19 Sep 2012
You need to tell your doc because it could be caused by something else. Here is what I found on enalapril. Remember this is only 2 patients of the many who take it. A 56-year-old woman with hypertension and diabetes developed acute abdominal pain, nausea, and vomiting associated upper abdominal tenderness, hyperamylasemia, hyperlipasemia, and normal upper abdominal ultrasonography within 24 hours of starting enalapril. The signs and symptoms of pancreatitis resolved over the next several days once the drug was discontinued. No rechallenge was performed.
A 65-year-old woman was diagnosed with acute pancreatitis by ultrasonography, CT scan, and serum amylase level of 980 units/L. The patient had been receiving enalapril, HCTZ, and amiloride for one year. The pancreatitis resolved over 7 days. The patient upon rechallenge with enalapril developed severe upper abdominal pain, vomiting, and hypotension. CT scan showed intrapancreatic necrosis and peripancreatic fluid. Four weeks later a CT scan showed three pseudocysts that took 4 months to resolve. The author of the report concluded that rechallenging patients who develop acute pancreatitis while on enalapril is not recommended.
Gastrointestinal side effects are unusual. Nausea, vomiting, or diarrhea has each been reported in less than 3% of patients. Dysgeusia is rare, occurring in less than 0.5% of patients. Rare cases of pancreatitis and acute small bowel mucosal edema associated with enalapril have been reported
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