Vasotec (Enalapril)

Prescription Required.

Product of Canada.

Express Ships from Canada.

Prescription Required.
Product of Canada.
Express Ships from Canada.

Vasotec (Enalapril)

What is Vasotec (Enalapril)?

Vasotec (enalapril) is an angiotensin-converting enzyme (ACE) inhibitor medication that is prescribed primarily for the treatment of high blood pressure (hypertension) and congestive heart failure but may also be used in the treatment of a variety of other cardiovascular conditions. This medication may be used on its own or alongside additional medications to manage a patient’s condition.

How is Vasotec Used?

This medication is available in tablet form and is ingested orally, once or twice per day, based on the patient’s prescribed dosage. It may be used alone for treatment, or it may be used in addition to other medications to manage the condition for which it has been prescribed.

Patients will typically begin with a low dosage of this medication and gradually increase to the appropriate maintenance dose to avoid significant and potentially problematic sharp drops in their blood pressure.


Vasotec tablets should be stored at room temperature, as close as possible to 77°F (25°C). Temporary exposure to temperatures as low as 59°F (15°C) or as high as 86°F (30°C) may be permitted in moderation if needed.

Keep this medication out of the reach of children at all times and ensure that it is stored in a tightly sealed container away from moisture.


Vasotec is prescribed for a variety of conditions, including but not limited to:

  • cardiovascular disease
  • congestive heart failure
  • eclampsia
  • heart disease
  • hypertension
  • hypertensive congestive heart failure
  • hypertensive encephalopathy
  • hypertensive heart disease
  • hypertensive heart and renal disease (with or without congestive heart failure)
  • hypertensive renal disease
  • hypertensive retinopathy
  • left ventricular dysfunction
  • pre-eclampsia
  • renovascular hypertension

How Does Vasotec Work?

As an angiotensin-converting enzyme (ACE) inhibitor, this medication functions by inhibiting the enzyme within the body that causes an individual’s blood vessels to constrict and result in issues such as high blood pressure and other cardiovascular concerns. By preventing this constriction of the blood vessels, a patient’s blood is able to flow more freely throughout the body and reduce the strain placed on the heart associated with pumping blood in more difficult circumstances.


This medication is available in tablet form in the following strengths:

  • 5 mg
  • 10 mg
  • 20 mg

Most patients using this medication for hypertension will begin with an initial once-daily dose of 2.5 mg to 5 mg. The typical dose used for treatment for this condition may range from a once-daily dose of 2.5 mg up to a twice-daily dose of 20 mg, which will vary based on a number of individual factors in each patient.

Pediatric patients using Vasotec will have their dosage determined based on their body weight.

Patients with congestive heart failure will typically begin treatment with a once-daily dose of 2.5 mg, which is often increased over time to no more than 40 mg per day based on the patient’s response to treatment.

Any individuals using this medication should be sure to take it exactly as instructed by their prescribing physician. The required dosage to safely and effectively treat the conditions for which it has been prescribed may vary greatly based on a variety of factors, and patients should not modify their dosage or change the way in which they take this medication without consulting their doctor first.


If an overdose of this medication has occurred or is suspected, the individual’s physician or their local Poison Control Center should be contacted for further guidance. If someone has ingested too much of this medication and experiences serious side effects such as difficulty breathing or collapsing, emergency medical attention should be sought immediately.

Side Effects

The most common side effects of taking Vasotec are as follows:

  • abdominal pain
  • appetite loss
  • constipation
  • decrease in sexual ability
  • diarrhea
  • dry and persistent cough
  • fatigue
  • feeling confused
  • headaches
  • heartburn
  • itchiness
  • joint pain
  • muscle pain
  • nausea
  • rash
  • sore throat
  • weakness

If you experience any of these side effects when taking this medication and they worsen in severity or become troublesome, please contact your prescribing physician for further advice.

