enalapril
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.
What is Enalapril (Vasotec)?
What is Enalapril (Vasotec) used for?
- High blood pressure
- Heart failure
How Enalapril (Vasotec) works
Enalapril (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. It relaxes your blood vessels by blocking a protein (called ACE) from squeezing your blood vessels.
Drug facts
Side effects of Enalapril (Vasotec)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Feeling tired (3%)
Less Common Side Effects
- Feeling dizzy while standing from a sitting position
- Weakness
- Cough
- Rash
Enalapril (Vasotec) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema: swelling (in the face, lips, tongue, throat, hands, or feet), trouble breathing, wheezing, nausea, vomiting
- Severe allergic reaction: trouble breathing, swelling of the face, lips, tongue, or throat
- Serious kidney problems: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
- High blood potassium levels: nausea, tiredness, chest pain, muscle weakness, tingling or numbness, pounding heart, nausea
- Severely low blood pressure: lightheadedness, dizziness, feeling faint, tiredness, confusion
The following Enalapril (Vasotec) side effects have also been reported
Along with its needed effects, a medicine 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:
More common
Blurred vision
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sweating
unusual tiredness or weakness
Some side effects 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
Dizziness
Less common
Lack or loss of strength
rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Enalapril (Vasotec)
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
Pharmacist tips for Enalapril (Vasotec)
- Take enalapril (Vasotec) with or without food at any time of day.
- You might feel dizzy when you start taking enalapril (Vasotec), and when your provider raises your dose. This should get better over time as you continue taking the medication and your body gets used to your new blood pressure. Stand up slowly and carefully from a sitting or lying down position to avoid falling.
- Let your provider know if you feel faint or pass out after taking enalapril (Vasotec). They might need to switch you to a different blood pressure medication.
- Make sure to drink enough water to stay hydrated while you're taking enalapril (Vasotec), especially on hot days or after exercising. Your blood pressure might drop too much if you don't have enough fluids in your body. This can worsen dizziness and raise your risk of falls.
- Enalapril (Vasotec) can interact with a lot of other medications. For example, you should avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), while taking enalapril (Vasotec) unless your provider says it's okay. This is because taking NSAIDs and enalapril (Vasotec) together might cause kidney problems. Make sure to tell your provider about all the medications you're taking before starting enalapril (Vasotec).
- Make sure to have a healthy diet, including a low-salt diet, while taking enalapril (Vasotec) to help lower your blood pressure. Depending on your risk factors and other medical problems, it's possible you might be able to stop taking enalapril (Vasotec) if your blood pressure is well-controlled through healthy eating and exercise.
- Don't take enalapril (Vasotec) if you're pregnant. If you're pregnant or thinking of getting pregnant, contact your provider right away. Your provider might prescribe you a different medication that's safer during pregnancy. Or, they might recommend ways to help control your blood pressure with lifestyle changes instead.
More tips for enalapril 1 mg/mL liquid:
- Only use an oral syringe or medication dose cup from the pharmacy to measure out your dose. Never use household spoons because they aren't accurate, which can make you take the wrong dose.
- You can store the enalapril (Vasotec) liquid in the refrigerator until the expiration date on the bottle. Or, you can store it at room temperature for up to 2 months.
Common questions about Enalapril (Vasotec)
You can track how well enalapril (Vasotec) is working for you by checking your blood pressure regularly at home. Most people will notice a drop in their blood pressure about an hour after they take enalapril (Vasotec), but it can take up to 4 to 6 hours to see the maximum benefits from this medication. Your provider might recommend for you to write down your blood pressure readings daily (or more than once a day) and bring them to your appointments. Based on how well enalapril (Vasotec) is controlling your blood pressure, your provider might need to adjust your dose several times before finding a dose that works best for you. It's important to take enalapril (Vasotec) regularly as directed in order to stay within your blood pressure goal.
Dry cough is a well-known side effect of ACE-inhibitors, like enalapril (Vasotec). It's possible for you to get a cough from taking enalapril (Vasotec). This side effect can appear at any time during treatment. If you get a cough from enalapril (Vasotec), talk to your provider. They'll likely stop enalapril (Vasotec) and choose a different blood pressure medication that's much less likely to cause this side effect, such as an angiotensin II receptor blocker (ARB).
Enalapril (Vasotec) isn't known to cause low heart rate. But there have been reports of people who did experience high and low heart rates while taking this medication. It isn't clear whether these changes in heart rate are caused by enalapril (Vasotec). Ask your provider if you're experiencing low heart rate while taking enalapril (Vasotec).
No, enalapril (Vasotec) and lisinopril (Zestril) aren't the same. While they both belong in the same medication class and work similarly well to lower blood pressure, there are some differences between them. (1) One difference is what conditions they're taken to treat. While both enalapril (Vasotec) and lisinopril (Zestril) can help with high blood pressure and heart failure, only lisinopril (Zestril) is approved to lower the risk of death after a heart attack. (2) Another difference is age cut-off for children. Enalapril (Vasotec) can be taken by children as young as 1 month old for blood pressure, whereas lisinopril (Zestril) is only for children ages 6 and older. Talk with your provider if you've any questions about enalapril (Vasotec) and lisinopril (Zestril).
Enalapril (Vasotec) doesn't have any specific food interactions. But if you have heart failure or high blood pressure, your provider will likely recommend that you avoid certain foods to prevent your condition from getting worse. For example, they might ask you to avoid or limit the amount of alcohol you drink because alcohol can raise your blood pressure. They'll likely ask you to avoid foods that are high in salt (e.g., canned foods, pickles, or preserved meats) because these can also worsen blood pressure and put you at higher risk for other conditions, like stroke or heart problems. Talk with your provider if you're not sure if you need to avoid or limit any specific food from your diet.
