enalapril vs hydralazine
Side-by-side comparison of enalapril and hydralazine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
Other Cardiovascular Agents Enalapril maleate has been used concomitantly with beta adrenergic-blocking agents, methyldopa, nitrates, calcium-blocking agents, hydralazine, prazosin and digoxin without evidence of clinically significant adverse interactions.
Recommendation: These drugs are generally safe to take together, but you should still watch for signs of very low blood pressure like dizziness.
Vasotec
Apresoline
Enalapril (Vasotec) is a medicine that lowers blood pressure and helps treat heart failure. It belongs to a class of drugs called ACE inhibitors.
Hydralazine is a drug that lowers blood pressure by relaxing blood vessels. It can be used alone or with other medications.
Enalapril is used to treat high blood pressure. It can be used alone or with other blood pressure medicines, like water pills. Enalapril also treats symptomatic congestive heart failure, usually with other medicines. It can also help clinically stable patients with left ventricular dysfunction.
Hydralazine is used to treat high blood pressure (hypertension). It can be used by itself or with other blood pressure medicines. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
Enalapril blocks a substance in your body that tightens blood vessels. This helps your blood vessels relax and widens them. As a result, blood pressure is lowered, and blood can flow more easily.
Hydralazine works by relaxing the muscles in your blood vessels. This allows blood to flow more easily. As a result, your blood pressure goes down.
- • Headache
- • Dizziness
- • Fatigue
- • Cough
- • Headache
- • Loss of appetite
- • Nausea
- • Vomiting
- • Diarrhea
- Diarrhea 2,806
- Difficulty breathing 2,659
- Feeling sick to your stomach 2,571
- Tiredness 2,374
- Medicine interfering with another medicine 2,337
- Long-term kidney disease 2,819
- Sudden kidney damage 2,616
- Kidney failure 2,097
- Final stage of kidney failure 1,585
- Tiredness 1,541
This drug can harm your unborn baby. Stop taking enalapril as soon as you know you are pregnant.
Taking high doses of hydralazine can cause a drug-induced lupus erythematosus (L.E.) cell syndrome. Your doctor will monitor your dose to avoid this.
Do not take enalapril if you are pregnant because it can cause harm or death to the developing fetus. Talk to your doctor about safe alternatives if you are breastfeeding.
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if hydralazine will harm an unborn baby. Talk to your doctor about the risks and benefits of taking hydralazine during pregnancy or while breastfeeding.
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How to Read This enalapril vs hydralazine Comparison
enalapril is classified in the ACE Inhibitor drug class, while hydralazine sits within the Vasodilator class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, enalapril has 12,747 submissions while hydralazine has 10,658. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to these two blood pressure medicines work in different ways to relax your blood vessels and have not been shown to cause harmful interactions when used together.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between enalapril and hydralazine - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.