enalapril maleate at a glance
Medicine class
ACE inhibitor
Main roles
High blood pressure, heart failure and prevention of symptomatic heart failure in selected people with left-ventricular dysfunction
Food
May be taken with or without food
Routine checks
Blood pressure, kidney function, potassium and sodium
What is enalapril maleate used for?
Licensed uses vary by product and formulation.
Tablets and oral solution: hypertension, symptomatic heart failure, and prevention of symptomatic heart failure in people with asymptomatic left-ventricular dysfunction.
Aqumeldi orodispersible tablets: heart failure in children from birth to under 18 years.
How does enalapril maleate work?
Enalapril is converted to enalaprilat, which inhibits ACE. This reduces angiotensin II and aldosterone activity, relaxing blood vessels, lowering blood pressure and reducing the heart's workload.
enalapril maleate preparations and strengths
Dispersible tablet
Route: Oral
Strengths: 0.25 mg, 1 mg
Oral solution
Route: Oral
Strengths: 5 mg/5 mL
Tablet
Route: Oral
Strengths: 2.5 mg, 5 mg, 10 mg, 20 mg
How to take enalapril maleate
Follow the dispensing label and product instructions. It may be taken with or without food.
Swallow standard tablets with water. A score line may only help swallowing rather than provide equal portions; check the leaflet.
Measure oral solution with the supplied device, not a household spoon.
Allow Aqumeldi to disperse on the tongue or inside the cheek. Follow its specific instructions for feeding-tube administration.
If dizziness occurs, avoid driving, cycling or machinery until it resolves.
enalapril maleate side effects
Common or expected effects
- Dizziness, particularly when standing
- Persistent dry cough
- Headache or blurred vision
- Nausea, vomiting or diarrhoea
- Taste changes
- Low blood pressure
- Raised potassium or altered kidney-function tests
Get urgent medical advice
- Swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing
- Collapse or severe symptomatic low blood pressure
- Markedly reduced urine or other signs of acute kidney problems
- Yellow skin or eyes, dark urine or pale stools
- Severe skin blistering or peeling
- Unexplained fever, sore throat or infection suggesting a blood-cell disorder
enalapril maleate in pregnancy
Enalapril is generally avoided during pregnancy and is contraindicated during the second and third trimesters because ACE inhibitors can harm fetal kidney development. Request a treatment review when planning pregnancy. If pregnancy occurs, contact the prescriber promptly.
enalapril maleate while breastfeeding
UK specialist guidance considers enalapril the preferred ACE inhibitor when one is needed during breastfeeding. This applies to full-term, healthy infants. Seek specialist advice for premature, newborn or unwell infants, and monitor for poor feeding, unusual sleepiness, pallor, poor weight gain or fewer wet nappies.
enalapril maleate interactions
Check prescribed, over-the-counter and complementary products with a pharmacist or prescriber. Important interactions include:
Sacubitril/valsartan
Using these together is contraindicated because it substantially increases angioedema risk.
Potassium supplements, potassium salt substitutes and potassium-sparing diuretics
These can cause dangerous hyperkalaemia.
Trimethoprim or co-trimoxazole
These may raise potassium further.
Common questions about enalapril maleate
Answers are fully visible for fast scanning and source review.
Can enalapril maleate be taken with food?
Yes. It may be taken with or without food.
Why can it cause a dry cough?
ACE inhibition reduces bradykinin breakdown, which may contribute to a persistent dry cough.
What blood tests are needed?
Kidney function, potassium and sodium are checked before treatment, after starting or changing treatment, and periodically thereafter.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.