Enalapril Tablet: Uses, Dosage & Side Effects in Pakistan

Enalapril Tablet Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Enalapril Tablet? (Enalapril Tablet kya hai)

Enalapril Tablet (Renitec / Enapril) is widely used in Pakistan for high blood pressure, heart failure, and diabetic nephropathy. It belongs to the ACE Inhibitor class with Enalapril as the active ingredient. Enalapril is a prodrug — it is converted in the liver to enalaprilat (active form) — which blocks the ACE enzyme, preventing the conversion of Angiotensin I to Angiotensin II — resulting in dilation of blood vessels, reduced aldosterone, and lower blood pressure. Bradykinin breakdown is also inhibited — which is why ACE inhibitors cause a dry cough. The dose is always titrated by the doctor with monitoring of renal function and potassium.

3. Uses (Fayde / Kis kaam aati hai)

• Hypertension — blood pressure control
• Heart failure
• Post-MI left ventricular dysfunction — protecting the heart after a heart attack
• Diabetic nephropathy and proteinuric renal disease — kidney protection
• Asymptomatic left ventricular dysfunction — preventing future heart failure

4. Who Should Take (Kis ko leni chahiye)

• Hypertension patients who have been prescribed by a doctor
• Heart failure (reduced EF) patients — core therapy
• Patients with LV dysfunction after a heart attack
• Diabetes patients who have nephropathy or proteinuria
• Specialist-prescribed patients with LV dysfunction prevention

5. When NOT to Take (Kab nahi leni chahiye)

• NEVER in PREGNANCY — Category D foetal renal toxicity (2nd/3rd trimester)
• Prior angioedema with ACE inhibitor or history of angioedema
• Bilateral renal artery stenosis — acute renal failure risk
• Severe aortic stenosis
• Allergy to Enalapril or any ingredient
• Hyperkalemia (high potassium)

6. Dosage (Kitni leni hai)

• Hypertension: typically 5mg once daily (2.5mg in elderly / renal impairment / diuretic use)
• Heart failure: 2.5mg twice daily — cautiously titrate up
• Post-MI: 2.5mg initially, titrate under supervision

• Hypertension: 10–20mg once daily
• Heart failure: 10mg twice daily (target); titration over several weeks
• Diabetic nephropathy: 5–10mg once daily

• Up to 40mg per day (divided) for hypertension; rarely used; dose always doctor-titrated

• If you miss a dose, take it as soon as you remember — if it is almost time for the next dose, skip the missed one. Never take a double dose.

7. How to Take (Kaise leni hai)

• As directed by your doctor — once or twice daily

• Same time

• Morning is preferred — or follow the doctor-advised schedule

• With or without food

8. Best Time (Kab leni chahiye)

• Morning — or at the time advised by your doctor

• Same time daily to maintain a routine

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

Enalapril can be taken on an empty stomach or after food — food does not affect absorption. However, if stomach upset occurs, taking it after food is better.

10. Warnings (Ihtiyat)

• PREGNANCY CONTRAINDICATED — Category D foetal renal toxicity (2nd/3rd trimester)
• Prior angioedema
• Bilateral renal artery stenosis

• Renal function and potassium: check 1–2 weeks after starting and after dose increases
• ACE inhibitor cough: dry cough is common — not an allergy; if intolerable, switch to ARB
• Angioedema alert: swelling of lips/tongue/throat — STOP drug immediately and call emergency

11. Precautions (Ahm ehtiyaat)

• Store in a cool, dry place (below 30°C)
• Keep away from direct sunlight
• Keep out of the reach of children

• Volume-depleted patients (diuretics, low salt diet, dehydration): higher risk of first-dose hypotension — start with a low dose
• Diabetics: ACEi improve insulin sensitivity — monitor for hypoglycaemia
• Elderly: lower starting dose — renal impairment is more common

12. Side Effects (Nuksanat)

• Dry persistent cough — bradykinin accumulation; up to 30% in South Asians; not an allergy
• Hypotension — first-dose and in volume-depleted patients
• Dizziness / headache
• Hyperkalaemia
• Transient creatinine rise (renal impairment — usually mild)

• Angioedema — EMERGENCY: swelling of face, lips, tongue, throat; airway obstruction; STOP drug immediately, call emergency
• Severe renal impairment (bilateral RAS patients)
• Severe hyperkalaemia — cardiac arrhythmia
• Teratogenicity

13. Drug Interactions (Dawaon ke sath reaction)

• "Triple whammy" — MOST IMPORTANT: ACEi + diuretic + NSAID → Acute Kidney Injury — combining enalapril and a diuretic with ibuprofen/diclofenac is DANGEROUS
• Potassium-sparing diuretics / K supplements: spironolactone, amiloride, potassium tablets — hyperkalaemia risk
• ARBs (losartan/valsartan): dual RAAS blockade — hyperkalaemia + renal failure — generally avoid combination
• Lithium: enalapril reduces the renal clearance of lithium — lithium toxicity risk
• Antidiabetics (insulin/metformin): ACEi improve insulin sensitivity — monitor for hypoglycaemia
• Immunosuppressants (azathioprine, ciclosporin): haematological toxicity risk

Blood pressure may drop significantly.

14. When to See Doctor (Kab doctor ke paas jayein)

• EMERGENCY: swelling of mouth, lips, tongue, throat — angioedema — STOP drug immediately and call emergency services
• Severe dizziness or loss of consciousness — first-dose hypotension
• Reduced urine output (oliguria) — renal failure
• Irregular heartbeat — hyperkalaemia
• Cough that is intolerable and affects daily life
• Muscle weakness or numbness — severe hyperkalaemia

15. Alternatives (Sasti Dusri Dawaein)

16. Price in Pakistan (Price kitni hai)

17. FAQs (Aksar poochay jane walay sawalat)

Q: Enalapril kis kaam aata hai?

A: Enalapril (Renitec) is used to lower blood pressure, treat heart failure, protect the heart after a heart attack, and protect the kidneys in diabetes. It belongs to the ACE Inhibitor class.

Q: Enalapril se khansi kyun hoti hai?

A: Enalapril prevents bradykinin from breaking down — this is why dry persistent cough is a common side effect, especially in South Asians (up to 30%). It is not an allergy — if intolerable, the doctor switches to an ARB.

Q: Enalapril ke side effects kya hain?

A: Most common — dry cough, low blood pressure with the first dose (dizziness), and elevated potassium. Serious — angioedema, renal impairment, severe hyperkalemia.

Q: Enalapril price Pakistan mein kitni hai?

A: Renitec (MSD brand) and local generic enalapril are available in Pakistan. Confirm the latest price at your pharmacy or at dawaai.pk.

Q: Enalapril diabetes mein kyun diya jata hai?

A: In diabetes, the kidneys suffer greater damage (diabetic nephropathy). Enalapril reduces proteinuria and slows renal function deterioration — this renoprotective effect makes ACE inhibitors an essential part of diabetes management.

18. Medical Review (Medical jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.