Enalapril

What is enalapril?

Enalapril has many different effects on your body, so is used to treat a range of conditions. It belongs to a group of medicines called ACE inhibitors.

Enalapril may be used for the following conditions:

• High blood pressure – by relaxing and widening your blood vessels it lowers your blood pressure.
• Heart failure – to help your heart pump blood more easily. This can help to relieve symptoms such as shortness of breath and swelling in your feet, legs and abdomen (tummy).
• Diabetic kidney disease (diabetic nephropathy) – to protect your kidneys and help them to function.

Enalapril can work quickly for hypertension (high blood pressure). If you have heart failure it may be a few weeks before you notice an improvement in your symptoms. Once you have started enalapril you usually keep taking it for life, unless you have a serious side effect. In New Zealand enalapril is available as tablets.

Dose

Enalapril tablets are available in different strengths: 5 mg, 10 mg and 20 mg. 

• Your doctor will tell you the dose that is right for you.
• Your dose of enalapril will depend on what it is being used for.
• Your doctor will usually start you on a low dose and increase the dose depending on how you respond. This allows your body to get used to the medicine and reduces side effects.
• Enalapril is usually taken once a day.
• Always take your enalapril exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.
• Check with your pharmacist if your tablets are different to what you expect.

My dose

How to take enalapril

• Timing: Enalapril is usually taken once a day. Take your enalapril dose at the same time each day. It is best taken in the morning. You can take enalapril with or without food.
• Limit or avoid alcohol while you are taking enalapril. Alcohol can increase your chance of side effects such as dizziness and light-headedness.
• Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.

Cautions while you are taking enalapril

Have a sick day plan

If you have diarrhoea (runny poo) or are vomiting (being sick) from a stomach bug, or have dehydration from other causes, it’s important to let your GP know, as they may advise you to stop taking your enalapril for a few days and start again when you feel better. 

Be careful when taking some pain relief medicines

ACE inhibitors can be used to protect your kidneys from damage if you have diabetes. However, if you are taking enalapril and diuretics (water pills), the combination of these with NSAIDs (anti-inflammatory pain relief medicines) can be very harmful to your kidneys. It can cause acute kidney injury. This combination is called the ‘dangerous trio’ or ‘triple whammy’. You have a higher risk of harm to your kidneys if you are also an older adult (over 65 years) or are dehydrated. 

If you are taking an ACE inhibitor with a diuretic, do not use NSAIDs for pain relief. Ask your doctor or pharmacist for a safer option. Read more about NSAIDs and protecting your kidneys.

Are you pregnant or planning a pregnancy?

Tell your doctor if you become pregnant or are planning a pregnancy while you are taking enalapril.

Side effects

Like all medicines enalapril can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Interactions

• Enalapril interacts with a few medicines and herbal supplements, so check with your doctor or pharmacist before starting enalapril and before starting any new medicines.
• Also, check with your pharmacist before taking over-the-counter medicines, including:
  • anti-inflammatories such as diclofenac (eg, Voltaren Rapid)
  • ibuprofen (eg, Nurofen)
  • naproxen (eg, Naprogesic).

Learn more

The following links provide more information on enalapril.

Enalapril (Māori) NZ Formulary Patient Information
Acetec, Renitec Medsafe Consumer Information, NZ

Reference

1. Enalapril New Zealand Formulary