For high blood pressure, it’s often prescribed with other blood pressure medications.

Interactions and warnings for enalapril

Below, you’ll find information about enalapril’s possible interactions and warnings.

Interactions of enalapril

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take enalapril, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription medications
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for enalapril” section below.

Warnings for enalapril

Enalapril should not be taken by certain people. It should be taken cautiously by certain others.

Boxed warning: Risk of fetal harm

Enalapril has a boxed warning about the risk of fetal harm. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

For more information about this risk, see the “Pregnancy or breastfeeding and enalapril” section below.

Other warnings

Enalapril could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether enalapril is a safe option for you.

Ask your doctor about specific warnings for enalapril, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Enalapril can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to enalapril or any of its ingredients, your doctor will likely not prescribe enalapril. And they’ll likely not prescribe it if you’ve had an allergic reaction to other angiotensin converting enzyme (ACE) inhibitor drugs. (Enalapril is an ACE inhibitor). They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing or swallowing problems

If you have an allergic reaction to enalapril, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and enalapril

Information about enalapril and pregnancy and breastfeeding is described below.

Enalapril and pregnancy

Enalapril should not be taken during pregnancy. In fact, the drug has a boxed warning for risk of fetal harm. See below for details.

If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with enalapril.

Boxed warning: Risk of fetal harm

Enalapril has a boxed warning for risk of fetal harm. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

Taking enalapril during pregnancy may harm the fetus. It may cause kidney, lung, or bone problems and low blood pressure in the fetus. It can even cause pregnancy loss.

If you become pregnant, you should stop taking enalapril and contact your doctor right away. They’ll likely prescribe a different medication for your blood pressure or heart condition.

To learn more, talk with your doctor or pharmacist.

Enalapril and breastfeeding

Enalapril should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with enalapril.

Enalapril coupon

You may be able to save money on your prescription for enalapril by using our Perks discount coupons. They can be found at the end of this article.

If you have questions about how to pay for enalapril, talk with your doctor or pharmacist.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

What to ask your doctor

This article describes enalapril’s uses and side effects, ways to save on cost, and more. Let your doctor know if you have questions about enalapril or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• What dosage of enalapril will I need?
• Will I need to take other medications with enalapril?
• If I have side effects with enalapril, how will these be managed?

Article resources

• Enalapril maleate- enalapril maleate tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/0f535883-a5c8-4914-ba8c-2e1adcc6fafe/spl-doc
• Enalapril maleate oral solution. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/b63bdaa6-b57b-417b-9a79-29f1fd5bbf08/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks 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 another 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.