enalapril
Brand names: Vasotec
Enalapril (Vasotec) is a medicine that lowers blood pressure and helps treat heart failure. It belongs to a class of drugs called ACE inhibitors.
Drug Pricing (NADAC)
Generic Price
$1.33/unit
Generic Available
Yes (15 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Enalapril is used to treat high blood pressure.
Common side effects
Headache, Dizziness, Fatigue
Key warnings
This drug can harm your unborn baby.
How It Works
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.
How to Take It
If you take water pills, your doctor might have you stop them for 2-3 days before starting enalapril. The usual starting dose is 5 mg once a day if you don't take water pills. Your doctor will adjust your dose based on how your blood pressure responds. The usual dose is 10 mg to 40 mg per day, taken as one dose or two divided doses.
Pregnancy & Breastfeeding
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.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store at room temperature (68° to 77°F). Keep the container tightly closed and protect from moisture.
Side Effects (from patient reports)
Based on 23,317 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 54,355 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2002–2025.
Total Reports
54,355
Death-Related Reports
5,908
Hospitalization Reports
26,280
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DIARRHOEA | 2,807 |
| 2 | DYSPNOEA | 2,659 |
| 3 | NAUSEA | 2,574 |
| 4 | DRUG INEFFECTIVE | 2,548 |
| 5 | FATIGUE | 2,377 |
| 6 | DRUG INTERACTION | 2,336 |
| 7 | DIZZINESS | 2,213 |
| 8 | ACUTE KIDNEY INJURY | 2,007 |
| 9 | VOMITING | 1,988 |
| 10 | HEADACHE | 1,819 |
| 11 | PAIN | 1,805 |
| 12 | ASTHENIA | 1,755 |
| 13 | HYPERTENSION | 1,695 |
| 14 | OFF LABEL USE | 1,695 |
| 15 | MALAISE | 1,673 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
This drug can harm your unborn baby. Stop taking enalapril as soon as you know you are pregnant.
Known Drug Interactions
Dual Blockade of the Renin-Angiotensin System (RAS) Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Do not coadminister aliskiren with enalapril maleate in patients with diabetes. Avoid use of aliskiren with enalapril maleate in patients with renal impairment (GFR <60 mL/min).
Mechanism: Both drugs work on the same system to lower blood pressure, which can lead to dangerously low blood pressure or kidney damage.
What to do: Avoid taking these together if you have diabetes or kidney disease, as it can be harmful.
Potassium-sparing diuretics (e.g., spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium.
Mechanism: Both of these medications can cause your body to hold onto potassium instead of flushing it out. This can lead to dangerously high levels of potassium in your blood.
What to do: Your doctor will need to check your blood potassium levels frequently to ensure they stay in a safe range.
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.
Mechanism: 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.
What to do: These drugs are generally safe to take together, but you should still watch for signs of very low blood pressure like dizziness.
Lithium Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs which cause elimination of sodium, including ACE inhibitors. A few cases of lithium toxicity have been reported in patients receiving concomitant enalapril maleate and lithium and were reversible upon discontinuation of both drugs. It is recommended that serum lithium levels be monitored frequently if enalapril is administered concomitantly with lithium.
Mechanism: Enalapril can cause your body to lose sodium, which makes it harder for your kidneys to get rid of lithium. This can cause lithium to build up to toxic levels in your blood.
What to do: Your doctor should check your lithium blood levels often to prevent them from getting too high.
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.
Mechanism: Both drugs are used to lower blood pressure, but studies show they do not cause harmful interactions when taken together.
What to do: You can take these medications together, but your doctor will likely monitor your blood pressure to ensure it stays in a healthy range.
Common Questions
Can I take enalapril with other medications?
What should I do if I feel dizzy after taking enalapril?
Can I drink alcohol while taking enalapril?
How long does it take for enalapril to start working?
Can I stop taking enalapril if I feel better?
Does enalapril affect my kidneys?
Can enalapril cause a cough?
Are there any foods I should avoid while taking enalapril?
What if I have swelling in my face, tongue, or throat?
Can I take enalapril if I have diabetes?
What are the common side effects of enalapril?
Does enalapril interact with other medications?
What drug class is enalapril?
Is enalapril safe during pregnancy?
Has enalapril been recalled?
Active Recalls
CGMP Deviations
Golden State Medical Supply Inc.
CGMP Deviations
Golden State Medical Supply Inc.
CGMP Deviations
Golden State Medical Supply Inc.
Related Medications in ACE Inhibitor
Other drugs grouped near enalapril — same-class peers and common alternatives.
acebutolol
Sectral
Acebutolol is a medicine that helps lower blood pressure and control irregular heartbeats.
Compare with enalapril →
aliskiren
Tekturna
Tekturna is a medicine used to treat high blood pressure.
Compare with enalapril →
amiloride
Midamor
Amiloride is a water pill that helps your body hold onto potassium.
Compare with enalapril →
amlodipine
Norvasc
Amlodipine (Norvasc) is a drug that lowers blood pressure and treats chest pain.
Compare with enalapril →
amlodipine/benazepril
Lotrel
Lotrel is a combination medicine that contains amlodipine and benazepril.
Compare with enalapril →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
Related Health & Safety Data
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What the FDA Data Shows for enalapril
The FDA label for enalapril (sold under brand names such as Vasotec) classifies it as a prescription-only medication in the ACE Inhibitor class. Enalapril is used to treat high blood pressure. Official labeling lists 4 commonly reported side effects, including Headache, Dizziness, Fatigue.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 23,317 voluntary reports. The database also lists 16 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $1.33.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 3 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: October 9, 2023
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages