PRESCRIPTION NOTICE: Enalapril is a Prescription Only Medicine (POM). It cannot legally be dispensed without a valid prescription from a licensed healthcare provider in Kenya. Do not use this medicine without medical supervision. Do not share this medicine with others even if they appear to have the same condition
Enalapril Tablets 5 mg are a prescription-only angiotensin-converting enzyme (ACE) inhibitor indicated for the management of hypertension (high blood pressure), heart failure, and certain forms of kidney disease. Each pack contains 10 tablets of enalapril maleate 5 mg, a well-established cardiovascular medicine with decades of clinical evidence supporting its safety and efficacy across a broad range of patients.
Enalapril is one of the most widely prescribed antihypertensive medicines in Kenya and globally, forming a cornerstone of treatment guidelines for hypertension and heart failure management. As a prescription-only medicine, the price of Enalapril 5 mg in Kenya and its availability are subject to individual pharmacy stock and require a valid prescription for dispensing. If you have been prescribed Enalapril for hypertension treatment in Kenya, this medicine should be used strictly as directed by your healthcare provider.
Key Benefits
- Effectively lowers and controls blood pressure in patients with hypertension
- Reduces the workload on the heart in patients with heart failure
- Provides kidney protection in patients with diabetic nephropathy and proteinuria
- Reduces the risk of cardiovascular events including heart attack and stroke when used as part of a comprehensive management plan
- Once or twice daily dosing supports treatment adherence
- Well-established safety profile with extensive clinical use worldwide
- Available in multiple strengths — allows for precise dose titration as directed by a physician
- Generally well tolerated in the majority of patients at recommended doses
What It Is & How It Works
Active Ingredient
Each tablet contains:
| Active Ingredient | Strength | Role |
|---|---|---|
| Enalapril Maleate | 5 mg | ACE inhibitor — blocks the renin-angiotensin-aldosterone system (RAAS) to lower blood pressure and reduce cardiac workload |
How It Works
Enalapril maleate is a prodrug that is hydrolysed following oral absorption to its active form, enalaprilat. Enalaprilat inhibits angiotensin-converting enzyme (ACE), the enzyme responsible for converting angiotensin I to angiotensin II — a potent vasoconstrictor. By blocking this conversion:
- Blood vessels relax and widen (vasodilation), reducing peripheral vascular resistance and lowering blood pressure
- Aldosterone secretion is reduced, decreasing sodium and water retention and lowering blood volume
- The workload on the heart is reduced, improving cardiac output in heart failure patients
- Intraglomerular pressure in the kidneys is reduced, providing a protective effect against diabetic and hypertensive nephropathy
Classification
Enalapril is classified as a Prescription Only Medicine (POM) in Kenya. It must only be used under the supervision and direction of a licensed healthcare provider — a doctor, clinical officer, or specialist physician. This medicine requires a valid prescription for dispensing at any registered pharmacy in Kenya.
Formulation
Film-coated or uncoated tablets. Each pack contains 10 tablets. Tablets should be swallowed whole with water and may be taken with or without food.
Uses & Indications
Enalapril Tablets 5 mg are indicated for the treatment of:
- Hypertension (high blood pressure) — mild, moderate, and severe, as monotherapy or in combination with other antihypertensive agents
- Symptomatic heart failure — as adjunctive therapy alongside diuretics and, where appropriate, digitalis or beta-blockers
- Asymptomatic left ventricular dysfunction — to reduce the risk of progression to overt heart failure
- Diabetic nephropathy — to reduce proteinuria and slow the progression of kidney disease in patients with type 1 and type 2 diabetes
- Hypertensive nephropathy — to provide renal protection in hypertensive patients with evidence of kidney impairment
IMPORTANT: The decision to initiate, adjust, or discontinue Enalapril therapy must be made by a licensed healthcare provider. Do not self-prescribe, self-adjust your dose, or stop taking this medicine without consulting your doctor, as abrupt discontinuation may result in a dangerous rebound increase in blood pressure.
Dosage & Administration
This medicine requires a valid prescription. Use only as prescribed by your healthcare provider. The following dosage information is provided for reference only and does not constitute prescribing advice.
| Indication | Starting Dose | Usual Maintenance Dose | Maximum Daily Dose |
|---|---|---|---|
| Hypertension | As directed by physician | As directed by physician | As directed by physician |
| Heart Failure | As directed by physician | As directed by physician | As directed by physician |
| Asymptomatic LV Dysfunction | As directed by physician | As directed by physician | As directed by physician |
| Diabetic Nephropathy | As directed by physician | As directed by physician | As directed |
| Renal Impairment | Dose reduction required | As directed by physician | As directed |
Administration Instructions
- Take this medicine exactly as prescribed by your healthcare provider — do not increase, decrease, or skip doses without medical advice
- May be taken with or without food — take at the same time each day for consistency
- Swallow tablets whole with a full glass of water
- Do not stop taking this medicine suddenly — always consult your doctor before making any changes to your treatment
- If a dose is missed, take it as soon as you remember — if it is almost time for the next dose, skip the missed dose and continue as normal; do not double dose
- Regular monitoring of blood pressure, kidney function, and blood electrolytes (particularly potassium) is required during treatment — attend all follow-up appointments as directed
Possible Side Effects
Like all medicines, Enalapril may cause side effects in some patients. Report any new or worsening symptoms to your healthcare provider promptly.
