Enalapril: uses, dosing, side effects & brands
Enalapril is an angiotensin converting enzyme inhibitor sold in the U.S. under 4 brand and generic names, for rheumatoid arthritis, bartter syndrome and diabetic nephropathies. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Angiotensin Converting Enzyme Inhibitor
- Treats (across its forms)
- Rheumatoid Arthritis, Bartter Syndrome and Diabetic Nephropathies
- Available as
- Solution · Tablet
- Sold as
- 4 products — Enalapril Maleate, Epaned and Epaned Kit, and others
- Prescription?
- Prescription only
- Generic available?
- Yes
- What the pharmacy pays
- about $0.07 per ml — not your price
- Boxed warning
- Boxed warning
How Epaned is dosed
From the FDA label for Epaned (application NDA208686). Other enalapril products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Hypertension Adult: recommended initial dose is 5 mg once daily. Maximum dose is 40 mg daily ( 2.1 ). Pediatrics: recommended starting dose is 0.08 mg/kg (up to 5 mg) once daily ( 2.1 ). Heart Failure: Initiate at 2.5 mg twice daily. Titrate up to 20 mg twice daily as tolerated ( 2.2 ). Asymptomatic Left Ventricular Dysfunction: Initiate at 2.5 mg twice daily. Titrate up to 10 mg twice daily ( 2.3 ). Enalapril maleate oral solution is a ready-to-use solution intended for oral use only. 2.1 Hypertension Adults :The recommended initial dose in adults is 5 mg taken orally once a day. Titrate upward to maximum of 40 mg daily as needed to help achieve blood pressure goals. The dose may be divided and administered twice daily if the antihypertensive effect diminishes at the end of the dosing interval. Use with diuretics: If additional blood pressure reduction is needed, enalapril maleate may be administered with a low dose of diuretic. The recommended initial dose in patients taking diuretics is 2.5 mg daily. Dosage Adjustment for Renal Impairment: See table below. The dosage may be titrated upward as needed to a maximum of 40 mg daily. Renal Status Creatinine-Clearance mL/min Initial Dose mg/day Normal or Mild Impairment of Renal Function >30 mL/min 5 mg Moderate to Severe Impairment ≤30 mL/min 2.5 mg Dialysis Patients [See Warnings and Precautions ( 5.2)] . Should be taken after…
Everything below is the FDA label for Epaned (solution). Enalapril is also sold as tablet, and those are different medicines to take — follow the label for the one you were prescribed.
Epaned side effects
The following adverse reactions are described elsewhere: Angioedema [see Warnings and Precautions ( 5.2 )] Hypotension [see Warnings and Precautions ( 5.3 )] Hepatic failure [see Warnings and Precautions ( 5.4 )] Renal impairment [see Warnings and Precautions ( 5.5 )] Hyperkalemia [see Warnings and Precautions ( 5.6 )] The most common adverse reaction for patients treated for hypertension (≥3%) was fatigue ( 6.1 ). The most common adverse reactions for patients treated for heart failure (>6%) were hypotension and dizziness ( 6.1 ). To report SUSPECTED ADVERSE REACTIONS, contact Wilshire Pharmaceuticals, Inc. at 1-877-495-6856 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. Enalapril has been evaluated for safety in more than 10,000 patients, including over 1,000 patients treated for one year or more. In clinical trials, discontinuation of therapy for clinical adverse experiences was required in 3.3% of patients with hypertension and in 5.7% of patients with heart failure. Hypertension Adverse reactions (where rate on enalapril exceeds the rate on placebo by at least 0.2%)…
Who shouldn’t take Epaned
Enalapril maleate is contraindicated in patients with: •a history of angioedema or hypersensitivity related to previous treatment with an angiotensin converting enzyme (ACE) inhibitor [see Warnings and Precautions ( 5.2 )]. •hereditary or idiopathic angioedema [see Warnings and Precautions ( 5.2 )] . Do not co-administer aliskiren with enalapril maleate in patients with diabetes [see Drug Interactions ( 7.2 )] . Enalapril maleate is contraindicated in combination with a neprilysin inhibitor (e.g., sacubitril). Do not administer enalapril maleate within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor [see Warnings and Precautions ( 5.2 )] . Hypersensitivity related to previous treatment with an ACEI ( 4 ). Hereditary or idiopathic angioedema ( 4 ). Do not co-administer aliskiren in patients with diabetes ( 4 ). In combination with a neprilysin inhibitor ( 4 ).
