From the FDA Drug Label
Enalapril absorption is not influenced by the presence of food in the gastrointestinal tract. The ACE inhibitor enalapril can be taken with or without food, as food does not affect its absorption. 1
From the Research
ACE inhibitors can generally be taken with or without food, but it is recommended to take them consistently with or without meals to minimize potential interactions and side effects. Most ACE inhibitors, including lisinopril, enalapril, ramipril, and captopril, can be taken regardless of meal timing, with the exception of captopril which is better absorbed on an empty stomach (1 hour before meals or 2 hours after) 2. Taking ACE inhibitors with food may help reduce the risk of digestive side effects like nausea that some patients experience. However, consistency is important - if you choose to take your medication with meals, try to do so regularly.
Key Considerations
- ACE inhibitors work by blocking the enzyme that converts angiotensin I to angiotensin II, thereby relaxing blood vessels and lowering blood pressure 3.
- This mechanism of action is not significantly affected by food for most ACE inhibitors.
- Some ACE inhibitors, such as captopril and moexipril, have potential drug-food interactions and should be spaced from meals 2.
- The bioavailability of ACE inhibitors may be reduced by concomitant food or antacids, which can slow gastric emptying and raise gastric pH 4.
Recommendations
- Always follow your doctor's specific instructions, as individual circumstances may vary, and never adjust your medication schedule without consulting your healthcare provider.
- If you experience digestive side effects, consider taking your ACE inhibitor with food to minimize these effects.
- Be aware of potential interactions with other medications, such as diuretics, beta-blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs), which can affect the efficacy and safety of ACE inhibitors 4, 5.