What it does
Enalapril is a medication that helps lower blood pressure and improve heart function.
Commonly used for: high blood pressure (hypertension), heart failure
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Source: Pharmacy and Medicines Regulatory Authority · fetched 2026-04-21 17:37:38 · updated 2026-09-29 04:33:04
About this medicine
Enalapril is a medication that helps lower blood pressure and improve heart function.
What it treats
- high blood pressure (hypertension)
- heart failure
How it works
Enalapril works by relaxing blood vessels, which makes it easier for the heart to pump blood and helps lower blood pressure.
Who it's for
Enalapril is for adults who have high blood pressure or certain heart conditions.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: enalarpril
Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used primarily for the treatment of hypertension and heart failure. It works by relaxing blood vessels, which reduces blood pressure and decreases the workload on the heart. Enalapril is a prodrug that is converted to its active form, enalaprilat, in the body.
Indications
- Hypertension
- Heart failure
- Left ventricular dysfunction following myocardial infarction
Dosage
Children: Refer to the BNF for Children for appropriate pediatric dosing guidelines.
Adults: Refer to the BNF for specific dosing recommendations based on individual patient factors.
Mechanism of action
Enalapril inhibits the angiotensin-converting enzyme, which is responsible for the conversion of angiotensin I to angiotensin II, a powerful vasoconstrictor. By reducing the levels of angiotensin II, enalapril causes vasodilation, leading to decreased blood pressure and reduced strain on the heart muscle. Additionally, it decreases aldosterone secretion, which results in reduced sodium and water retention.
Pharmacodynamics
Enalapril demonstrates a dose-dependent effect on blood pressure reduction. The antihypertensive effect begins within one hour of administration, reaches a peak at 4 to 6 hours, and may last for up to 24 hours. It has been shown to improve symptoms and reduce morbidity and mortality in patients with heart failure.
Pharmacokinetics
Enalapril is well absorbed after oral administration, with a bioavailability of approximately 60%. It undergoes hepatic metabolism to form the active metabolite enalaprilat. The drug is primarily excreted via the kidneys, with a half-life of approximately 11 hours. Renal function significantly affects the pharmacokinetics of enalapril, necessitating dose adjustments in patients with renal impairment.
Contra-indications
- History of hypersensitivity to enalapril or any component of the formulation
- History of angioedema related to previous ACE inhibitor therapy
- Severe renal impairment (creatinine clearance < 30 mL/min)
- Pregnancy and lactation
Adverse effects
- Cough
- Hyperkalemia
- Hypotension
- Angioedema
- Renal impairment
- Dizziness
- Fatigue
Interactions
- Potassium-sparing diuretics or potassium supplements may increase the risk of hyperkalemia
- Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effect
- Lithium levels may increase due to reduced renal clearance when used concurrently
- Other antihypertensive medications may increase the risk of hypotension
Precautions
- Monitor renal function, especially in patients with renal impairment or those on diuretics
- Use with caution in patients with aortic stenosis or hypertrophic cardiomyopathy
- Assess for a history of angioedema before initiation
- Caution in patients with a history of heart failure or electrolyte imbalances
Pregnancy
Enalapril is contraindicated in pregnancy due to risks of fetal harm, particularly during the second and third trimesters.
Breast-feeding
Enalapril is excreted in breast milk; caution is advised when administered to nursing mothers.
Storage
Store in a cool, dry place away from light. Keep out of reach of children.
Formulations
- Tablets of 2.5 mg, 5 mg, 10 mg, and 20 mg
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.