Enalapril is a medicine used to treat high blood pressure. It is part of a group of medicines called ACE inhibitors (angiotensin-converting enzyme inhibitors). These are usually prescribed first to treat high blood pressure in people who are under 55 years old; and in those who have type 2 diabetes.

What is high blood pressure?

If you have been diagnosed with high blood pressure, it means your heart is working harder to pump blood out through your arteries to other organs in your body. This is usually because you have certain risk factors or medical conditions that have caused your arteries to become narrower or clogged over time.

1 in 3 adults in the UK have undiagnosed high blood pressure. You can only know if you have high blood pressure by getting your blood pressure checked.

High blood pressure has been linked with risk factors like being overweight, older age, smoking, unhealthy eating and not enough exercise or sometimes because of ethnicity or genetics.

You can also have high blood pressure if you have medical conditions like diabetes, thyroid conditions, kidney problems, or if you are taking medications which may contribute to high blood pressure, like the combined contraceptive pill or steroids.

If you do not treat high blood pressure, you may be at risk of having a stroke or heart attack. Many people with high blood pressure do not have any symptoms. However, If your blood pressure is severely high, you may experience symptoms like headaches, dizziness, confusion, or changes in your vision.

If you think you have high blood pressure, you can visit your local GP, who can measure your blood pressure and explain the readings to you. Your GP can also provide advice on lifestyle changes to help you keep your heart and blood vessels healthy. You should have your blood pressure checked regularly and your GP can help arrange this.

Enalapril is a type of medicine known as an ACE inhibitor. ACE inhibitor medicines all generally work in the same way to lower blood pressure. They block an enzyme needed to produce angiotensin II. Angiotensin II is a compound that causes the muscles around your blood vessel to become narrow, raising your blood pressure.

So, ACE inhibitors work by blocking the production of angiotensin II, so your blood vessels relax and become wider. This in turn lowers your blood pressure and makes it easier for your heart to pump blood around your body.

ACE inhibitors also work on the kidneys, causing them to get rid of more urine and salt, so there is less pressure in the blood vessels of your kidneys, which also helps to lower your blood pressure. It usually starts to work to lower blood pressure about an hour after you take it. The effects of one dose of enalapril can stay in your body for up to 24 hours.

Take enalapril as prescribed by your doctor. You can swallow your tablets whole with water, with or without food and you should try to take your tablets at the same time everyday.

The best time of the day to take your first dose of enalapril is at bedtime as you may experience side effects of dizziness. For future doses, if you do not experience dizziness, you can take it any time of the day but try to take it at the same time everyday.

The normal starting dose to treat high blood pressure is one 5mg Enalapril tablet to be taken once a day. This can be increased up to 20mg a day over a few weeks, until you reach the right dose for you.

Your doctor will decide a suitable starting dose depending on how high your blood pressure is, and if you have other medical conditions or are taking other medications. Your doctor will also monitor how well you are responding to Enalapril by taking your blood pressure and doing some blood tests.

What should I do if I miss my enalapril tablet?

If you forget you take enalapril when you should, you can forget about the missed dose and take the next dose when it is due. Do not take two doses to make up for a missed dose. If you tend to forget to take your tablets, you can try setting an alarm to remind you when your next dose is due.

Enalapril tablets come in different doses. Your doctor will usually start you on a dose that is more suitable for you. This will usually depend on other medications you are taking or if you also have other medical conditions like kidney problems. 

• Enalapril 2.5mg: a low starting dose that may be prescribed if you have kidney problems, or for patients with heart failure
• Enalapril 5mg: the usual starting dose but may be increased in a few weeks to a suitable dose that controls your blood pressure with minimum side effects
• Enalapril 10mg: a higher starting dose which may be prescribed if your blood pressure is very high at diagnosis 
• Enalapril 20mg: often used as a long term maintenance dose, this is the maximum usually prescribed. It is usually prescribed later if a lower dose doesn’t control your blood pressure effectively. The maximum Enalapril dose you can be prescribed is up to 40mg a day.

You can buy enalapril online from UK registered pharmacies like Superdrug Online Doctor, after a brief consultation with one of our doctors.

How much does enalapril cost?

You can buy a 3 month supply (84 tablets) of Enalapril with Superdrug Online Doctor from £20, or a six month supply (168 tablets) from £25.

Can I get enalapril on the NHS?

You may be able to get enalapril on the NHS if you are eligible. You will need to contact your local GP to book an appointment first.

Can I get enalapril over the counter ?

No. You cannot get enalapril over the counter as it is a prescription-only medicine. This means you need a prescription from a medical doctor who will usually need a brief consultation with you before giving out a prescription for enalapril.

Some common enalapril side effects may include:

• a dry tickling continuous cough
• dizziness
• headaches
• feeling sick
• low blood pressure
• fast heartbeat
• Angina or chest pain
• diarrhoea
• rash
• blurred vision
• tiredness
• increase of potassium levels in your blood

Some uncommon or rare enalapril side effects may include:

• low blood sugar levels
• confusion
• feeling flushed
• hair loss
• itching
• problems with sleeping
• muscle cramps

Enalapril may not be suitable for everyone. You should tell your doctor about any medical conditions you have and all medicines you are taking, including over the counter medicines. Tell your doctor before taking enalapril if you:

• are over 70 years old
• are pregnant or planning to be pregnant, or breastfeeding
• have heart problems or problems with your blood cells
• have kidney problems
• have liver problems
• have unstable blood pressure (sometimes low or high)
• are taking other medicines that lower blood pressure
• have diabetes
• have ever had an allergic reaction to an ACE inhibitor medicine
• are having a surgical operation soon
• Or any other medical problems

Tell your doctor before taking enalapril if you are on any other medications as they may interact with enalapril in a negative way. These can include:

• anti-inflammatory medicines like ibuprofen or high dose aspirin (simple painkillers like paracetamol or low dose aspirin is safe with enalapril)
• medicines to treat heart failure
• Medicines to treat asthma or allergies
• immunosuppressant medicines like tacrolimus or ciclosporin
• medicines that lower blood pressure like GTN sprays, viagra or antidepressants
• lithium
• allopurinol
• steroid medicines

Avoid drinking alcohol when taking enalapril because it can increase some side effects such as feelings of dizziness and lightheadedness. The patient information leaflet supplied with your medicine contains all known enalapril side effects, cautions and drug interactions. You should read it and be familiar with its information while you are taking enalapril.

If enalapril is not able to lower your blood pressure effectively, there are other medicines for lowering blood pressure. Your doctor may also recommend making some healthy lifestyle changes.

Angiotensin-II receptor blockers (ARB)

Angiotensin-II receptor blockers (ARB) work in a similar way to ACE inhibitors to lower high blood pressure. They are good alternatives for people who experience side effects like a dry cough when taking ACE inhibitors. Losartan is an example of an Angiotensin-II receptor blocker (ARB).

Calcium channel blockers

Calcium channel blockers are usually offered first to people over 55 years old or from an African or Afro-Caribbean ethnicity, according to NICE guidelines. Nifedipine or amlodipine are examples of calcium channel blockers.

Diuretics or ‘water tablets’

Diuretics work by removing more salt and fluid from your body through your urine, which reduces pressure in your blood vessels and lowers blood pressure. Diuretics are usually added to your current medication if your blood pressure is not properly controlled with ACE inhibitors/ARBs or calcium channel blockers alone. Some common diuretics are indapamide or Bendroflumethiazide.

Alpha blockers

Alpha blockers are another type of blood pressure medication that may be added to your treatment plan if your blood pressure is not properly controlled with your current medications alone. Doxazosin is an example of an alpha blocker.