1 May 2026Oral drugs
Enalapril oral
Enalapril guidance for hypertension and heart failure, with renal monitoring and hyperkalaemia precautions.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Antihypertensive vasodilator (ACE inhibitor).
Indications
- Hypertension.
- Heart failure.
Forms and strengths
- 5 mg and 20 mg tablets.
Dose
- Adult: start with 5 mg once daily and increase according to clinical response.
- In older patients, patients taking diuretics, and patients with renal impairment, start with a lower dose and increase cautiously.
Duration
According to clinical response.
Contra-indications, adverse effects, precautions
- Do not administer to patients with history of angioedema related to ACE inhibitors, severe hypotension, or bilateral renal artery stenosis.
- May cause dry cough, hypotension, renal impairment, hyperkalaemia, dizziness, and rarely angioedema.
- Monitor renal function and serum potassium, especially in patients with renal impairment or those taking diuretics or potassium-increasing drugs.
- Avoid or monitor combination with potassium salts, spironolactone, NSAIDs, and co-trimoxazole because hyperkalaemia risk increases.
- Pregnancy: contraindicated.
- Breast-feeding: no contra-indication.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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