Search for articles or Rx savings
Key takeaways
Enalapril belongs to a class of medications called ACE inhibitors. It’s most commonly prescribed to treat high blood pressure and heart failure.
After taking a dose of enalapril, it can take three to five days before it is completely flushed out of your system, but for those with kidney function disorders, it could take longer.
Side effects of enalapril are typically mild, but they may include cough, diarrhea, and headache.
One of the most popular angiotensin-converting enzyme inhibitors, more commonly referred to as ACE inhibitors, is enalapril. This generic medication, also sold under the brand name Vasotec, treats hypertension (high blood pressure) and helps to reduce your risk of heart attack, heart disease, and stroke.
Enalapril works by inhibiting the angiotensin-converting enzyme (ACE), which in turn relaxes blood vessels and makes it easier for the heart to pump blood throughout your body. Along with hypertension, enalapril can also help treat certain cardiovascular conditions, like congestive heart failure and left ventricular dysfunction.
Taken as an oral solution, tablet, or injection, enalapril typically begins to take effect in about one hour after administration. However, it remains in your body for much longer. For most people, enalapril will be completely eliminated from the body in two to three days.
Save up to 80% on Enalapril with SingleCare
Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.
How long does enalapril stay in your system?
Before explaining how long enalapril stays in the body, it’s important to first understand how it’s metabolized. “After taking enalapril, your body converts it into its active form, enalaprilat, which lowers blood pressure,” explains Erika Gray, Pharm.D., pharmacist and founder of ToolBox Genomics. “The antihypertensive effects usually begin within an hour and can last for 12 to 24 hours, making it effective for once or twice daily dosing.”
The peak concentration of enalapril, or when the drug has the highest concentration in the bloodstream, is usually within one hour. The time it takes for the amount of enalapril within the body to decrease by half, or its half-life, is 11 hours for the average healthy adult.
If you were to take enalapril in the morning, the amount of the drug left in your system will be reduced by that evening, but it likely won’t be completely metabolized until a few days after. “Enalapril levels typically start decreasing in your body around 11 hours, but it can take up to 3 to 5 days for the drug to fully leave your system,” Dr. Gray says.
To determine how much enalapril is left in your system, researchers have found two enzyme-linked immunosorbent assay (ELISA) methods to detect enalapril and enalaprilat in plasma, though this testing is not commonly used.
What influences how long enalapril stays in your system?
There is one main factor that influences how long enalapril will stay in your system: kidney function.
Kidney function
“Kidney functioning is a huge indicator of how long enalapril stays in your system,” explains Ryan Sultan, MD, a healthcare provider based in New York, New York. “Because it is excreted through the renal system, people with kidney issues may take longer to clear the drug.”
To further explain, approximately two-thirds of enalapril is excreted through the urine as it leaves the body. This begins in the kidneys, which play a key role in filtration as part of the urinary tract. Those with kidney disease have impaired renal function and will take longer to filter the drug effectively.
Side effects and risks of enalapril
There are various reasons someone may want to discontinue taking enalapril, a big one being unwanted side effects. That being said, the side effects of enalapril are typically mild and go away over time. Common side effects of enalapril include:
- Dry cough
- Lightheadedness or dizziness
- Headaches
- Diarrhea
- Itching
- Rash
- Blurred vision
- Increase in blood potassium levels
- Hypotension (low blood pressure)
It’s also possible to experience more serious side effects that can be life-threatening. This can include liver problems, chest pain, pancreatitis (an inflamed pancreas), and kidney problems. Some individuals may also experience a serious and sometimes life-threatening reaction called angioedema (swelling of the tissues of the lips, mouth, and tongue). It is important to know that if you experience any swelling of the lips, mouth, or tongue while on enalapril, you should seek emergency medical care. You should not take enalapril if you have had an allergic reaction to it in the past.
Before starting enalapril, you should give your healthcare provider and pharmacist a complete list of the prescription and over-the-counter medications you currently take, as there are possible drug interactions. Some medications that interact with enalapril include aliskiren, diuretics (like hydrochlorothiazide and furosemide), sacubitril, lithium, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. It’s also important to inform your healthcare provider about any supplements you’re taking, as certain vitamins, such as potassium supplements and salt substitutes, can interact with enalapril.
RELATED: 6 foods to avoid when taking enalapril
Enalapril can also cause blood sugar to drop more frequently, so those with diabetes may need to monitor their blood glucose levels more often when taking it. Patients with a history of angioedema or allergic reactions to ACE inhibitors in the past are also not good candidates for this drug, as well as those who are pregnant or breastfeeding.
Enalapril is generally safe for long-term use. However, one possible long-term side effect is decreased kidney function. Your healthcare professional can monitor how well your body is tolerating the drug by checking electrolyte and potassium levels with regular blood tests.
How long does it take for side effects to go away after stopping enalapril?
Mild side effects of enalapril may go away as your body adjusts to the new medication. Generally, side effects will lessen as the amount of the drug decreases in your body, so they should start to clear up within a day.
Enalapril alternatives
Enalapril is one of the most popular antihypertensive drugs because the benefits typically outweigh the risks. But that doesn’t mean it’s for everyone. “If enalapril is not well tolerated due to side effects like coughing or swelling, there are alternative options available,” Dr. Gray explains.
Possible blood pressure-lowering alternatives for enalapril include:
- ACE inhibitor drugs, such as lisinopril, ramipril, perindopril, and captopril
- Angiotensin receptor blockers (ARBs), like losartan, candesartan, or valsartan
- Calcium channel blockers, including amlodipine, diltiazem, or verapamil
- Diuretics, such as hydrochlorothiazide or spironolactone
- Beta blockers, like atenolol, metoprolol, or propranolol
“The best alternative depends on your overall health and specific treatment needs,” Dr. Gray adds.
Abruptly ending the use of most blood-pressure-lowering drugs can cause a rapid rise in blood pressure, though these effects have not been seen with enalapril. Regardless, you should not discontinue your medication before seeking medical advice from your healthcare team.
- Enalapril, StatPearls (2025)
- FDA approves hypertension treatment for adults and children over one month old, American College of Cardiology (2013)
- An overview of the clinical pharmacology of enalapril, British Journal of Clinical Pharmacology (1984)
- Determination of enalapril and enalaprilat by enzyme linked immunosorbent assays: application to pharmacokinetic and pharmacodynamic analysis, Fundamental Clinical Pharmacolology (2002)