Vasotec (Enalapril) - Oral

Warning:

Enalapril can be toxic to a developing fetus, potentially causing injury or even death. Don't take enalapril if you are pregnant. If you become pregnant while taking this medicine, immediately stop taking it and report to your healthcare provider.

What Is Vasotec?

Vasotec (enalapril) is a prescription medication used alone or in combination with other medications to treat high blood pressure, also known as hypertension. It belongs to the angiotensin-converting enzyme (ACE) inhibitor drug class.

Vasotec contains the active drug enalapril. It works on the renin-angiotensin-aldosterone system to lower blood pressure. Enalapril decreases the chemicals that tighten blood vessels, causing the blood vessels to relax. This action improves the blood flow and makes it easier for the heart to circulate blood efficiently.

Enalapril is available under the brand names Vasotec (in tablet form) and Epaned (as an oral solution). It is also available as a generic drug.

Drug Facts

Generic Name: Enalapril

Brand Name(s): Vasotec, Epaned

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antihypertensive

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Enalapril maleate

Dosage Form(s): Tablet, solution (liquid)

What Is Vasotec Used For?

Vasotec is indicated to treat high blood pressure as monotherapy (by itself) or in combination with other blood pressure lowering drugs. Lowering high blood pressure helps prevent:

This medication is sometimes combined with drugs such as diuretics (also known as water pills) and digitalis (another medication used for heart conditions) to treat congestive heart failure. Vasotec also helps prevent heart failure due to a heart problem called left ventricular dysfunction. In this type of heart failure, the left side of the heart must work harder to pump the same amount of blood to the rest of the body.

Vasotec (Enalapril) Drug Information: A person standing with areas affected

Verywell / Dennis Madamba

How to Take Vasotec

Before taking enalapril, read your prescription label and talk to your healthcare provider if you have any questions or concerns.

Vasotec is available as an immediate and extended-release (long-acting) oral tablet.  Take one tablet once or twice a day, with or without food, exactly as your healthcare provider prescribes. Do not take more, less, or more often than prescribed.

If taking the solution form (Epaned), shake the bottle well each time before use. Accurately measure the dose with a measuring device or spoon provided. Do not use a household spoon, which can result in incorrect dose measurement. The dosing schedule for the solution is usually once daily for high blood pressure and twice daily for heart failure.

Children may start at a lower dose than adults. Talk to the child's healthcare provider about the correct dosage if you are a parent or caregiver.

Take the medication around the same time(s) every day to help you adhere to your regimen. Your healthcare provider may start you on a low dose and gradually increase it. Continue to take it even if you feel better; do not stop the medication without asking your healthcare provider.

Storage

Keep the tablets in a well-closed container. Store at room temperature (around 68 degrees F) away from light, heat, and moisture. Do not store it in the bathroom. Keep all medications locked out of the sight and reach of children.

Store the solution in its container with a tightly closed lid, away from moisture, at 77 degrees F. Do not store it in the bathroom or freeze it.

Do not keep unwanted or expired medications with you. Never throw medicines in a waste bin or flush down the toilet unless instructed. Instead, the most suitable way to dispose of unwanted medication is through a medicine take-back program. Contact your pharmacist or local waste disposal company in your community.

Off-Label Uses

A healthcare provider may prescribe off-label treatments when the decision is supported by scientific evidence or expert clinical experience.

Enalapril may be prescribed for some off-label uses, such as:

  • Heart failure in adolescents, children, and infants
  • Post-transplant erythrocytosis (increased number of red blood cells)
  • Proteinuric chronic kidney disease (loss of excessive protein when you urinate)
  • Stable coronary artery disease
  • To control abnormal heart rhythms after a heart attack
  • Migraine prevention
  • Raynaud’s phenomenon (a disease in which areas such as fingers and toes feel numb and cold in cold temperatures or when under stress)

How Long Does Vasotec Take to Work?

Enalapril starts to lower hypertension within a few hours, but it may take a few weeks to show its full effect. Taking enalapril for heart failure may take several weeks before you feel any improvement.

What Are the Side Effects of Vasotec?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Vasotec may cause some side effects, such as:

  • Cough
  • Dizziness
  • Fatigue
  • Headache
  • Rash
  • Weakness

These side effects are not severe and do not need medical attention. However, contact your healthcare provider or pharmacist if the symptoms are severe or do not go away.

Severe Side Effects

Vasotec may cause some severe side effects. Call your healthcare provider right away if you have:

  • Lightheadedness
  • Chest pain
  • Change in amount of or no urination
  • Flu-like symptoms, such as fever, chills, or sore throat
  • High potassium (hyperkalemia): Symptoms can include nausea, weakness, tingly feeling, and irregular heartbeat.
  • Jaundice (yellowing of the skin and whites of the eyes)

Get emergency medical help if you have signs of an allergic reaction to enalapril, which can include swelling of the face, throat, tongue, or lips and difficulty breathing or swallowing.

