Please wait...
Don’t see your pharmacy listed? Most pharmacies accept our discounts, so have your pharmacist enter this coupon to see if you will save money:
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.
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.
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.
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.
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.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
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.
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.
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.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use enalapril only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Enalapril Maleate (www.drugs.com/enalapril.html).
Commonly reported side effects of enalapril include: increased blood urea nitrogen and increased serum creatinine. Other side effects include: hypotension. See below for a comprehensive list of adverse effects.
Applies to enalapril: oral solution, oral tablet
Oral route (Tablet; Solution; Powder for Solution)
Discontinue enalapril maleate as soon as possible when pregnancy is detected, since fetal toxicity, including injury and death to the developing fetus, can be caused by drugs that act directly on the renin-angiotensin system.
Along with its needed effects, enalapril may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking enalapril:
More common
Less common
Some side effects of enalapril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Applies to enalapril: compounding powder, intravenous solution, oral liquid, oral tablet
Predisposing risk factors for hypotension after enalapril administration are decreased intravascular volume (angiotensin-dependency), hyponatremia, and concurrent use of a diuretic agent.
Very common (10% or more): Hypotension
Common (1% to 10%): Edema
Uncommon (0.1% to 1%): Angioedema
Very common (10% or more): Headache
Common (1% to 10%): Vertigo, fatigue, peripheral paresthesias, insomnia, dizziness, syncope
Enalapril, like other angiotensin converting enzyme inhibitors, may decrease serum aldosterone levels, resulting in mild to moderate hyperkalemia. Diuretic use and advanced age increase the risk of renal impairment. Enalapril reduced the risk of renal impairment compared to placebo in diabetic patients. The concomitant use of beta blockers with enalapril has been shown to be renoprotective.
Enalapril may worsen renal insufficiency, especially if the patient is hypovolemic or hypotensive.
Patients with underlying congestive heart failure are predisposed to renal side effects associated with enalapril.
Common (1% to 10%): Increased serum creatinine, uric acid, and potassium
Rare case reports of enalapril-associated hepatitis, where liver function tests rose despite resolution of congestive heart failure, are reported.
A 54-year-old woman with hypertension developed asymptomatic abnormal liver function tests associated with eosinophilia and relatively normal abdominal ultrasonography seven weeks after beginning enalapril. An extensive work-up revealed no evidence of infection; liver biopsy revealed cellular degeneration, portal eosinophilic and mononuclear infiltration, and centrilobular necrosis. The signs and symptoms of hepatitis resolved upon discontinuation of enalapril.
An 80-year-old woman with hypertension and mild heart failure developed hepatomegaly and icterus accompanied by increased conjugated bilirubin, alkaline phosphatase, and aspartate aminotransferase thirty days after beginning enalapril treatment. The patient had not been taking any other medications or herbal products. Tests for hemochromatosis, Wilson's disease, and alpha-1 antitrypsin deficiency returned with normal results. Serology for hepatitis A, B, C and autoimmune screen were negative. Other infectious causes were ruled out. Twenty days after admission, the patient developed grade III encephalopathy and severe coagulation disorders and died 30 days after admission.
In patients with liver dysfunction, frequent monitoring of liver function tests during enalapril administration is recommended.
Frequency not reported: Cholestatic jaundice, centrilobular necrosis, fulminant hepatic necrosis, death
Uncommon (0.1% to 1%): Photosensitivity, urticaria
Frequency not reported: Angioedema, obstructive laryngeal and glossal angioedema, intestinal angioedema, Henoch-Schonlein purpura
Late-onset enalapril-induced angioedema (more than three months) is reported in at least one patient who had taken enalapril without incident for three years. Patients with intestinal angioedema generally present with abdominal pain (with or without nausea or vomiting) and in some cases there was no prior history of facial angioedema, and C-1 esterase levels were normal. These symptoms resolve after stopping the ACE inhibitor.
Common (1% to 10%): Dry, nonproductive cough
Frequency not reported: New bronchial hyperactivity, rhinorrhea, exacerbation of obstructive sleep apnea
Rare case reports of asthma associated with some angiotensin converting enzyme inhibitors suggest that these drugs seem to play a role in the genesis and metabolism of bronchodilatory mediators. For this reason, some experts recommend cautious use of enalapril in patients with preexisting asthma.
A retrospective study has revealed a significantly higher incidence of discontinuation of angiotensin converting enzyme (ACE) inhibitor therapy due to cough among black patients compared with non-black patients (9.6% vs. 2.4%).
