Enalapril

What it is

Enalapril is an ACE inhibitor, a prescription-only cardiovascular drug. It blocks the enzyme that converts angiotensin I to angiotensin II, so blood vessels relax and the heart works against less resistance. It is used for high blood pressure and for heart failure, where it also reduces the strain the failing heart carries.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Hypertension
• Heart failure

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It can be taken with or without food, and the timing that matters most is consistency from day to day. Ibuprofen and other anti-inflammatory painkillers blunt its effect and are harder on the kidneys alongside it, while spironolactone, potassium supplements and potassium-containing salt substitutes add to its own tendency to raise potassium, as do potassium and magnesium aspartate supplements where they are marketed, which in Finland they are not, since the Fimea register holds no such preparation. Blood potassium, creatinine and eGFR are the usual follow-up tests, and long use has been linked with lower zinc. A dry, persistent cough is a known class effect rather than an infection, and the drug is not used in pregnancy because it harms the developing kidneys.

When to see a doctor

See a doctor for muscle weakness, an irregular or unusually slow heartbeat, or much less urine, which can point to rising potassium or falling kidney function. Swelling of the lips, tongue or throat, or difficulty breathing, needs emergency care. A cough that will not settle, or a pregnancy or plan for one, is also a reason to see a doctor rather than adjust anything alone.

Worth knowing

• Can raise potassium
• Dry cough is a known effect
• Not during pregnancy

Markers to watch

• Potassium
• Creatinine
• eGFR

Nutrients affected

• potassium — raised by (Potassium)
• zinc — depleted by (Free T3, Testosterone, TSH)