Enalapril is generally well tolerated and in most cases does not cause side effects requiring the drug to be withdrawn.
Co cardiovascular system: excessive a decrease in blood pressure,
orthostatic collapse, rarely chest pain, stenocardia, myocardial infarction or stroke (usually associated with a marked decrease in blood pressure), rarely arrhythmias (atrial brady or tachycardia, atrial fibrillation), palpitations, pulmonary artery thromboembolism, Raynaud's syndrome.
Co side of the central nervous system: dizziness, headache, weakness, insomnia, anxiety, confusion, increased fatigue, drowsiness (2-3%), very rarely with high doses - nervousness, depression, paresthesia.
Co side of the senses: disturbances of the vestibular apparatus, hearing and vision impairment, tinnitus.
Co side of the digestive system: dry mouth, anorexia, dyspeptic disorders (nausea, diarrhea or constipation, vomiting, abdominal pain), intestinal obstruction, pancreatitis, liver and biliary dysfunction, hepatitis (hepatocellular or cholestatic), jaundice.
Co the respiratory system: nonproductive dry cough, sore throat, hoarseness, pulmonary infiltrates, interstitial pneumonitis, bronchospasm, dyspnea, rhinorrhea, pharyngitis.
Allergic reactions: skin rash, itching, urticaria, angioedema, extremely rare dysphonia, polymorphic erythema, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pemphigus, photosensitivity, serositis, vasculitis, myositis, arthralgia, arthritis, stomatitis, glossitis, intestinal edema rarely).
Co side of laboratory indicators: hypercreatinemia, increased
plasma urea levels, increased activity of "hepatic" enzymes, hyperbilirubinemia, hyperkalemia, hyponatremia, hypoglycemia in patients with diabetes mellitus receiving hypoglycemic agents for ingestion or insulin. In some cases, a decrease in the concentration of hemoglobin and hematocrit, increased ESR, thrombocytopenia, neutropenia, agranulocytosis (in patients with autoimmune diseases), eosinophilia are noted.
Co side of the urinary system: impaired renal function, rarely proteinuria.
Other: alopecia, decreased libido, impotence, "hot flashes".