Enalapril typically begins to lower high blood pressure  within a few hours of taking it, but its full effects may not be felt for several weeks. Similarly, if prescribed for heart failure, improvement may take weeks or even months. Initial doses of enalapril may cause dizziness, so it’s advisable to take it at bedtime. Subsequent doses can be taken at any time of day if dizziness doesn’t occur. Some individuals may experience a dry, tickly cough with enalapril. If severe diarrhoea or vomiting occurs due to illness, it’s important to inform your doctor, as temporarily stopping  enalapril might be necessary until symptoms improve. Additionally, drinking alcohol with enalapril can make you feel dizzy or light-headed, so it’s best to exercise caution when consuming alcohol while on this medication.

Enalapril is generally suitable for most adults and children. However, if you have diabetes, it’s important to monitor your blood sugar levels more frequently, especially during the initial weeks of taking enalapril, as it can lower blood sugar levels.

Despite its wide usage, enalapril may not be suitable for everyone. To ensure safety, it’s essential to inform your doctor if you have had an allergic reaction to enalapril or any other medication in the past, if you are pregnant, breastfeeding, or trying to conceive, if you are undergoing dialysis or any other blood filtration procedure, if you have heart, liver, or kidney issues, if you have unstable or low blood pressure, if you have diabetes, if you are scheduled for major surgery or general anaesthetic, if you’ve recently experienced diarrhoea or vomiting, if you are on a low-salt diet, if you are planning desensitisation treatment for insect sting allergies, or if you have any blood disorders such as neutropenia or agranulocytosis. This comprehensive information helps your doctor determine whether enalapril is appropriate for your  specific medical condition and circumstances. For further details refer to the Patient Information Leaflet.

Your prescribed dosage of enalapril will vary depending on the purpose of your treatment. It’s crucial to adhere to your doctor’s instructions regarding dosage. To determine the appropriate dosage, your doctor will assess your blood pressure  and enquire about any potential side affects you may be experiencing. Additionally, blood tests may be conducted to evaluate kidney function and potassium levels in your blood. Typically, for adults, the initial dose ranges between 2.5mg and 5mg once daily, with gradual adjustments over several weeks. The usual maintenance dose for high blood pressure is 10mg daily, while for heart failure, it may be 10mg twice daily or 20mg once daily. The maximum daily dose is 40mg, administered either as a single dose or in divided doses. Dosages are generally lower for children and individuals with kidney issues, with adjustments based on age, weight, and the specific medical condition requiring treatment. Your doctor will carefully determine the appropriate enalapril dosage tailored to your individual needs or those of your child.

Enalapril, like all medicines, can potentially induce side effects in some individuals, although many experience either no side effects or only minor ones. Often, side effects diminish as the body adjusts to the medication. Common side effects of enalapril, occurring in more than 1 in 100 people, are typically mild and transient. These include a dry, tickly cough, dizziness, headaches, diarrhoea, itching, mild rash, and blurred vision. While there are strategies to manage these effects, such as staying hydrated or adjusting posture slowly to reduce dizziness, it’s essential to consult a doctor or pharmacist if these measures are ineffective or if side effects persist. On the other hand, some individuals may experience more severe side effects after taking enalapril. It’s important to seek medical attention immediately by contacting a doctor or calling 111 if any of the following serious side effects occur: Yellowing of the whites of the eyes or skin, which could indicate liver problems. Unusual paleness, fatigue, faintness, dizziness, signs of bleeding (such as bleeding gums or increased bruising), sore throat, high temperature, or increased susceptibility to infections, which could be indicative of a blood or bone marrow disorder. Severe abdominal pain that may radiate to the back, which could indicate pancreatitis. Swollen ankles, presence of blood in urine, or absence of urine output, which could indicate kidney problems. Monitoring and addressing any side effects promptly ensures the safe and effective use of enalapril. For further details and a full list of side effects consult your doctor.

Enalapril is not recommended during pregnancy due to its potential to reduce the level of amniotic fluid around the baby, particularly if taken during the second and third trimesters. This reduction can lead to long-term damage to the baby’s kidneys and lungs, among other complications. If you discover you are pregnant while taking enalapril, it’s crucial to cease the medication immediately and consult your doctor for an alternative treatment that is safe during pregnancy. Typically, enalapril should be discontinued by the 12th week of pregnancy. Contraception should be used while taking enalapril, and any plans for pregnancy should be discussed thoroughly with your doctor or a specialist to assess your condition and medication before conception. While most women stop taking enalapril before becoming pregnant, some may continue until they receive a positive pregnancy test, followed by cessation under medical guidance based on individual circumstances and the risks and benefits of enalapril.

Regarding breastfeeding, it’s generally considered safe to take enalapril, but consulting with your doctor or pharmacist is advisable, especially if your baby was born prematurely. While only minimal amounts of enalapril are excreted into breast milk, causing unlikely side effects in the baby, there is a small risk of lowering the baby’s blood pressure. If you notice any changes in your baby’s feeding behaviour, unusual sleepiness, paleness, or have other concerns, prompt consultation with a healthcare professional is recommended.

Regarding fertility, there’s no conclusive evidence suggesting that enalapril affects fertility in either men or women. However, if attempting to conceive, it’s advisable to discuss your treatment plan with a pharmacist or doctor for a comprehensive review.