Report Side Effects

Vasotec may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Modifications

Dose modifications (changes) may be necessary for people older than 65 or those with kidney impairment.

This medication also comes in two oral forms: a tablet (Vasotec) and a solution (Epaned). The solution version may be better for children and people who have difficulty swallowing tablets.

Enalapril can also be given intravenously (directly into the vein).

Missed Dose

If you missed a dose, take it as soon as you remember. Leave the missed one if it is nearly the time for your next dose. Take the following doses at the regular time. Don't take two doses at a time to make up for the missed one.

Overdose: What Happens If I Take Too Much Vasotec?

Overdose data on enalapril is limited in humans. However, it is expected that an overdose would cause hypotension (too low blood pressure).

Symptoms of hypotension include:

  • Dizziness
  • Lightheadedness
  • Tiredness
  • Weakness
  • Blurry vision
  • Confusion
  • Fainting or feeling faint

What Happens If I Overdose on Vasotec?

If you think you or someone else may have overdosed on Vasotec, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Vasotec, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

You should not use this medicine together with sacubitril. Do not use this medicine and sacubitril/valsartan (Entresto®) within 36 hours of each other.

This medicine may cause serious allergic reactions, including anaphylaxis. This can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of a condition called intestinal angioedema.

Dizziness, lightheadedness, or fainting may also occur, especially when you get up from a lying or sitting position or if you have been taking a diuretic (water pill). Do not drive or do anything else that could be dangerous until you or your child know how this medicine affects you. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. You can also lose water by sweating, so drink plenty of water during exercise or in hot weather.

Check with your doctor if you have a fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cells.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have the following symptoms: abdominal or stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, shortness of breath, or weakness or heaviness of the legs. Do not use supplements or salt substitutes containing potassium without first checking with your doctor.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, troubled breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Vasotec?

It is not recommended to use Vasotec:

  • With aliskiren-containing products (e.g., certain blood pressure medications, such as Tekturna) in people with diabetes or kidney impairment
  • If you are hypersensitive to enalapril or any of the ingredients in the tablet
  • If you have a history of angioedema (short-lived swelling in the deeper layers of the skin) associated with previous treatment with ACE inhibitor drugs
  • Have idiopathic or hereditary angioedema (swelling of the lower layer of tissue under the skin or mucous membranes)
  • During pregnancy or while breastfeeding
  • With Entresto (sacubitril and valsartan) therapy: Vasotec must be initiated more than 36 hours after the last dose of sacubitril and valsartan.

What Other Medications Interact With Vasotec?

Tell your healthcare provider about all the medications you take before starting the treatment with Vasotec. Many drugs can interact with enalapril, including:

This may not be a complete list of drugs or supplements that interact with Vasotec. Consult your healthcare provider for more information on potential interactions.

What Medications Are Similar?

Other ACE inhibitors include:

The choice of a specific ACE inhibitor drug depends on various factors. Studies have examined the efficacy and safety differences between many of these drugs.

Compared with other ACE inhibitors (e.g., captopril, lisinopril, ramipril, trandolapril, or combinations of these), enalapril appeared to be most effective in treating heart failure. However, it was also associated with the highest incidence of cough, declining kidney function, and gastrointestinal discomfort.

Other findings suggested:

  • Lisinopril is associated with a higher rate of all-cause mortality (death from any cause) compared with a placebo or ramipril.
  • Lisinopril was the least effective in lowering systolic and diastolic blood pressure.
  • Ramipril was associated with the lowest incidence of all-cause mortality.

Your healthcare provider will likely consider many factors when deciding which treatment is the best for you and your health.

How Can I Stay Healthy While Taking Vasotec?

Hypertension is a growing challenge for health care systems. ACE inhibitors are a drug of choice and a mainstay for high blood pressure and heart failure treatment. However, there is a wide array of ACE inhibitor options to choose from. Enalapril is a commonly used ACE inhibitor and a well-tolerated option.

When taking Vasotec, keep the following in mind:

  • Dizziness can occur, so try to avoid moving too quickly to a standing position from lying or sitting down.
  • Drink adequate fluids and avoid overheating or dehydrating during exercise or in hot temperatures.
  • Don't drink alcohol as it can lower your blood pressure and enhance enalapril's side effects.
  • Do not use potassium supplements unless advised.
  • Keep up with your regular medical appointments and lab tests.

Along with medical treatment, lifestyle changes such as a healthy diet, exercise, quitting smoking, and reducing stress can help lead to a healthy life.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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