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6 foods to avoid when taking enalapril

Here’s what you should and shouldn’t eat when taking this blood pressure-lowering medication
By | Mar. 3, 2025 Medically reviewed by J. Elizabeth Allen, DO, FACEP
image of beer, bananas, avocado, bacon, and cookies - what foods to avoid while taking enalapril

Key takeaways

  • Enalapril is a blood pressure-lowering drug that belongs to the class of medications called ACE inhibitors.

  • It can increase potassium levels in the blood, so high-potassium foods should be avoided while taking enalapril.

  • Other foods to avoid include high-sodium foods, salt substitutes, fatty foods, alcohol, and processed foods.

  • Follow a heart-healthy diet, such as the DASH diet, which is rich in fruits, vegetables, whole grains, legumes, nuts, poultry, fish, and healthy fats.

In this article:

Enalapril is a prescription drug approved by the Food and Drug Administration (FDA) to treat high blood pressure and heart failure. It can also be used off-label to treat kidney disease. Enalapril is sold under various brand names, such as Epaned and Vasotec. When taking enalapril, ask your healthcare provider or pharmacist if you should change your diet. You may be advised to avoid certain foods, such as alcohol, processed foods, and foods high in potassium, sodium, or fat.

How enalapril works

Enalapril belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors. “Enalapril is an ACE inhibitor and works by blocking the action of the enzyme that produces angiotensin II, a substance in the body that causes blood vessels to narrow and tighten,” explains Supriya Rao, MD, an internist based in Boston, Massachusetts. “When angiotensin II is reduced, blood vessels can relax and widen, leading to lower blood pressure.” Enalapril can work as soon as one hour after taking the first dose, but full effects may not be seen for several weeks, Dr. Rao says.

6 foods to avoid with enalapril

When taking prescription drugs, your healthcare provider may advise you to make some dietary changes. In the case of ACE inhibitors like enalapril, there are some possible food interactions to know.

1. High potassium foods

ACE inhibitors like enalapril can cause too high potassium levels. Enalapril may lower aldosterone levels, which reduces the amount of potassium the kidneys eliminate from the body, explains Michelle Routhenstein, RD, a registered dietitian in New York City who specializes in cardiology. “This increase may lead to serious health issues.”

Eating too many potassium-rich foods or taking potassium supplements while taking this medication can exacerbate the problem and cause hyperkalemia. “Hyperkalemia is a condition where the level of potassium in your blood is too high, which can impact heart and muscle function,” Dr. Rao explains. According to an observational study, high potassium levels in hypertensive patients were associated with a significantly higher risk of death. Hyperkalemia can also cause side effects, including muscle weakness, paralysis, and electrical abnormalities in the heart. It is important to know that most people will not have symptoms of high potassium until the levels are dangerously high. Very high potassium levels can cause an irregular heartbeat and, in the worst-case scenario, cardiac arrest (sudden death).

The following are potassium-rich foods, according to the Dietary Guidelines for Americans:

  • Dark leafy greens, such as beet greens, swiss chard, and spinach
  • Legumes, such as lima beans and adzuki beans
  • Fruits, such as avocados, bananas, and kiwifruit
  • Fruit juice, such as prune, orange, and grapefruit juice
  • Root vegetables, such as carrots, potatoes, and sweet potatoes

While the general recommendation is to monitor potassium intake while taking enalapril, the amount of potassium-rich foods you should eat should ultimately be personalized. Routhenstein recommends regular lab testing to monitor your potassium levels while on enalapril.

2. High-sodium foods

People with high blood pressure are often advised to avoid foods that contain high amounts of sodium, says Karishma Patwa, MD, a board-certified cardiologist at Manhattan Cardiology in New York City. While this is generally a good idea for those with hypertension, it’s also recommended for those who take enalapril.