Additionally, some of the following side effects may also occur and should be reported to your doctor as soon as possible as they may be indicative of more serious health-related concerns developing:

  • anemia symptoms
    • dizziness
    • shortness of breath
    • skin paleness
    • unusual fatigue
    • unusual weakness
  • bleeding symptoms
    • blood in the urine
    • bruising
    • coughing up blood
    • cuts that will not stop bleeding
    • unusual nosebleeds
  • blurry vision
  • chest pain
  • dizziness
  • enlargement of breasts (in men)
  • fainting
  • feeling lightheaded
  • flu-like symptoms
    • cough
    • fever
    • sore throat
    • sudden fatigue
  • hyperkalemia symptoms
    • breathing difficulties
    • feeling confused
    • heavy feeling in the legs
    • irregular heartbeat
    • nervousness
    • shortness of breath
    • tingling or numbness in the lips, feet, or hands
    • weakness in the legs
  • hypoglycemia symptoms
    • cold sweating
    • headache
    • rapid heart rate
    • skin that’s pale and cool
    • weakness
  • infection symptoms
    • chills
    • diarrhea (severe)
    • fever
    • neck stiffness
    • prolonged dizziness
    • shortness of breath
    • weight loss
  • shortness of breath
  • sores in the mouth
  • symptoms of kidney issues
    • decrease in urination
    • fatigue
    • nausea
    • swelling of hands or legs
    • vomiting
  • symptoms of liver issues
    • appetite loss
    • dark-colored urine
    • diarrhea
    • jaundice (yellowing of the scleras or skin)
    • nausea
    • pale-colored stools
    • vomiting
    • weight loss

Warnings & Precautions


Some patients experience severe allergic reactions when taking ACE inhibitors, such as Vasotec. This may result in symptoms of an allergic reaction, such as swelling of the throat, tongue, or face. If such symptoms occur, emergency medical attention should be sought immediately. Those who have previously experienced allergic reactions when taking any type of ACE inhibitor have a higher risk of experiencing angioedema when taking other ACE inhibitors, including Vasotec.


This medication is capable of impacting blood glucose levels in those using it, and this may make managing conditions like diabetes more difficult. Patients with diabetes may require additional monitoring of their blood glucose levels during treatment, and these individuals should discuss the potential effects of using Vasotec with their physician to ensure that they receive the appropriate dosage to safely and effectively manage their hypertension or other condition for which this medication has been prescribed without negatively impacting their ability to control their blood glucose levels.

Hepatic Function

Patients using this medication have experienced changes in their hepatic function during treatment, regardless of whether they have preexisting liver problems or none at all. Typically, this change in liver function is reversible when the patient stops using the medication. Any individuals using Vasotec who experience the following should inform their prescribing physician immediately: abdominal swelling or pain, appetite loss, dark-colored urine, fatigue, jaundice, malaise, nausea, or pale-colored stools.


When using this medication, some patients have experienced a sharp drop in their blood pressure before adjusting to Vasotec, typically when first beginning treatment or when increasing their dosage of the medication. There is an increased risk of hypotension occurring in those who are currently using water pills, restricting their salt intake, sweating excessively, becoming dehydrated, experiencing vomiting or diarrhea, are currently on dialysis, or are taking aliskiren. Those who meet any of these criteria will require additional monitoring during the beginning few weeks of their treatment, as well as when changes to their dosage may be made in the future.

Low blood pressure causes many patients to experience feelings of dizziness and lightheadedness. Patients at risk of hypotension and feeling dizzy should take their time when rising to a sitting or standing position from lying down. If the lightheaded or dizzy feelings remain persistent or worsen while using this medication, patients should inform their prescribing physician.

Additionally, the risks of developing this condition or having it worsen may be increased in those who experience diarrhea, vomiting, or excessive sweating. Patients using this medication should also be sure to stay hydrated properly, as a reduced intake of fluids and lack of proper hydration can also result in further decreases in blood pressure.

Neutropenia (Low White Blood Cell Count)

Neutropenia has occurred in some individuals using this medication, and this condition can increase a patient’s risk of developing infections due to impaired immunity. Patients using Vasotec may have their blood checked during treatment to monitor for this condition. Any individuals using this medication that experience symptoms of infection, such as a sore throat or fever, should inform their prescribing physician immediately.

Pediatric Patients

It has not been determined whether this medication is safe or effective for use in children with impaired renal function or in infants.

