Enalapril Dosages: Your GoodRx Guide

Enalapril (Vasotec, Epaned) is an angiotensin-converting enzyme (ACE) inhibitor. It’s FDA approved for high blood pressure and a number of other heart conditions in adults. And it’s one of the few medications that’s approved to treat high blood pressure in infants and children, too.

The typical enalapril dosage depends on your age and what you’re taking it for. Below, we’ll look at the recommended dosages and when they may require an adjustment. Keep in mind that your healthcare provider may prescribe a different dosage than what’s listed here based on your specific health needs.

What dosage forms does enalapril come in?

Enalapril comes as an oral tablet in the following doses:

• 2.5 mg

• 5 mg

• 10 mg

• 20 mg

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Enalapril is also available as an oral solution (liquid) that contains 1 mg per mL. The liquid form makes dosing more accurate for infants and children. It’s also a helpful option for infants, children, and adults who have trouble swallowing tablets. Enalapril solution should be refrigerated, but it’s also good at room temperature for up to 60 days.

Enalapril tablets can also be made into a compounded suspension (liquid) that contains 1 mg per mL. A compounded prescription is a medication that’s made to order by a compounding pharmacy following a specific recipe. The compounded enalapril suspension is only good for 30 days after it’s made and should be stored in the refrigerator. You’ll also need to shake it well before measuring each dose.

What’s the typical enalapril dosage for adults?

The typical enalapril dosage for adults depends on why you’re taking it. You can take enalapril with or without food, but you should try to take it at the same time every day.

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High blood pressure

The typical enalapril dosage for adults with high blood pressure (hypertension) starts at 5 mg per day. From there, your healthcare provider may increase your dosage based on how you respond to the medication. Most people take between 10 mg and 40 mg of enalapril per day. Doses over 40 mg aren’t recommended.

If you’re taking a diuretic (“water pill”), your provider may have you stop taking it for a few days before you start taking enalapril. Or they may have you start with a lower enalapril dosage of 2.5 mg along with your diuretic. In this case, they’ll likely give you your first enalapril dosage in the provider’s office and keep an eye on your blood pressure for a few hours afterward. This is to make sure your blood pressure doesn’t drop too low from the combined medications.

For some people, taking enalapril once a day can lead to a return of high blood pressure as the dose wears off throughout the day. In this case, your provider may recommend dividing your enalapril dosage in half and taking it twice a day instead. This can help manage your blood pressure around the clock.

Heart failure

The usual enalapril dosage for heart failure in adults starts at 2.5 mg per day. Your provider will likely have you take your first enalapril dose for heart failure in their office. This allows them to monitor you for signs of low blood pressure.

Your provider may slowly raise your enalapril dosage every few days or weeks based on your response. Most people take 2.5 mg to 20 mg twice daily. Doses over 40 mg per day aren’t recommended.

Asymptomatic left ventricular dysfunction

Enalapril is also used to treat asymptomatic left ventricular dysfunction. This is a condition where the left ventricle of the heart doesn't pump as well as it should.

The enalapril dosage for this condition starts at 2.5 mg by mouth twice daily. As with heart failure, your provider may monitor you for a few hours after your first dose to make sure your blood pressure doesn’t drop too low. From there, they’ll slowly increase your dose as tolerated. The target enalapril dosage for asymptomatic left ventricular dysfunction is 10 mg twice a day.

What’s the typical enalapril dosage for children?

Enalapril is also approved for high blood pressure in infants and children ages 1 month and older. The enalapril dosage for children is based on their body weight.

The recommended enalapril dosage for high blood pressure in children starts at 0.08 mg per kg of body weight (up to 5 mg) once daily. For example, a child weighing 22 lbs (10 kg) would take 0.8 mg of enalapril per day. This is where the oral solution comes in, since tablets aren’t available in doses lower than 2.5 mg.

From there, your child’s provider may raise the dosage as needed. Doses over 0.58 mg per kg of body weight (or 40 mg) per day aren’t recommended.

Are there any dosage adjustments for health conditions?

Enalapril is removed from your body by the kidneys. So if you have kidney problems, you may not be able to clear enalapril as quickly. This can raise enalapril levels in your body and make you more prone to side effects, such as dizziness.

If you have moderate to severe kidney problems, a lower starting enalapril dosage of 2.5 mg once daily is recommended. Your provider will determine if this applies to you. Enalapril isn’t recommended for infants or children with kidney problems.

What happens if you miss a dose of enalapril?

If you realize that you've missed a dose of enalapril, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and take the next regular dose. Don’t double up on your enalapril dosage to make up for the missed dose.

Taking your medication as prescribed is key to ensure it works properly. If you’re missing doses often, you may want to consider a medication reminder. There are a number of digital apps available to help you, and many are free of cost. Other strategies include a phone alarm or a sticky note somewhere you’ll see it every day.

What should you do if you take too much enalapril?

If you take an extra dose of enalapril, it’s unlikely to cause serious problems. You may feel dizzy or lightheaded, but it should be mild and go away on its own as the medication wears off.

Large doses of enalapril can cause a significant drop in your blood pressure (hypotension). You may feel lightheaded, weak, or dizzy. You may also have blurry vision or even lose consciousness. Too much enalapril may also cause kidney damage in some cases. Large overdoses can also cause sudden kidney failure. Symptoms may include not peeing or peeing very little and swelling in your legs and ankles. You may also feel short of breath or confused.

If you or your child takes too much enalapril, contact your healthcare provider or call Poison Control at 1-800-222-1222. If you have symptoms of low blood pressure or kidney failure, seek emergency care right away.

How to save on enalapril

Enalapril tablets and oral solution are available as both brand-name and generic medications. GoodRx can help you save over 70% off the average retail price of the generic version. The price of generic enalapril tablets at certain pharmacies is as low as $6.00 with a free GoodRx discount.

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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