Enap 10 mg and 20 mg tablets – enalapril for high blood pressure and heart failure

Enap 10 mg and 20 mg tablets contain the active substance enalapril maleate, which belongs to the group of ACE inhibitors (angiotensin-converting enzyme inhibitors). The medicine widens blood vessels and thereby lowers blood pressure. According to the leaflet, it usually starts to work within an hour and the effect lasts at least 24 hours; some patients need several weeks of treatment to achieve the best effect.

Enap is used to treat high blood pressure, to treat heart failure and to prevent its signs. It is available on prescription.

What is Enap used for and how should it be taken correctly?

Key facts about the medicine

What is Enap used for?

According to the patient leaflet, Enap is intended for:

• treatment of high blood pressure (hypertension);
• treatment of heart failure (weakened heart function) – it can reduce the need to go to hospital and may help some patients live longer;
• prevention of signs of heart failure, such as shortness of breath, tiredness after light physical activity or swelling of the ankles and feet.

Note from the leaflet: the 10 mg and 20 mg strengths are not suitable for starting treatment of symptomatic heart failure or its prevention in asymptomatic left ventricular dysfunction, because the starting dose of 2.5 mg cannot be achieved with them.

How is it taken and dosed?

The dose is always determined by the doctor, according to the patient’s condition, needs and other medicines taken. According to the leaflet:

• The medicine can be taken independently of meals, with a glass of water.
• Doses of 2.5 mg and 5 mg cannot be achieved with Enap 10 mg and 20 mg tablets – tablets of the appropriate strength from another manufacturer are used for this.
• If you feel the effect of the medicine is too strong or too weak, contact your doctor immediately.

Special patient groups

• Children: experience is limited. If the child can swallow a tablet, the recommended starting dose is 2.5 mg daily for body weight 20 to under 50 kg and 5 mg daily for 50 kg and more, once daily; at most 20 mg or 40 mg daily respectively. Not recommended in newborns and in children with kidney problems.
• Elderly patients: the dose should be adjusted to reduced kidney function.
• Kidney impairment: the dose is determined according to kidney function (see table); the doctor monitors potassium and creatinine.
• Liver impairment: tell your doctor before starting treatment.

Contraindications – when the medicine must not be used

Do not take Enap:

• if you are allergic to enalapril maleate or any of the excipients;
• if you have ever had an allergic reaction to any ACE inhibitor;
• if you have had swelling of the face, lips, mouth, tongue or throat with difficulty swallowing or breathing (angioedema) of unknown cause or hereditary;
• if you have diabetes or impaired kidney function and take aliskiren;
• if you are taking or have taken sacubitril/valsartan;
• if you are more than 3 months pregnant.

Warnings and precautions

• Tell your doctor if you have heart disease, changes in the blood vessels of the brain, blood disorders (neutropenia, thrombocytopenia, anaemia), liver or kidney disease, a transplanted kidney, if you are on dialysis or on a salt-restricted diet.
• Caution is needed after heavy vomiting or severe diarrhoea, with low blood pressure, collagen vascular diseases (lupus, rheumatoid arthritis, scleroderma), immunosuppressive therapy and with allopurinol or procainamide.
• If you have diabetes, monitor your blood sugar regularly, especially during the first month of treatment; potassium levels may also rise.
• Potassium supplements, potassium-sparing diuretics and potassium-containing salt substitutes can lead to a serious increase in blood potassium.
• In black patients the risk of angioedema is higher and the medicine lowers blood pressure less effectively.
• Racecadotril, mTOR inhibitors (temsirolimus, sirolimus, everolimus) and vildagliptin increase the risk of angioedema.
• Before surgery or anaesthesia (including at the dentist), LDL apheresis or desensitisation to wasp or bee stings, tell the doctor that you take Enap. The medicine contains lactose.

Interactions with other medicines, food and drink

Tell your doctor or pharmacist about all medicines you take, including herbal medicines. According to the leaflet, the following are particularly important:

• angiotensin II receptor blockers (sartans), aliskiren and other ACE inhibitors;
• other blood pressure medicines, beta blockers and diuretics;
• potassium-containing medicines and salt substitutes, potassium-sparing diuretics, heparin, trimethoprim/co-trimoxazole, ciclosporin – risk of increased potassium;
• antidiabetic medicines including insulin; lithium; tricyclic antidepressants; antipsychotics;
• sympathomimetics, certain cough and cold medicines and weight-loss medicines;
• painkillers and arthritis medicines, including gold therapy; non-steroidal anti-inflammatory drugs (including COX-2 inhibitors) and aspirin;
• thrombolytics, mTOR inhibitors, sacubitril (in combination with valsartan), racecadotril and vildagliptin;
• alcohol.

