Enalapril Side Effects

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Enalapril Overview

Enalapril is an ACE inhibitor prescribed as an antihypertensive (high blood pressure) medication. It is also prescribed for heart failure, diabetic kidney disease, treatment of heart attack, kidney failure, and other related conditions, and to prevent a second stroke. Enalapril is sold under the brand name Vasotec, and in combination with other drugs under the brand names Vaseretic and Lexxel.

ACE inhibitors work by inhibiting angiotensin-converting enzyme (ACE), a major component of the body’s fluid balance and blood pressure regulation system. ACE produces a hormone called angiotensin II that constricts blood vessels, which in turn raises blood pressure. ACE inhibitors help lower blood pressure by preventing this hormone from being produced. Enalapril helps treat kidney disease by lowering blood pressure in the kidneys, and helps prevent stroke because high blood pressure in blood vessels of the brain is a known risk factor for some types of stroke.

The difference between enalapril and enalapril maleate is one of terminology. Enalapril is the active ingredient, but it is found together with maleate. In other words, it is a maleate salt (not related to table salt). Many drugs are actually salts, and their names may be given with or without the salt name.

Side Effects of Enalapril

The most common enalapril side effects include the following:

  • dizziness
  • fatigue
  • headache
  • cough for the first few days

Less common side effects of enalapril include the following:

  • chest tightness or chest pain
  • dizziness when changing body position
  • fainting
  • abdominal pain
  • nausea, vomiting, diarrhea
  • bronchitis or breathing difficulties
  • urinary tract infection
  • weakness

Warnings With Enalapril

A rare potential side effect of enalapril is swelling of the face. This swelling can be so severe that it affects the airway, making it difficult for the patient to breathe. This is a medical emergency.

Strenuous exercise and hot weather can cause dehydration, which lowers blood pressure. Together with enalapril, the total effect can be a blood pressure drop so severe that it is dangerous. Avoid extremely hot weather and heavy exercise while taking this medication.

Enalapril and Pregnancy

Enalapril is dangerous to the baby during pregnancy. When taken by pregnant women in the second or third trimesters, enalapril can cause fetal injury or death. Generally, women who may become pregnant should not use enalapril. This problem is characteristic of drugs that inhibit angiotensin II, including other ACE inhibitors and angiotensin II receptor antagonists like Benicar.


“Enalapril.” The Pill Book, 12th Edition, 2006. Harold M. Silverman, Pharm. D., Editor-in-Chief. New York: Bantam Books.