Persistent Cough

The use of this medication may cause some patients to develop a cough that is both dry and persistent, and this cough typically persists until the individual’s dosage is decreased or they stop taking the medication. If you are currently using Vasotec and develop this type of cough that does not appear to be linked to any other illness or condition, please inform your prescribing physician.

Potassium Levels

Some patients using this medication have experienced increased levels of potassium in their blood during treatment. Although this may not result in symptoms for all individuals, this condition may require additional monitoring by the patient’s physician. Additionally, patients using Vasotec for treatment are advised to avoid using any salt substitutes that include potassium.

Renal Function

Some individuals using this medication have experienced changes in renal function during treatment. Those who are also using aliskiren or diuretics appear to be at an increased risk of these changes occurring. Patients with a medical history of impaired kidney function or kidney disease should inform their prescribing physician before beginning treatment with this medication, as changes to the dosage may be required. In some cases, patients with impaired kidney function may require special monitoring.

Senior Patients

Patients using this medication that are above the age of 65 years are at an increased risk of experiencing adverse side effects due to the level of impaired kidney function that commonly occurs in this age range. Most senior patients will typically be prescribed a lower dose of this medication for treatment to avoid such side effects.


Patients requiring surgery during their treatment with Vasotec should inform all relevant members of their healthcare team if undergoing anesthesia at any time, as this medication may impact the safety and efficacy of general anesthesia.

Pregnancy and Breastfeeding

This medication is capable of causing harm as well as death to a developing child in patients that are pregnant and using this medication. Vasotec should not be used during pregnancy. Patients using this medication that become pregnant during treatment should stop using this medication and contact their prescribing physician immediately.

Additionally, this medication has been found to be capable of passing into breast milk and should not be used by breastfeeding patients due to the risk that this poses to a breastfed child. Patients desiring to breastfeed while using this medication should discuss the alternative options for treatment with their physician.

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with this medication. Discuss any concerns you may have with your doctor or a trusted pharmacist.

The following medications are known to interact with Vasotec:

  • acarbose
  • acetylsalicylic acid (ASA)
  • aldesleukin
  • aliskiren
  • alfuzosin
  • allopurinol
  • alpha-agonists
  • alpha-blockers
  • amiloride
  • amiodarone
  • amlodipine
  • amphetamines
  • angiotensin II receptor blockers (ARBs)
  • angiotensin-converting-enzyme inhibitors (ACEIs)
  • apomorphine
  • atenolol
  • atypical antipsychotics
  • azathioprine
  • barbiturates
  • beta-adrenergic blockers
  • brimonidine
  • bromocriptine
  • butalbital
  • calcium channel blockers
  • canagliflozin
  • candesartan
  • captopril
  • clonidine
  • clozapine
  • conivaptan
  • dalteparin
  • dexmethylphenidate
  • dextroamphetamine
  • diabetes medications
  • diltiazem
  • diuretics
  • doxazosin
  • drospirenone
  • duloxetine
  • enoxaparin
  • eplerenone
  • everolimus
  • furosemide
  • “-gliptin” diabetes medications
  • glyburide
  • grass pollen allergen extract
  • guanfacine
  • heparin
  • hydrochlorothiazide
  • ibuprofen
  • indomethacin
  • insulin
  • iron dextran complex
  • iron gluconate
  • isosorbide dinitrate
  • isosorbide mononitrate
  • lanthanum
  • levodopa
  • linagliptin
  • lisdexamfetamine
  • lithium
  • losartan
  • low-molecular-weight heparins
  • medications that cause potassium levels to increase
  • metformin
  • methylphenidate
  • methyldopa
  • minoxidil
  • morphine
  • nabilone
  • naproxen
  • nifedipine
  • nitrates
  • nitroglycerin
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • obinutuzumab
  • olanzapine
  • pentobarbital
  • pentoxifylline
  • phenobarbital
  • phosphodiesterase-5 inhibitors
  • potassium supplements
  • pregabalin
  • propranolol
  • quetiapine
  • quinine
  • ramipril
  • rasagiline
  • riociquat
  • risperidone
  • ropinirole
  • rosiglitazone
  • rotigotine
  • sacubitril
  • salt substitutes that include potassium
  • saxagliptin
  • selegiline
  • sildenafil
  • sirolimus
  • sitagliptin
  • sodium phosphates
  • sotalol
  • spironolactone
  • tacrolimus
  • tadalafil
  • tamsulosin
  • temsirolimus
  • tinzaparin
  • tizanidine
  • tolcapone tolvaptan
  • triamterene
  • trimethoprim
  • vardenafil
  • verapamil
  • water pills
  • yohimbine

