Can You Take Enalapril With Food?

In our latest question and answer, the pharmacist discusses whether or not the blood pressure medicaiton enalapril should be taken with food.

Jun 12, 2018

Joel asked

The drug Enalapril Maleate 10 MG, what can I not eat before I take this drug? I’ve been eaten nothing but vegetables such as kale, spinach, & carrots & I heard somewhere not to mixed vegetables with taking this drug.

Answer

According to the manufacturer, enalapril can be administered without regard to meals. Absorption of the drug via the oral route is about 60% and is not significantly affected by food, including vegetables. Per the prescribing information for enalapril:

Enalapril absorption is not influenced by the presence of food in the gastrointestinal tract

Enalapril can cause an increase in potassium. This is more likely to occur in patients with renal impairment, diabetes, heart failure, and while taking other medications that increase potassium. Careful monitoring of potassium levels may be necessary if these risk factors are present.


Depending on lab results, it may be recommended to use caution with eating a substantial amount of potassium containing foods (bananas, spinach, nuts).

 

Information About Enalapril

Enalapril (Vasotec) is an angiotensin converting enzyme (ACE) inhibitor. There are several other ACE inhibitors that work in a similar fashion, including lisinopril, captopril, and benazepril. ACE inhibitors are commonly used for hypertension (high blood pressure) and heart failure. In fact, these agents are typically considered first-line treatments for these conditions.


ACE inhibitors can cause a persistent dry cough, hyperkalemia (high potassium), and rarely angioedema—swelling of the tongue, lips, and throat. Angiotensin receptor blockers (ARB) work in a similar fashion, but are less likely to cause this dry cough. ARBs may also have slightly less risk of causing angioedema.


Enalapril reaches peak concentration in about 3 to 4 hours after oral administration. It takes about 1 hour to begin reducing blood pressure with maximum reduction occurring in about 4 to 6 hours. The blood pressure effect lessens at about 24 hours. Enalapril is also available as an IV formulation.

 

Summary

For most people, diet does not significantly impact the use of enalapril. However, in patients with high potassium levels, renal impairment, diabetes, heart failure, and use of other medications that increase potassium, careful monitoring may be necessary. In addition, a diet avoiding high potassium content may be required if recommended by a physician. 

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