Enalapril is generally well tolerated and in most cases does not cause side effects requiring the drug to be withdrawn.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, myocardial infarction (usually associated with a marked decrease in blood pressure),rarely arrhythmia (atrial or bradi- tachycardia, atrial fibrillation), palpitations, thromboembolism of pulmonary artery branches.
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.
From the digestive system, dry mouth, anorexia, dyspepsia (nausea, diarrhea or constipation, vomiting, abdominal pain), ileus, pancreatitis, liver dysfunction and biliary excretion, hepatitis, jaundice.
From the respiratory system: unproductive dry cough, interstitial pneumonitis, bronchospasm, dyspnea, rhinorrhea, pharyngitis.
Allergic reactions: skin rash, pruritus, urticaria, angioneurotic edema, rarely dysphonia, erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pemphigus, photosensitivity, serositis, vasculitis, myositis, arthralgia, arthritis, stomatitis, glossitis.
From laboratory indicators, hypercreatininaemia, 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.
On the part of the urinary system, impaired renal function, rarely proteinuria.
Other: alopecia, decreased libido, hot flushes.