Several agents have been studied for treating cough with ACE inhibitors. No long term trials exist to allow a definitive treatment option. Cromolyn has the most data showing some benefit. Other agents studied include baclofen, theophylline, sulindac, and benzonatate.
Rare, reversible cases of agranulocytosis associated with enalapril and other angiotensin converting enzyme (ACE) inhibitors have been reported. ACE inhibitors have been used to treat post renal transplant erythrocytosis. Data have shown that they may decrease circulating erythropoietin levels in these patients.
Rare (less than 0.1%): Neutropenia, agranulocytosis
Common (1% to 10%): Nausea, vomiting, diarrhea
Uncommon (0.1% to 1%): Dysgeusia
Frequency not reported: Pancreatitis, acute small bowel mucosal edema
A 56-year-old woman with hypertension and diabetes developed acute abdominal pain, nausea, and vomiting associated upper abdominal tenderness, hyperamylasemia, hyperlipasemia, and normal upper abdominal ultrasonography within 24 hours of starting enalapril. The signs and symptoms of pancreatitis resolved over the next several days once the drug was discontinued. No rechallenge was performed.
A 65-year-old woman was diagnosed with acute pancreatitis by ultrasonography, CT scan, and serum amylase level of 980 units/L. The patient had been receiving enalapril, HCTZ, and amiloride for one year. The pancreatitis resolved over 7 days. The patient upon rechallenge with enalapril developed severe upper abdominal pain, vomiting, and hypotension. CT scan showed intrapancreatic necrosis and peripancreatic fluid. Four weeks later a CT scan showed three pseudocysts that took 4 months to resolve. The author of the report concluded that rechallenging patients who develop acute pancreatitis while on enalapril is not recommended.
A 52-year-old Korean woman with hypertension experienced a generalized, erythematous, scaly rash associated with a positive Nikolsky sign and biopsy results consistent with pemphigus foliaceous within three weeks after beginning enalapril. Direct immunofluorescence revealed intercellular IgG deposition. The pemphigus remained active at least 12 months after enalapril was discontinued.
A 35-year-old woman with hypertension developed alopecia during enalapril therapy, which resolved upon discontinuation of the drug, and recurred upon rechallenge.
A 77-year-old man with heart failure developed a generalized morbilliform rash after starting enalapril. Biopsy was consistent with toxic pustuloderma.
Common (1% to 10%): Pruritic, maculopapular eruption
Uncommon (0.1% to 1%): Rash
Frequency not reported: Alopecia, photosensitive lichenoid eruptions, erythema with vasculitis, bullous pemphigoid, pemphigus foliaceous, toxic pustuloderma
Frequency not reported: Depression, acute psychosis
A 52-year-old woman with hypertension and a history of depression associated with the use of beta-blockers, developed fatigue, malaise, and clinical signs and symptoms of depression, including suicidal ideation, within five weeks after starting enalapril. The depression gradually resolved with substitution of a thiazide diuretic and a low sodium diet. Rechallenge resulted in recurrent depression.
A 41-year-old man with hypertension became agitated, anxious, depressed, and unable to sleep four weeks after starting enalapril. The psychosis resolved when enalapril was stopped, and recurred upon rechallenge.
Frequency not reported: Syndrome of inappropriate ADH secretion, gynecomastia
A 69-year-old woman with diabetes mellitus and hypertension developed symptomatic hyponatremia associated with decreased plasma and increased urine osmolalities, normal thyroid and basal cortisol studies, and a positive water load test four months after beginning enalapril. The syndrome resolved upon discontinuation of enalapril, and recurred upon rechallenge.
Frequency not reported: Severe arthralgias and myalgias
A 76-year-old woman with hypertension, on enalapril monotherapy for three weeks, developed progressive myalgias, asthenia, morning stiffness, and weakness associated with no abnormal laboratory values. Due to the absence of other apparent causes, enalapril was discontinued, and the patient's myalgias disappeared. In at least one other case, rechallenge resulted in recurrent symptoms.
Frequency not reported: Positive fluorescent antinuclear antibody test
Frequency not reported: Vulvovaginal pruritus, dysuria, incontinence
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Enalapril Maleate (www.drugs.com/enalapril.html).
March 28, 2020
March 28, 2020
March 28, 2020
March 28, 2020
March 28, 2020
March 28, 2020
