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- What is enalapril, and how does it work (mechanism of action)?
- What brand names are available for enalapril?
- Is enalapril available as a generic drug?
- Do I need a prescription for enalapril?
- What are the side effects of enalapril?
- What is the dosage for enalapril?
- Which drugs or supplements interact with enalapril?
- Is enalapril safe to take if I'm pregnant or breastfeeding?
- What else should I know about enalapril?
What is enalapril, and how does it work (mechanism of action)?
Enalapril is a drug that is used for treating high blood pressure. It is in a class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE is an enzyme in the body that causes the formation of angiotensin II. Angiotensin II causes the arteries in the body to narrow, thereby elevating blood pressure. ACE inhibitors, such as enalapril, lower blood pressure by preventing the formation of angiotensin II thereby relaxing the arteries. ACE inhibitors also improve the effectiveness of the heart in patients with heart failure by reducing the blood pressure that the heart must maintain. Enalapril was approved by the FDA in December 1985.
What are the side effects of enalapril?
Enalapril is generally well tolerated, and side effects usually are mild and transient. A dry, persistent cough has been reported commonly with the use of ACE inhibitors. Coughing resolves after discontinuing the medication.
Other important side effects include:
- abdominal pain,
- loss of appetite,
- nausea and vomiting,
- chest pain,
- numbness or tingling in the hands or feet,
- rash, and a
- sore or swollen throat.
In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors. In susceptible individuals ACE inhibitors may reduce kidney function. Enalapril may cause hypersensitivity (allergic) reactions and angioedema (swelling of face, lips, tongue, throat).
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What is the dosage for enalapril?
The usual oral dose for treating high blood pressure is 2.5-40 mg once daily. It may also be administered twice daily in two divided doses. The dose for treating heart failure is 2.5-20 mg given twice daily. The usual starting intravenous dose is 1.25 mg administered over a 5 minute period every 6 hours. If a patient is receiving diuretic therapy the initial intravenous dose is 0.625 mg every 6 hours.
Which drugs or supplements interact with enalapril?
Patients receiving diuretics may experience excessive reduction in blood pressure when enalapril is started. Stopping the diuretic or increasing salt intake prior to taking enalapril may prevent excessive blood pressure reduction. Close supervision for at least 2 hours after the start of enalapril and until blood pressure is stable is recommended if the diuretic cannot be stopped.
Enalapril may increase potassium levels (hyperkalemia) in blood. Therefore, there is an increased risk of hyperkalemia when enalapril is given with potassium supplements or drugs that increase potassium levels (for example, spironolactone [Aldactone]).
There have been reports of increased lithium (Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The reason for this interaction is not known, but the increased levels may lead to toxicity from lithium. There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors.
Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable gold (sodium aurothiomalate [Myochrysine]), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including enalapril.
Is enalapril safe to take if I'm pregnant or breastfeeding?
ACE inhibitors, including enalapril, can be harmful to the fetus and should not be taken by pregnant women.
ACE inhibitors, including enalapril, should be avoided in nursing mothers.
What else should I know about enalapril?
What preparations of enalapril are available?
- Tablets: 2.5, 5, 10, and 20 mg.
- Injection: 1.25 mg/mL
- STORAGE: Tablets should be stored at room temperature between 15 C - 30 C (59 F - 86 F). The injectable formulation should be stored at 20 C to 25 C (68 F to 77 F).
Reference: FDA Prescribing Information
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Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as
- allergic rhinitis,
- sinus infection,
- cigarette smoking,
- postnasal drip,
- medications, and
- less frequently tumors or other lung disease. Treatment of chronic cough is dependent upon the cause.
Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
Congestive Heart Failure (CHF) OverviewCongestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Heart AttackHeart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Heart Attack and Atherosclerosis Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience:
- Extreme fatigue
- Pain in the upper abdomen
Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
High Blood Pressure HypertensionHigh blood pressure is defined as a pressure of 140/90 mmHg or higher in the arteries. Genetic factors, high salt intake, and increased arterial stiffness cause high blood pressure. Dizziness, headache, nausea, and shortness of breath are just a few symptoms of high blood pressure. Untreated high blood pressure increases the risk of heart disease, kidney disease, atherosclerosis, eye damage, stroke, and increased risk of aneurysms. High blood pressure can be managed with weight loss, lifestyle changes, and medication.
High Blood PressureWhat causes high blood pressure (hypertension)? Know the warning signs and symptoms of high blood pressure. Read about high blood pressure medications, diet, and long term treatments.
Take the HBP QuizTake this quiz and test your IQ of high blood pressure (hypertension), the cardiovascular disease that causes most strokes and heart attacks. How are dizziness, snoring, and gout related to HBP? Find the answer and learn how medical treatments and lifestyle adjustments fight this common problem.
Hypertension PictureHigh blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 with a diastolic pressure above 90. See a picture of Hypertension and learn more about the health topic.
Kidney Disease (Hypertension-Related)High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
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- multiple myeloma, and
- acute glomerulonephritis.
- bladder obstruction,
- prostate problems,
- tumors, or
- kidney stones.
ParathyroidectomyParathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:
- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
- and recurrence of the tumor.
Pregnancy Drug DangersTaking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.