Meds and you

Updated 11 February 2013


Enalapril is an angiotensin-converting enzyme inhibitor prescribed for the treatment of high blood pressure and congestive heart failure.


Enalapril is the active ingredient of Adco-Enalapril, Alapren, Ciplatec, Enap, HR-Enalapril Maleate, Pharmapress and Renitec.

Enalapril is also one of multiple active ingredients found in Co-Renitec, Enap-Co and Pharmapress Co (enalapril + hydrochlorothiazide).

General information

Enalapril is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the treatment of high blood pressure and congestive heart failure, a condition where the heart battles to cope with its workload. It causes blood vessels to relax and widen, thereby reducing high blood pressure.

This medication is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective you must take it regularly - high blood pressure declines slowly and it may take a few weeks to reach full effect. Keep taking this medicine even if you are feeling better or fail to notice any improvement.

Enalapril can be used on its own, or in combination with certain other medications for high blood pressure. It is often effectively combined with diuretics - in black patients enalapril is significantly less effective if not prescribed together with a diuretic.

The first couple of doses may cause a sudden drop in blood pressure which may cause dizziness or blackouts when you suddenly get up. It is therefore advised to be resting when starting treatment, and to lie down for 2 hours afterwards.

The use of enalapril is often associated with a dry and persistent cough. Should this develop while you are being treated with this drug, contact your doctor.

Enalapril should be avoided during pregnancy, especially the second and third trimester. Speak to your doctor if you are planning to get pregnant, as it may cause harm to the unborn baby.

How does enalapril work?

Enalapril works by preventing the conversion of angiotensin I, a chemical in your blood, to a more powerful version, angiotensin II. Angiotensin II has a narrowing effect on blood vessels, thereby increasing blood pressure. Angiotensin II furthermore stimulates the production of aldosterone, a hormone which promotes salt (sodium) retention in the body, an action which increases blood pressure.

By inhibiting the forming of angiotensin II, enalapril lowers blood pressure and decreases the workload on the heart.

Fast facts

Drug schedule: Schedule 3

Available as: Tablets

What does it do? Lowers blood pressure

Overdose risk: Medium

Dependence risk: Low

Available as a generic? Yes

Available on prescription only? Yes

User information

Dietary advice: Enalapril can be taken with or without food. It is advised to follow a low-potassium diet, avoiding foods such as tomatoes and bananas.

Stopping: Suddenly stopping the drug may cause your blood pressure to increase dangerously. Use as prescribed by your doctor, and do not discontinue treatment without consultation. Dosage should be deceased gradually as directed by your doctor.

Prolonged use: No problems are expected. Your doctor may perform periodic tests of blood and urine should the need arise.

Special precautions

Alert your doctor before using this drug if:

  • You have a kidney disease,
  • You have a heart condition of which your doctor is not aware,
  • You are allergic to ACE-inhibitor drugs,
  • You are taking other medication, or
  • You are pregnant or planning to become pregnant.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Dosage may need to be adjusted according to kidney function and other medical conditions.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use of alcohol as it may worsen the possibility of dizziness.

Possible side effects

Side effect


Consult your doctor



Only if severe

In all cases







Dry cough









Loss of appetite



Rash/ itch



Muscle cramps



Swelling of face, lips, tongue or throat



Swelling of arms and legs



Difficulty swallowing



Abdominal pain with/without nausea/vomiting




Drug interactions


Possible allergic reactions


Enhanced blood pressure-lowering effect

Other medication for high blood pressure

Enhanced blood pressure-lowering effect


Increased risk of potassium toxicity


Effect on blood pressure is enhanced


Increased risk of lithium toxicity

Non-steroidal anti-inflammatory drugs

Effect on blood pressure is impaired

Potassium supplements

Increased risk of potassium toxicity


May increase blood pressure

Food interactions

It is advised to follow a low potassium diet, avoiding foods such as tomatoes and bananas.

Disease interactions

Consult your doctor before using this drug if you have a kidney disease, a heart condition of which your doctor is not aware, or if you are allergic to ACE-inhibitor drugs.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms of an overdose may include dizziness and/or fainting.

Recommended dosage

High blood pressure: 2.5-20mg/day as a single dose or in divided doses.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.


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