Enalapril
2 medicines
Enalapril is an ACE inhibitor used for high blood pressure and heart failure; it must not be used during pregnancy because it can cause serious injury or death to the developing baby, and it can rarely cause sudden, dangerous throat swelling (angioedema).
Key facts
- Enalapril (sold as Vasotec, Renitec and generics) is an ACE inhibitor. It relaxes blood vessels by blocking the formation of angiotensin II, a hormone that narrows them.
- It treats high blood pressure and heart failure, and is also used after a heart attack to ease the heart's workload.
- It must not be used in pregnancy: ACE inhibitors can cause serious fetal kidney damage, low amniotic fluid, and death, particularly if taken in the second or third trimester.
- It can rarely cause angioedema, sudden swelling of the face, lips, tongue, or throat that can block breathing; this is a medical emergency.
What enalapril treats
Enalapril treats high blood pressure and chronic heart failure, where it eases the heart's workload and improves survival. It is also used to protect kidney function in some people with diabetic kidney disease, and to support recovery after a heart attack. It is not a treatment for angina or an acute hypertensive crisis.
How enalapril works
After you swallow it, enalapril is converted in the body to its active form, enalaprilat, which blocks angiotensin-converting enzyme (ACE). This enzyme normally produces angiotensin II, a hormone that narrows blood vessels and triggers release of aldosterone, which makes the body retain salt and water. By blocking this pathway, enalapril relaxes blood vessels and reduces fluid retention, lowering blood pressure and easing the heart's workload.
Before you take it
- Do not take it if you are pregnant, trying to become pregnant, or if you or a family member has had angioedema with an ACE inhibitor before.
- Tell your prescriber about kidney disease, since ACE inhibitors reduce kidney filtration pressure and blood tests are needed to check kidney function and potassium.
- Potassium supplements, salt substitutes, and potassium-sparing diuretics can push potassium too high when combined with enalapril.
- Do not combine it with an angiotensin receptor blocker (ARB) or aliskiren, since this raises the risk of kidney injury, high potassium, and low blood pressure.
Side effects
Common effects include a dry, persistent cough, dizziness, headache, and fatigue, especially after the first dose.
Seek urgent medical care for:
- Swelling of the face, lips, tongue, or throat, or sudden difficulty breathing or swallowing.
- Fainting or severe dizziness.
- Signs of high potassium: muscle weakness or an irregular heartbeat.
- Little or no urine output.
Safety essentials
- Stop enalapril and seek advice as soon as you know or suspect you are pregnant; ACE inhibitors are contraindicated in pregnancy because of the risk of fetal injury and death.
- Treat any facial, lip, tongue, or throat swelling as an emergency, and do not take enalapril or any other ACE inhibitor again if this occurs.
- Your prescriber will check your kidney function and blood potassium before starting and periodically during treatment.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.