Pregnancy and breast-feeding

Your doctor will usually advise you to stop taking Enap before you become pregnant or as soon as you know you are pregnant and will recommend another medicine. Use in early pregnancy is not recommended, and after the third month of pregnancy the medicine must not be used because it may cause severe harm to the unborn baby. Breast-feeding newborns (first few weeks after birth), especially premature babies, is not recommended while taking the medicine; for older babies the doctor weighs benefits and risks.

Driving and using machines

Dizziness, drowsiness and tiredness may occur due to a drop in blood pressure, especially at the start of treatment or when the dose is increased. Caution is therefore needed when driving or operating machines.

Possible side effects

Like all medicines, Enap can cause side effects, although not everybody gets them. At the start of treatment dizziness or faintness due to a drop in blood pressure is possible – lie down if this happens.

• Very common (more than 1 in 10): feeling dizzy, weak or sick, blurred vision, cough.
• Common (up to 1 in 10): low blood pressure, heart rhythm changes, fast heartbeat, angina or chest pain, depression, headache, fainting, taste changes, shortness of breath, diarrhoea, abdominal pain, tiredness, rash, allergic reactions with swelling of the face and throat, increased blood potassium and creatinine.
• Uncommon (up to 1 in 100): flushing, sudden drop in blood pressure, palpitations, heart attack or stroke in patients at increased risk, anaemia, confusion, insomnia or drowsiness, nervousness, tingling of the skin, ringing in the ears, runny nose and hoarseness, asthma, inflammation of the pancreas, vomiting, constipation, dry mouth, ulcer, muscle cramps, reduced kidney function, sweating, itching, hives, hair loss, impotence.
• Rare and very rare: Raynaud’s phenomenon, blood count changes, autoimmune diseases, pneumonia, severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), liver problems and jaundice, gynaecomastia, swelling of the intestinal wall (intestinal angioedema).

Overdose, missed dose and stopping treatment

• Overdose: contact your doctor immediately or go to the nearest hospital and take the medicine pack with you. Symptoms include a sudden or marked drop in blood pressure with light-headedness and dizziness.
• Missed dose: skip the missed dose and take the next one at the usual time. Do not take a double dose.
• Stopping treatment: do not stop treatment yourself unless your doctor has told you to.

Related information

For regular blood pressure monitoring at home, see also the category Blood pressure monitors – products in this category do not replace the medicine prescribed for you.

Composition, pack and manufacturer

• Active substance: enalapril maleate – 10 mg or 20 mg per tablet.
• Excipients: lactose monohydrate; maize starch; sodium hydrogen carbonate; talc; magnesium stearate; red iron oxide (E172); 20 mg tablets also contain yellow iron oxide (E172).
• Appearance: 10 mg – round, flat, reddish-brown tablets; 20 mg – round, flat, light orange tablets; the score line is not intended for breaking the tablet.
• Pack: carton with 2 perforated OPA/Al/PVC-aluminium unit-dose blisters, 20 tablets in total.
• Marketing authorisation holder: Krka-Farma d.o.o. Belgrade. Manufacturer: Krka d.d., Novo Mesto, Slovenia.

Storage

• Keep out of the sight and reach of children.
• Store below 25 °C in the original package in order to protect from moisture.
• Do not use after the expiry date stated on the pack.
• Return unused medicines to a pharmacy that collects medicines from the public.

Frequently asked questions

Can I split an Enap tablet in half?

No. According to the leaflet, Enap 10 mg and 20 mg tablets cannot be divided – the score line is not intended for breaking. If you need a 2.5 mg or 5 mg dose, your doctor will prescribe tablets of the appropriate strength.

Should Enap be taken before or after meals?

Enap can be taken independently of meals; swallow the tablet with a glass of water, preferably at the same time every day.

Why do I have a dry cough with Enap?

Cough is listed in the leaflet as a very common side effect. Do not stop treatment on your own – see your doctor, who will decide on further treatment.

How quickly does Enap start to work?

According to the leaflet, the medicine usually starts to work within an hour and the effect lasts at least 24 hours, but some patients need several weeks to achieve the best effect on blood pressure.

Sources

• ALIMS – Summary of Product Characteristics, Enap® 10 mg tablets (SmPC, Serbian)
• ALIMS – Patient leaflet, Enap® 10 mg and 20 mg tablets (PIL, Serbian)
• ALIMS – Summary of Product Characteristics, Enap® 20 mg tablets (SmPC, Serbian)
• ALIMS – Patient leaflet, Enap® 20 mg tablets (PIL, Serbian)

Sources checked on: 25 October 2026.