No, enalapril (Vasotec) isn't a beta blocker. But rather, it belongs to a class of medication called ACE inhibitors. While both beta blockers and ACE inhibitors can help lower blood pressure, they do so in different ways. ACE inhibitors, like enalapril (Vasotec), are considered first-choice medications for blood pressure, but beta blockers are not. In general, your provider might consider a beta blocker for you only if you can't take ACE inhibitors or if you have certain medical conditions. Ask your provider if you have more questions about how enalapril (Vasotec) works or what blood pressure medications are the best for you.
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Risks and warnings for Enalapril (Vasotec)
Enalapril (Vasotec) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not for use during pregnancy
Enalapril (Vasotec) can cause severe and sometimes life-threatening harm to unborn babies so it shouldn't be used during pregnancy. If you find out that you're pregnant while taking enalapril (Vasotec), stop and let your provider know right away. If you're pregnant before starting enalapril (Vasotec) or thinking of becoming pregnant during treatment, discuss with your provider about safer options to treat your blood pressure.
Angioedema (swelling)
- Risk factors: Black people | Having angioedema in the past
People who take medications that contain an ACE inhibitor, like enalapril (Vasotec), can experience a rare, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, and tongue. Swelling of the tongue or throat area can be potentially life-threatening, since it can make it difficult to breathe. Angioedema can happen at any time during treatment. You're more likely to experience angioedema if you're Black, an older adult, or female. Get medical attention immediately if you experience swelling in any of the areas mentioned above, stomach pain, or difficulty breathing. You'll have to stop taking enalapril (Vasotec) if this happens.
Low blood pressure
- Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking higher doses of diuretic medications
Sometimes, taking enalapril (Vasotec) can cause your blood pressure to drop too much. This can cause you to feel dizzy, tired, or lightheaded. This side effect is more common when you first start enalapril (Vasotec) or when the dose is raised. Make sure to stay well-hydrated. If your blood pressure drops too much and you feel dizzy, make sure to sit down slowly while holding onto something and let your provider know. If you fall and hit your head, get medical help right away. If you feel dizzy, lightheaded, faint, tired, or confused while taking enalapril (Vasotec), contact your provider right away.
Worsening kidney problems
- Risk factors: Severe heart failure | Kidney problems | Not enough fluid in your body | Taking other medications that can cause kidney damage | History of narrow heart valves (aortic stenosis)
Enalapril (Vasotec) is usually good for the kidneys. But in some cases it can make kidney problems worse. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or very severe heart failure. Your provider might order lab tests every so often to make sure your kidneys are healthy and working properly. Your provider will check your kidneys before starting enalapril (Vasotec) and regularly as needed. Let your provider know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Heart problems due to high potassium
- Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium
Enalapril (Vasotec) can raise the amount of potassium in your body, which can be dangerous. Your risk of developing high potassium is greater if you have diabetes, kidney problems, or are taking other medications that also raise potassium levels. For this reason, make sure your provider knows your full medical history and what medications you're taking before starting enalapril (Vasotec). If you experience signs of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat, tell your healthcare provider right away.
Liver problems
- Risk factors: History of liver problems | Drinking large amounts of alcohol
In some rare cases, people who took ACE inhibitors like enalapril (Vasotec) have developed a blocked bile duct. This condition can lead to liver problems or liver failure. Your provider might order blood tests to check your liver health from time to time. If you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin, let your provider know right away.
Enalapril (Vasotec) dosage
Typical dosage for Enalapril (Vasotec)
High blood pressure
- Adults: The typical starting dose ranges from 2.5 mg to 5 mg by mouth once daily, depending on whether or not you're also taking a water pill. The maximum dose is 40 mg once daily.
- Children ages 1 month and older: Your child's provider will determine your child's dose based on their body weight. The typical starting dose is 0.08 mg/kg of body weight (up to 5 mg of enalapril) by mouth once daily. The maximum dose is 0.58 mg/kg (up to 40 mg of enalapril) daily.
Heart failure
- Adults: The typical recommended dose is 2.5 mg by mouth twice daily. The maximum recommended dose ranges from 10 mg to 20 mg twice daily, depending on your condition.
Your dose might be different if you have kidney problems
More on Enalapril (Vasotec) dosage
Interactions between Enalapril (Vasotec) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aliskiren
- Sacubitril
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Allopurinol
- Alteplase, Recombinant
- Amiloride
- Azathioprine
- Azilsartan
- Azilsartan Medoxomil
- Candesartan Cilexetil
- Canrenoate
- Eplerenone
- Eprosartan
- Everolimus
- Interferon Alfa-2a
- Irbesartan
- Lithium
- Losartan
- Mercaptopurine
- Olmesartan Medoxomil
- Oxypurinol
- Potassium Phosphate
- Sirolimus
- Spironolactone
- Telmisartan
- Triamterene
- Trimethoprim
- Valsartan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aspirin
- Azosemide
- Bromfenac
- Bufexamac
- Bumetanide
- Bupivacaine
- Bupivacaine Liposome
- Capsaicin
- Celecoxib
- Choline Salicylate
- Clomipramine
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Furosemide
- Gold Sodium Thiomalate
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Nesiritide
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piretanide
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rifampin
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Valdecoxib
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Enalapril (Vasotec) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Enalapril (Vasotec) will not be safe for you to take.
- History of angioedema
- Taking at the same time as aliskiren (Tekturna) for people with high blood sugar
- Taking at the same time or within 36 hours of neprilysin inhibitors, such as Entresto (sacubitril / valsartan)
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