Epaned drug interactions
In patients who are elderly, volume-depleted (as on diuretic therapy), or with compromised renal function, use with NSAIDs, including selective COX-2 inhibitors, may result in deterioration of renal function, including renal failure. Monitor renal function periodically ( 7.1 ). Dual inhibition of the renin-angiotensin system: Increased risk of renal impairment, hypotension and hyperkalemia ( 7.2 ). Avoid potassium sparing agents in patients with heart failure ( 7.3 ). Monitor serum lithium levels frequently ( 7.4 ). 7.1 Non-Steroidal Anti-Inflammatory Agents (NSAIDs) Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors) In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including enalapril, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving enalapril and NSAID therapy. In a clinical pharmacology study, indomethacin or sulindac was administered to hypertensive patients receiving enalapril maleate. In this study, there was no evidence of a blunting of the antihypertensive action of enalapril maleate. However, reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors. 7.2 Dual Blockade of the Renin-Angiotensin System (RAS) Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. In most patients no benefit has been associated with using two RAS inhibitors concomitantly. In general, avoid combined use of RAS inhibitors. Closely monitor blood pressure, renal function and electrolytes in patients on enalapril maleate and other agents that affect the RAS. Do not co-administer aliskiren with enalapril maleate in patients with diabetes. Avoid use of aliskiren with enalapril maleate in patients with renal impairment (GFR <60 mL/min). 7.3 Agents Increasing Serum Potassium Enalapril maleate attenuates potassium loss caused by thiazide-type diuretics. Potassium-sparing diuretics (e.g., spironolactone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium. 7.4 Lithium Lithium toxicity has been reported in patients receiving enalapril and lithium concomitantly which was generally reversible. It is recommended that serum lithium levels be monitored frequently if enalapril is administered concomitantly with lithium. 7.5 Gold Nitritoid reactions (symptoms include facial flushing, nausea, vomiting, and hypotension) have been reported rarely in patients on therapy with injectable gold (sodium aurothiomalate) and concomitant ACE inhibitor therapy including enalapril. 7.6 mTOR Inhibitors Patients taking concomitant mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema [ see Warnings and Precautions (5.2) ]. 7.7 Neprilysin Inhibitor Patients taking concomitant neprilysin inhibitors may be at increased risk for angioedema [see Warnings and Precautions ( 5.2 )] .
Enalapril and food
Potassium-rich foods & salt substitutes
Don't use potassium-based salt substitutes unless your clinician approves, and ask before taking potassium supplements. Your clinician may check your potassium level with blood tests.
Lisinopril (an ACE inhibitor) — MedlinePlus (U.S. National Library of Medicine) ↗
Every enalapril product we track (4)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 70/100 | Prescription | Solution | Generic | $0 | View → | |
| 2 | 70/100 | Prescription | Solution | Generic | $0 | View → | |
| 3 | 70/100 | Prescription | Solution | Generic | $0 | View → | |
| 4 | Not yet rated | Prescription | Tablet | Generic | $0 | View → |
What enalapril pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
Combination products containing enalapril
A combination is a different drug — different dosing, different warnings. It is listed here so you can find it, not so you can substitute it.
Enalapril recalls
From the FDA Enforcement database. A recall covers specific lots — not the drug as a whole.
Can you crush or split enalapril?
The enalapril labels that address it permit crushing or splitting in the terms they state — quoted per product, because the instruction belongs to the form.
What each enalapril label says about crushing, splitting and chewingHow long enalapril keeps
The date on a sealed pack is not the only one: some enalapril labels start a second clock once the product is opened or mixed, as short as 60 days.
Does enalapril expire? The in-use limits and storage rules from its labelsEnalapril and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for enalapril: levels in milk, effects in breastfed infants, and the drugs it would consider insteadBecause of the very low levels of enalapril in breastmilk, amounts ingested by the infant are small and have not been detected in infant serum or caused any adverse effects in a few breastfed infants. If a mother requires enalapril, it is not a reason to discontinue breastfeeding.
National Institute of Child Health and Human Development, record revised July 15, 2026. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about enalapril
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 21,466 reports naming enalapril, and the FDA flagged 84% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- diarrhoea1,112 reports
- nausea1,097 reports
- dyspnoea1,030 reports
- fatigue942 reports
- dizziness905 reports
- vomiting809 reports
- asthenia736 reports
- fall727 reports
Read these as a signal, not a rate. A report does not mean enalapril caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved August 25, 2026.
Related guides
Related calculators
Frequently asked questions
What is Epaned?
Epaned (Enalapril Maleate) is an angiotensin converting enzyme inhibitor used to treat Rheumatoid Arthritis, Bartter Syndrome, Diabetic Nephropathies, Edema.
What kind of drug is enalapril?
The FDA classifies enalapril as an angiotensin converting enzyme inhibitor. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take enalapril with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run enalapril against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is enalapril sold under?
We track 4 enalapril-containing products in the U.S.: Enalapril Maleate, Epaned, Epaned Kit and Vasotec. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does enalapril come in?
Across the brands we track, enalapril is currently marketed as solution and tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic enalapril?
Yes. Our catalog lists 1 generic enalapril product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Has enalapril been recalled?
The FDA's Enforcement database lists 1 recall record whose product description mentions enalapril. The most recent: Enalapril Maleate Tablets (Apr 23, 2026). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.
What should I avoid while taking enalapril?
Food: salt substitutes containing potassium, and large amounts of potassium-rich foods or supplements — see the food section above for what each one does and whether it means avoiding it or just being consistent. This is what the FDA label and our cited sources say — it is not a complete list. Your pharmacist can check your own combination.
Cite this page
- APA
- pharmaranks. (2026, July 24). Enalapril: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/enalapril
- MLA
- “Enalapril: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/enalapril.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for enalapril on DailyMed (NIH) ↗ — including its boxed warning in full.