Is ACE2 enzyme (oral supplement) Safe with Enalapril?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid combining oral ACE2 enzyme supplements with enalapril or benazeprilat; if ACE2 supplementation is clinically desired (e.g., for pulmonary hypertension or RAS modulation), consider switching to an ARB under physician supervision, as ARBs allow significantly greater ACE2 activity (670–755% increase vs. reduced activity with ACEIs).
Why this interaction occurs
In vitro and clinical data in MMVD dogs showed enalapril and benazeprilat inhibited recombinant ACE2 activity by >90% at higher doses, and background ACEI therapy inhibited membrane ACE2 activity by 211% compared to ARB therapy. ACEIs also reduced the Ang1-7 pool proportionately, counteracting the intended benefit of ACE2 supplementation.
Evidence
Evidence level: limited.
Data source
PubMed - PMID 39837966
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 61,312 reports mentioning Enalapril. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Enalapril + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All ACE2 enzyme (oral supplement) interactions → · All Enalapril interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.