Enalapril

Generic name: enalapril (e NAL a pril)
Brand name: Epaned, Vasotec
Drug class: Angiotensin Converting Enzyme Inhibitors

Enalapril is an ACE inhibitor. ACE stands for angiotensin converting enzyme.

Enalapril is used to treat high blood pressure (hypertension) in adults and children who are at least 1 month old.

Enalapril is also used to treat congestive heart failure (CHF). CHF is a disorder of the ventricles (the lower chambers of the heart) which decreases the heart’s ability to pump blood to the body.

Warnings

Do not use enalapril if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.

You should not use enalapril if you have ever had angioedema. Do not take enalapril within 36 hours before or after taking any medicine that contains sacubatril (such as Entresto).

If you have diabetes, do not use enalapril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

Enalapril can affect your heart or your electrolyte levels. Call your doctor if you have chest pain, pounding heartbeats or fluttering in your chest, a slow heart rate or weak pulse, a tingly feeling, muscle weakness, or muscle tightness or contraction.

Before taking this medicine

You should not use enalapril if you are allergic to it, or if you have:

  • you have a history of angioedema;
  • you recently took a heart medicine called sacubatril; or
  • if you are allergic to any other ACE inhibitor, such as benazepril, captopril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

Do not take enalapril within 36 hours before or after taking medicine that contains sacubatril (such as Entresto).

If you have diabetes, do not use enalapril together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo).

You may also need to avoid taking enalapril with aliskiren if you have kidney disease.

To make sure enalapril is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);
  • liver disease;
  • a history of blood clot or stroke (including TIA or "mini-stroke");
  • an electrolyte imbalance (such as high levels of potassium in your blood); or
  • heart disease.

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Enalapril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

Enalapril can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.

How should I take enalapril?

Take enalapril exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take enalapril with or without food.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking enalapril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

If you need surgery, tell the surgeon ahead of time that you are using enalapril.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Store the liquid medicine in the refrigerator, do not freeze. Throw away any liquid medicine not used within 60 days.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Drinking alcohol can further lower your blood pressure and may increase certain side effects of enalapril.

Do not use salt substitutes or potassium supplements while taking enalapril, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Enalapril side effects

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

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;
  • slow heartbeats;
  • pounding heartbeats or fluttering in your chest;
  • little or no urination;
  • jaundice (yellowing of the skin or eyes);
  • numbness, tingling, or burning pain in your hands or feet;
  • fever, chills, cold or flu symptoms;
  • easy bruising, unusual bleeding; or
  • high potassium - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common enalapril side effects may include:

  • dizziness, feeling tired;
  • cough; or
  • feeling light-headed.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect enalapril?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with enalapril, especially:

  • lithium;
  • a diuretic or "water pill";
  • gold injections to treat arthritis; or
  • NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with enalapril, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.