Enalapril

What is enalapril?

Enalapril is a prescription-only medicine that belongs to a group of drugs called ACE inhibitors (angiotensin-converting enzyme inhibitors). It is commonly used to treat high blood pressure (hypertension), heart failure, and to help prevent future heart-related problems[1]. 

What is enalapril used to treat?

Enalapril is used to treat and manage several cardiovascular conditions, including[1]: 

• High blood pressure (hypertension) – helps reduce the risk of stroke and heart attack 

• Heart failure – improves symptoms and reduces hospitalisation 

• Asymptomatic left ventricular dysfunction – helps prevent symptomatic heart failure 

How does enalapril work?

Enalapril works by interfering with the body's renin-angiotensin system[1]: 

• It blocks the enzyme that converts angiotensin I to angiotensin II 

• Angiotensin II normally narrows blood vessels – blocking it helps blood vessels relax and widen 

• This lowers blood pressure and reduces the workload on the heart 

Who can take enalapril?

Most adults and children can take enalapril, but it may not be suitable if you[1]: 

• Are pregnant or breastfeeding 

• Have had an allergic reaction to ACE inhibitors, enalapril or any other ingredients listed in your medicine 

• Have had swelling of your face, lips, mouth, tongue or throat which caused difficulty in swallowing or breathing (angioedema) 

• Have kidney or liver disease 

• Have low blood pressure or are dehydrated 

• Are undergoing dialysis 

• Have diabetes and are also taking aliskiren 

• Have taken or are currently taking sacubitril/valsartan  

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of enalapril?

Depending on why you’re taking enalapril, the usual starting dose is between 2.5mg and 5mg once a day. This will be gradually increased over a few weeks to a maximum of 40mg, but it all depends on the condition[1]: 

• For high blood pressure, the dose is usually 10mg to 20mg taken once a day 

• For heart failure, the usual dose is initially 2.5mg once daily increased to10mg to 20mg taken twice a dayFor children, the dose is based on age and body weight and the condition being treated 

How do you take enalapril?

Enalapril is usually taken once or twice daily[1]: 

• The first dose is often taken at bedtime to reduce dizziness 

• Can be taken with or without food 

• Try to take it at the same time each day 

Can you stop taking enalapril?

Do not stop taking enalapril without speaking to your doctor or pharmacist. Stopping suddenly may cause your blood pressure to rise or your heart failure to worsen. It is usually a long-term treatment[1]. 

What do you do if you take too much enalapril?

Taking too much enalapril can cause dizziness, sleepiness, or a  or a pounding heartbeat. If this happens, call 111 or go to A&E immediately and take the medication packaging with you[1]. 

What do you do if you forget to take enalapril?

If you miss a dose, skip the missed dose and take the next one at the usual time. Do not double your dose at the same time to make up for a missed one[1]. 

How should I store enalapril?

Store at room temperature in the original package and out of the reach of children. Only use before the expiry date shown on the blister pack or packaging[1].  

What medicines can’t you take with enalapril?

Enalapril can interact with certain medicines. You should avoid or use caution with[1]: 

• NSAIDs (e.g., ibuprofen) – may reduce effectiveness 

• Potassium supplements or potassium-sparing diuretics – risk of high potassium levels 

• Lithium – increased risk of toxicity 

• Other blood pressure medications – may cause low blood pressure 

• Diabetes medications – may enhance their effect 

• Aliskiren – especially if you have diabetes or kidney issues  

• Angiotensin II receptor blockers (ARB) or other ACE inhibitors 

• Allopurinol – increased risk of reactions 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of enalapril?

Common side effects include[1]: 

• Dizziness or light-headedness 

• Persistent dry cough 

• Headache 

• Fatigue 

• Nausea 

Serious side effects include[1]: 

• Swelling of the face, lips, or throat (angioedema) 

• Fainting or very low blood pressure 

• Irregular heartbeat 

• Signs of kidney problems (e.g., reduced urination) 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

 If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about enalapril

How long does enalapril take to work? 
It starts lowering blood pressure within hours, but full benefits may take weeks[1]. 

Can I drink alcohol while taking enalapril? 
Yes, but alcohol may increase the risk of dizziness or light-headedness[1]. 

Will I have to take it forever? 
Often yes, especially for blood pressure or heart failure management[1]. 

What if I get a cough while taking enalapril? 
Speak to your doctor or pharmacist – it may be a side effect of the medicine[1]. 

Can I take enalapril during pregnancy? 
No – enalapril can harm the baby in all stages of pregnancy[1]. 

Can I take herbal supplements with enalapril? 
Check with your doctor or pharmacist first – some supplements may interact with enalapril[1]. 

Is it safe for children? 
Yes, but only under specialist supervision[1]. 

Can enalapril affect my kidneys? 
Yes – regular blood tests are needed to monitor kidney function[1]. 

What if I feel dizzy? 
Lie down until the dizziness passes – it’s common when starting enalapril[1]. 

For the official NHS guide for enalapril, visit their website.