Supplements and Enalapril maleate.
Enalapril maleate, sold under the brand names Innovace, Vasotec, is an ACE inhibitor: it lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II.
Enalapril maleate is an ACE inhibitor. The class blocks the conversion of angiotensin I to angiotensin II, dropping blood pressure and reducing afterload on the heart. The defining side effect is a dry persistent cough from bradykinin accumulation. It affects around 10 to 15 percent of UK patients and is the most common reason for switching to an ARB. Renal function depends on renin-angiotensin signalling for glomerular filtration pressure, so annual U&E checks are standard. The most clinically important class interaction with supplements is with chronic NSAID use, which blunts the antihypertensive effect and adds renal stress in older patients. Additive BP supplements (beetroot extract, hibiscus, garlic) CoQ10 lowers systolic pressure by roughly 3 to 5 mmHg in people with cardiometabolic conditions (Zhao 2022), though a Cochrane review found no effect in primary hypertension and no study has tested it alongside a blood-pressure drug, so watch readings rather than treat it as a known interaction. stack on top, sometimes usefully. Real liquorice opposes the BP effect by retaining sodium, driven by glycyrrhizin rather than by aldosterone, which reads low. It warrants caution at habitual intake, though deglycyrrhizinated (DGL) liquorice does not carry the effect.
Below are the 4 documented pairs we have explicitly assessed against Enalapril maleate in the Distil database: 1 red and 3 amber. The pairs cluster around 3 mechanisms: Additive hyperkalaemia (raised potassium), Reduced renal lithium clearance, and Renal zinc wasting (drug-induced). Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive hyperkalaemia (raised potassium)
Red Does Potassium interact with ?
Enalapril raises blood potassium by reducing how much the kidneys pass out. A potassium supplement adds more potassium on top. Together they can push potassium high enough to affect the heart rhythm, which can be dangerous. Do not take a potassium supplement alongside enalapril unless your GP has specifically advised it and is checking your blood potassium.
Evidence: Supported by human study data.
Reduced renal lithium clearance
Amber Does Lithium Orotate interact with ?
ACE inhibitor blood pressure tablets such as enalapril can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution, especially in older people. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take an ACE inhibitor, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Renal zinc wasting (drug-induced)
Amber Does Zinc interact with ?
Enalapril can make the kidneys pass out more zinc in the urine, so people on it long term can drift towards low zinc. This works the opposite way to most interactions: the medicine lowers your zinc rather than the supplement affecting the medicine, so taking zinc is generally a supportive response rather than a hazard. If you take enalapril long term it is worth letting your GP know you supplement zinc, and not taking very high doses without a reason, since too much zinc over time can lower copper.
Evidence: Supported by human study data.
Amber Does Zinc Bisglycinate interact with ?
Enalapril can make the kidneys pass out more zinc in the urine, so people on it long term can drift towards low zinc. This works the opposite way to most interactions: the medicine lowers your zinc rather than the supplement affecting the medicine, so taking zinc is generally a supportive response rather than a hazard. If you take enalapril long term it is worth letting your GP know you supplement zinc, and not taking very high doses without a reason, since too much zinc over time can lower copper.
Evidence: Supported by human study data.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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