Alternative Medications

For patients who are unable to take Vasotec or experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • benazepril (Lotensin)
  • captopril (Capoten)
  • fosinopril (Monopril)
  • lisinopril (Prinivil, Qbrelis, Zestril)
  • moexipril (Univasc)
  • quinapril (Accupril)
  • ramipril (Altace)
  • trandolapril (Mavik)

Frequently Asked Questions

This medication is used to treat hypertension, congestive heart failure, heart disease, left ventricular dysfunction, cardiovascular disease, hypertensive renal disease, and other associated conditions.

Patients should not use this medication if they’ve had previous reactions to ACE inhibitors, are currently taking sacubitril, or have hereditary angioedema. This medication should also not be mixed with aliskiren. Patients with kidney disease, that are pregnant or planning to become pregnant, or who are breastfeeding should also avoid using Vasotec.

Most patients using this medication will experience side effects such as feeling lightheaded, tired, or dizzy.

Some of the serious side effects associated with this medication that will require medical attention include the following: chills, fever, reduced urination, a lack of urination, sore throat, jaundice, chest pain, feeling faint, or experiencing symptoms of high potassium levels.

This medication should be used by those who are pregnant or planning to become pregnant due to the risk of injury it poses to an unborn and developing child.

Patients using this medication should not breastfeed.

Patients using this medication should avoid potassium-based salt substitutes, potassium supplements, consuming alcohol, dehydration, and becoming overheated. Additionally, those using this medication should exercise caution when rising to a sitting or standing position quickly, as they may experience significant dizziness.

This medication should be taken exactly as instructed by the patient’s physician. The most common dosage of this medication is 5 mg, taken orally once per day. However, this dosage may vary amongst patients based on a variety of factors and may be adjusted as needed by the patient’s prescribing physician to more safely and effectively manage their condition.

If you have missed a dose of this medication, you should generally try to take the missed dose as soon as you remember. However, if your next scheduled dose is occurring, you should simply skip the missed dose and proceed with your regular dosing schedule. Patients should not consume two doses of this medication at once.

If an overdose has occurred or is suspected, the individual’s physician or their local Poison Control Center should be contacted as soon as possible. If a serious reaction occurs after overdosing on this medication, including symptoms such as collapsing or having their breathing stop, emergency medical attention should be sought immediately.

This medication functions by inhibiting the enzymes responsible for blood vessel constriction, allowing the blood vessels within a patient’s body to relax and lower their blood pressure.

This medication is available in tablet form in the following strengths: 5 mg, 10 mg, and 20 mg.

You should not take this medication if you are currently taking sacubitril, taking aliskiren while also having kidney disease or diabetes,  have experienced angioedema after previously taking an ACE inhibitor, have hereditary angioedema, are planning to become pregnant, are currently pregnant, or if you are allergic to any of the ingredients in Vasotec.

There are a number of different medications that are known to interact with Vasotec, including drugs that fall into the following categories: angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, certain diuretics, COX-2 inhibitors, gold, lithium, neprilysin inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), renin inhibitors, and more.

Vasotec tablets contain enalapril maleate as their active ingredient. These tablets also include the following inactive ingredients: starch, sodium bicarbonate, magnesium stearate, and lactose. Iron oxide is included in the 10 mg tablets as well as the 20 mg tablets.

Some of the off-label uses for this medication include managing a patient’s abnormal heart rhythms after they’ve experienced a heart attack and treating Bartter syndrome, Raynaud’s phenomenon, migraines, and rheumatoid arthritis.

Most patients will not see improvement in their conditions until a few weeks after beginning treatment with Vasotec.