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Compare Enalapril vs. Spironolactone

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Enalapril (Vasotec) and spironolactone (Aldactone) are both used to treat high blood pressure and heart failure, but they work in different ways and belong to different medication classes. Enalapril is an ACE inhibitor that relaxes blood vessels by blocking a protein called ACE, while spironolactone is a potassium-sparing diuretic that helps your kidneys remove extra water and sodium without lowering potassium levels. Enalapril is typically taken once or twice daily and can cause side effects like tiredness, dizziness, and a dry cough. On the other hand, spironolactone is taken once or a few times a day and can cause side effects such as breast tenderness, lower sex drive, and more frequent urination. Enalapril is not recommended during pregnancy and can cause serious side effects like angioedema and high potassium levels. Spironolactone also has risks, including high potassium levels and abnormal electrolyte levels, and it is not recommended for people with Addison's disease or high potassium levels. Both medications are available in generic forms and require regular blood tests to monitor your health.

  • Enalapril (Vasotec)
    Spironolactone (Aldactone)
  • Enalapril (Vasotec)
    Spironolactone (Aldactone)

  • Summary of Enalapril vs. Spironolactone

    Summary for ACE inhibitor
    Prescription only

    Enalapril (Vasotec) is a first-choice medication used for treating high blood pressure. It's also approved for heart failure. Enalapril (Vasotec) belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It's taken by mouth, once or twice daily. Enalapril (Vasotec) doesn't cause many side effects, but some include tiredness, dizziness, and cough.

    Summary for Potassium sparing diuretic
    Prescription only

    Spironolactone (Aldactone) is a type of potassium-sparing diuretic (water pill). It's used to treat heart failure, high blood pressure, and swelling from kidney or liver problems in adults. Because it blocks aldosterone (a hormone that affects sodium and potassium levels), spironolactone (Aldactone) can also treat conditions where there's too much aldosterone. Spironolactone (Aldactone) is taken by mouth, generally once or a few times a day, depending on your condition. Some common side effects of this medication include breast tenderness (males and females) and loss of libido (in males).

  • Indications of Enalapril vs. Spironolactone

    Indications for
    •High blood pressure
    •Heart failure
    Indications for
    •Heart failure
    •High blood pressure
    •Swelling due to liver damage (cirrhosis)
    •Swelling due to nephrotic syndrome (a rare kidney condition) - tablets only
    •Primary aldosteronism (a hormone imbalance) - tablets only

  • Pros and Cons of Enalapril vs. Spironolactone

    Pros and Const for ACE inhibitor
    Pros
    •A first-choice blood pressure lowering medication for many people
    •Taken by mouth
    •Can be taken by children as young as 1 month old (high blood pressure only)
    •Available as a liquid for people who have trouble swallowing pills
    Cons
    •More likely to cause a dry cough, compared to angiotensin II receptor blockers (ARBs)
    •Can't be taken during pregnancy or breastfeeding
    •Might not work as well for lowering high blood pressure in black people
    •Need to take twice daily for heart failure
    Pros and Const for Potassium sparing diuretic
    Pros
    •Taken by mouth
    •Oral suspension available for adults who've difficulty swallowing tablets
    •Lower-cost generics available
    Cons
    •Can make you urinate more often
    •Need to get blood tests regularly to check your electrolytes and kidney health
    •Can cause breast growth and lower sex drive in males

  • Common Side Effects of Enalapril vs. Spironolactone

    Common Side Effects for
    •Feeling tired (3%)
    Common Side Effects for
    •Dizziness
    •Headache
    •Sleepiness
    •Nausea
    •Vomiting
    •Diarrhea
    •Stomach cramps
    •Enlargement of male breasts
    •Breast pain
    •Lower sex drive
    •Sexual dysfunction
    •Irregular or lack of menstrual periods
    •Leg cramps
    •Higher potassium levels
    •Lower sodium levels

  • Warnings of Enalapril vs. Spironolactone

    Common Side Effects for
    •Not for use during pregnancy
    •Angioedema (swelling)
    •Low blood pressure
    •Worsening kidney problems
    •Heart problems due to high potassium
    •Liver problems
    Common Side Effects for
    •High blood potassium levels
    •Low blood pressure and kidney problems
    •Abnormal electrolyte levels
    •Breast pain or swelling

  • Prices with our coupons for Enalapril vs. Spironolactone

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