Studies show that there’s a close association between hypertension and sodium intake. In one clinical trial, older adults who followed a low-sodium diet experienced a significant reduction in blood pressure. Though enalapril is used to lower blood pressure, high-sodium foods can worsen blood pressure and reduce its effectiveness, Routhenstein says. She recommends avoiding the following foods that tend to be high in sodium:

  • Bacon
  • Ham
  • Sausage
  • Canned soups
  • Packaged snacks
  • Pickled foods

Fast food also tends to be high in sodium, Dr. Rao adds. A good rule of thumb is to limit your sodium intake to no more than 1,500 milligrams per day, in line with recommendations from the American Heart Association.

3. Salt substitutes

If your healthcare provider recommends cutting down on sodium when taking prescription drugs like enalapril, you may resort to salt substitutes to add flavor to your meals. While it may seem like an easy swap, it’s not recommended. “Some salt substitutes contain potassium chloride, which is challenging for the kidneys to excrete,” Routhenstein explains. “This could potentially lead to elevated blood potassium levels, especially when taking enalapril.” Opt for spices and herbs instead to enhance the flavor of your meals.

4. Fatty foods

Saturated fats and trans are considered a risk factor for high blood pressure, research shows. “Fatty foods can slow down gastric mobility, which may reduce the absorption of medications,” Dr. Patwa explains.

According to the Mayo Clinic, saturated and trans fats are found in:

  • Baked goods, such as packaged cookies and crackers
  • Fried foods
  • Red meat and full-fat dairy products
  • Partially hydrogenated oils, such as margarine and shortening

Avoiding saturated and trans fats is beneficial for heart health, blood pressure, and possibly the effectiveness of enalapril.

5. Alcohol

Chronic alcohol consumption can worsen high blood pressure. However, it may come as a surprise that in the short-term, “alcohol can temporarily lower your blood pressure,” Dr. Patwa says. That effect contributes to side effects like dizziness when combined with blood pressure-lowering medications like enalapril.

6. Processed foods

If you’re taking enalapril to manage your blood pressure, it’s good practice to avoid highly processed foods, Dr. Rao says. In one meta-analysis, researchers found that higher consumption of ultra-processed foods—such as instant noodles, candy, or sugary cereal—significantly increased the risk of hypertension. Highly processed foods can also worsen some of the gastrointestinal side effects of enalapril, such as nausea, diarrhea, and abdominal pain, Dr. Rao says.

What should you eat while taking enalapril?

Enalapril is used to treat hypertension and heart failure, so a heart-healthy diet is typically recommended. The best diet for high blood pressure is usually the DASH diet (dietary approaches to stop hypertension), which has been shown to effectively manage hypertension and lower the risk of heart disease.

Created by the National Heart, Lung, and Blood Institute, the DASH diet recommends eating the following foods to improve blood pressure:

  • Fat-free or low-fat dairy products
  • Fish
  • Fruits and vegetables
  • Legumes
  • Poultry
  • Whole grains
  • Vegetable oils

Gastrointestinal side effects of enalapril

As with any prescription drug, enalapril may have some side effects. Per the National Library of Medicine, the general side effects of enalapril include:

  • Cough
  • Dizziness
  • Rash
  • Weakness
  • Lightheadedness

Common gastrointestinal side effects of enalapril include:

  • Nausea
  • Diarrhea
  • Abdominal pain

Enalapril can also cause more serious and potentially life-threatening side effects, including difficulty breathing, swelling of the lips and tongue, yellowing of the skin, fever, or fainting. If you experience any of these serious side effects of enalapril, you should get emergency medical care immediately.

Additionally, enalapril has numerous drug interactions. According to the Mayo Clinic, enalapril shouldn’t be taken with certain diuretics, angiotensin II receptor blockers (ARBs), and other prescription drugs. Share a full list of all medications and over-the-counter supplements you take with your healthcare provider or pharmacist before taking enalapril.

Tips for maximizing enalapril benefits

Your diet can exacerbate some of the side effects of enalapril. A good time to take enalapril is about an hour before eating, Dr. Patwa suggests. However, if the medication upsets your stomach, taking it with food can help.

It’s important to take enalapril on a consistent schedule. Make sure to take it at the same time every day, Dr. Rao says. Taking enalapril at the same time each day can help you remember to take it, per the National Library of Medicine.

It is also good for your health to stay hydrated and monitor your blood pressure levels regularly, Routhenstein says.