Enalapril is generally well tolerated and in most cases does not cause side effects requiring the drug to be withdrawn.
Co cardiovascular system: excessive reduction in blood pressure, orthostatic collapse, rarely - chest pain, angina pectoris, myocardial infarction (usually associated with a marked decrease in blood pressure), rarely arrhythmia (atrial brady or tachycardia, atrial fibrillation), palpitation, thromboembolism of the pulmonary artery branches.
Co the central nervous system: dizziness, headache, weakness, insomnia, anxiety, confusion, increased fatigue, drowsiness (2-3%), very rarely with high doses - nervousness, depression, paresthesia.
Co sensory side: violations of the vestibular apparatus, hearing and vision impairment, tinnitus.
Co the sides of the digestive system: dry mouth, anorexia, dyspeptic disorders (nausea, diarrhea or constipation, vomiting, abdominal pain), intestinal obstruction, pancreatitis, impaired liver function and bile secretion, hepatitis, jaundice.
Co of the respiratory system: unproductive dry cough, 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.
Co side of laboratory indicators: hyperkreatininemia, increased urea levels, increased activity of "hepatic" enzymes, hyperbilirubinemia, hyperkalemia, hyponatremia. In some cases, reduced hematocrit, increased ESR, thrombocytopenia, neutropenia, agranulocytosis (in patients with autoimmune diseases), eosinophilia.
Co side of the urinary system, impaired renal function, rarely proteinuria.
Other: alopecia, decreased libido, hot flashes.