How does this medication work? What will it do for me?
Enalapril belongs to the class of medications called angiotensin converting enzyme (ACE) inhibitors. It is used to treat high blood pressure and congestive heart failure.
This medication works by relaxing blood vessels and by making the heart pump more efficiently. The injectable form is used to lower high blood pressure when the oral form cannot be used.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each white to off-white, oval-shaped, scored, biconvex compressed tablet, engraved "N" scoreline "N" on one the scoreside and "2.5" on the other side, contains 2.5 mg of enalapril maleate that appears as 2 mg of enalapril sodium in the tablet. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, lactose monohydrate, magnesium stearate, povidone, pregelatinized starch, sodium bicarbonate, and talc.
Each white to off-white, barrel-shaped, biconvex tablet, engraved "N | N" on one side and "5" on the other side, contains 5 mg of enalapril maleate that appears as 4 mg of enalapril sodium in the tablet. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, lactose monohydrate, magnesium stearate, povidone, pregelatinized starch, sodium bicarbonate, and talc.
Each rust-red, barrel-shaped, biconvex tablet, engraved "N" on one side and "1 | 0" on the other side, contains 10 mg of enalapril maleate that appears as 8 mg of enalapril sodium in the tablet. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, lactose monohydrate, magnesium stearate, povidone, pregelatinized starch, sodium bicarbonate, talc, D&C Red No. 30 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake HT, and FD&C Yellow No. 6 Aluminum Lake HT.
Each peach coloured, barrel-shaped, biconvex tablet, engraved "N" on one side and "2 | 0" on the other side, contains 20 mg of enalapril maleate that appears as 16 mg of enalapril sodium in the tablet. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, lactose monohydrate, magnesium stearate, povidone, pregelatinized starch, sodium bicarbonate, talc, D&C Red No. 30 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake HT, and FD&C Yellow No. 6 Aluminum Lake HT.
Each peach, rounded triangle-shaped, scored, compressed tablet, engraved N scoreline N on one side and 40 on the other side contains 40 mg of enalapril maleate that appears as 32 mg of enalapril sodium in the tablet. Nonmedicinal ingredients: colloidal silicon dioxide, corn starch, lactose monohydrate, magnesium stearate, povidone, pregelatinized starch, sodium bicarbonate, talc, D&C Red No. 30 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake HT, and FD&C Yellow No. 6 Aluminum Lake HT.
How should I use this medication?
The recommended dose ranges from 2.5 mg once daily to 20 mg twice daily, depending on the needs and circumstances of the person using the medication. The dose may need to be adjusted according to how well the kidneys are functioning.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, administer it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Enalapril should not be taken by anyone who:
- is allergic to enalapril or to any of the ingredients of the medication
- is pregnant
- has had episodes of angioedema (swelling of the face, lips, mouth, and throat), which has been associated with hereditary or idiopathic angioedema
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- cough (dry, persistent)
- unusual tiredness
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- chest pain
- dizziness, lightheadedness, or fainting (signs of low blood pressure)
- shortness of breath
- signs of too much potassium in the body (e.g., confusion; irregular heartbeat; nervousness; numbness or tingling in the hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness of legs)
- skin rash with or without itching, fever, or joint pain
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of angioedema (e.g., swelling of face, mouth, hands, or feet)
- stomach pain, itching of skin, or yellow eyes or skin
- trouble in swallowing or breathing (sudden)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
HEALTH CANADA ADVISORY
February 4, 2014
Health Canada has issued new restrictions concerning the use of enalapril. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Angioedema: Angioedema (a serious allergic reaction that causes the area around the throat and tongue to swell) may occur with ACE inhibitors, including enalapril, although uncommonly. If you experience swelling of the face, tongue, or throat, you should stop taking this medication at once and get immediate medical attention. People who have had angioedema caused by other substances may be at increased risk of angioedema while receiving an ACE inhibitor such as enalapril.
Cough: People taking enalapril may develop a dry, persistent cough that usually disappears only after stopping or lowering the enalapril dose. Be sure to tell your doctor of any cough that does not seem to be related to a usual cause.
Kidney function: Changes in kidney function have been seen in certain people taking this medication.
Liver function: Changes in liver function have occurred in people with or without preexisting liver problems during treatment with this medication. In most cases, the changes were reversed when the medication was stopped.
Low blood pressure: Occasionally, blood pressure drops too low after taking enalapril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur in those who are on dialysis, are suffering from diarrhea or vomiting, are sweating excessively and not drinking enough fluids, have a salt-restricted diet, or are taking water pills. If low blood pressure causes you to faint or feel lightheaded, contact a doctor.
Potassium levels: Increases in blood levels of potassium occur for a small percentage of people taking enalapril. This rarely causes problems, but potassium levels should be monitored by your doctor.
Pregnancy: ACE inhibitors should not be taken by pregnant women. If you discover you are pregnant, you should stop taking enalapril at once.
Breast-feeding: Enalapril passes into breast milk in trace amounts. This medication should not be used by breast-feeding women.
Children: The safety and effectiveness of this medication have not been established for children. Its use by children is not recommended.
What other drugs could interact with this medication?
There may be an interaction between enalapril and any of the following:
- angiotensin II receptor blockers (e.g., candesartan, losartan)
- antidiabetes medications (e.g., insulin, metformin, glyburide)
- blood pressure lowering medications (e.g., beta-blockers)
- diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
- medications that increase potassium levels (e.g., potassium supplements, spironolactone, amiloride, and salt substitutes containing potassium)
- nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.