Common
- Persistent dry cough — one of the most frequently reported side effects of ACE inhibitors; affects up to 10–15% of patients and may necessitate a switch to an alternative medicine
- Dizziness or light-headedness — particularly after the first dose or following dose increases; rise slowly from sitting or lying positions
- Headache
- Fatigue or weakness
- Nausea
Less Common
- Hypotension (low blood pressure) — particularly after the first dose, in volume-depleted patients, or those on diuretics; first-dose hypotension is an important clinical consideration
- Elevated blood potassium levels (hyperkalaemia) — particularly in patients with kidney impairment or those taking potassium-sparing diuretics or potassium supplements
- Impaired kidney function — particularly in patients with pre-existing renal artery stenosis or advanced kidney disease
- Skin rash or itching
- Altered taste sensation (dysgeusia)
WARNING: Rare but serious — seek immediate medical attention if you experience: angioedema (sudden swelling of the face, lips, tongue, throat, or extremities — a potentially life-threatening emergency requiring immediate treatment), signs of severe hyperkalaemia (muscle weakness, paralysis, irregular heartbeat), acute kidney injury (significant reduction in urine output, swelling), or severe skin reactions. ACE inhibitor-induced angioedema is more common in patients of African descent — inform your doctor of your ethnicity before starting treatment.
This is not a complete list of side effects. Report all side effects to your healthcare provider.
Warnings & Precautions
CONTRAINDICATION: Do NOT use Enalapril if you have a history of angioedema related to previous ACE inhibitor use, hereditary or idiopathic angioedema, or if you are allergic to enalapril or any other ACE inhibitor.
Do Not Use If You:
- Have a history of ACE inhibitor-induced angioedema — risk of recurrent and potentially fatal angioedema
- Are pregnant or planning to become pregnant — Enalapril is teratogenic and is absolutely contraindicated in pregnancy; it can cause serious fetal harm including renal dysplasia, oligohydramnios, limb contractures, and fetal death
- Are breastfeeding — enalapril passes into breast milk; consult your doctor before use
- Are taking aliskiren-containing medicines and have diabetes or kidney impairment — combined RAAS blockade is contraindicated
- Have bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney
Use With Caution If You Have:
- Kidney disease or renal impairment — dose adjustment is required; regular monitoring of renal function and electrolytes is essential
- Significant aortic or mitral valve stenosis — haemodynamic caution is required
- Hypertrophic cardiomyopathy with outflow tract obstruction
- Severe volume or sodium depletion — risk of profound first-dose hypotension
- Diabetes mellitus — monitor potassium and renal function closely
- Collagen vascular disease (e.g. systemic lupus erythematosus) — increased risk of neutropenia and agranulocytosis
Do Not Combine With:
- Potassium-sparing diuretics (spironolactone, amiloride) or potassium supplements — risk of dangerous hyperkalaemia
- NSAIDs (ibuprofen, diclofenac, aspirin at anti-inflammatory doses) — may reduce the antihypertensive effect of enalapril and worsen kidney function
- Lithium — ACE inhibitors reduce lithium excretion and may cause lithium toxicity
- Aliskiren — dual RAAS blockade increases the risk of hypotension, hyperkalaemia, and renal impairment
- Antidiabetic agents (insulin, oral hypoglycaemics) — ACE inhibitors may enhance their glucose-lowering effect; monitor blood sugar closely
- Alcohol — may potentiate the hypotensive effect of enalapril
CLINICAL NOTE (Kenya-specific): Hypertension is a major public health concern in Kenya, with an estimated prevalence of 24–30% among adults and rising. Enalapril is included on the Kenya Essential Medicines List (KEML) and is a first-line agent in the Kenya Clinical Guidelines for the management of hypertension, heart failure, and diabetic nephropathy. ACE inhibitor-induced cough and angioedema have a higher reported incidence in Black African patients compared to other ethnic groups — clinicians and patients should be aware of this and discuss alternative agents (such as angiotensin receptor blockers) if cough becomes intolerable. Regular blood pressure monitoring, kidney function tests, and serum potassium checks are essential components of safe long-term Enalapril therapy in Kenya.
Keep out of reach of children. Store all medicines safely and securely.
Storage Instructions
- Store below 25°C in a cool, dry place
- Protect from direct sunlight, moisture, and excessive heat
- Keep tablets in their original packaging
- Store out of reach and sight of children
- Do not use after the expiry date printed on the packaging
- Do not transfer tablets to another container
- Dispose of unused or expired tablets safely at your local registered pharmacy — do not flush down the toilet or discard in household waste
Mandatory Disclaimer
This medicine requires a valid prescription. Do not use without medical advice. Enalapril is a prescription-only medicine that must be initiated, monitored, and adjusted by a licensed healthcare provider. Do not self-prescribe, share this medicine with others, or adjust your dose without consulting your doctor. Regular medical follow-up, including blood pressure monitoring, kidney function tests, and serum electrolyte checks is an essential and non-negotiable part of safe Enalapril therapy. This product information is provided for general educational reference only and does not constitute medical advice or replace the guidance of a qualified healthcare professional.
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