Enalapril + Hydrochlorothiazide
Find more information about this combination medication at the webpages for hydrochlorothiazide and enalapril
Advisory
- This medicine contains a combination of 2 drugs enalapril and hydrochlorothiazide.
- enalapril and hydrochlorothiazide are both used to treat the same disease or symptom but work in different ways in the body.
- Most doctors will advise making sure that each individual medicine is safe and effective before using a combination form.
Drug Status
Government Approvals
UK(FDA), US(FDA)
WHO Essential Medicine
NO
Known Teratogen
Definite
Pharmaceutical Class
Angiotensin Converting Enzyme Inhibitor and Thiazide Diuretic
Controlled Drug Substance
NO

enalapril + hydrochlorothiazide
Summary
Enalapril and hydrochlorothiazide are used to treat high blood pressure, which is also known as hypertension. Enalapril is also used for heart failure, which is when the heart can't pump blood effectively. Hydrochlorothiazide helps with fluid retention, which is called edema, often linked to heart failure. Together, they manage blood pressure and reduce risks of heart attacks and strokes, especially when one medicine alone isn't enough.
Enalapril works by blocking an enzyme that narrows blood vessels, which helps relax and widen them, lowering blood pressure. Hydrochlorothiazide acts as a diuretic, which means it helps the body get rid of excess salt and water through urine, reducing fluid buildup and lowering blood pressure. Together, they provide a dual approach to managing high blood pressure by relaxing blood vessels and reducing fluid volume.
The usual adult dose for enalapril ranges from 5 to 40 mg per day, depending on the individual's response and medical condition. Hydrochlorothiazide is typically prescribed at 12.5 to 50 mg per day. These medicines are often taken by mouth, and the combination is adjusted based on blood pressure control and tolerance. It's important to follow the healthcare provider's instructions and not to adjust the dose without consulting them.
Common side effects of enalapril include dizziness, headache, and fatigue, which are related to its blood pressure-lowering effects. Hydrochlorothiazide may cause increased urination, dizziness, and electrolyte imbalances, such as low potassium levels. Both medicines can cause dizziness, especially when standing up quickly, due to their effects on blood pressure. It's important to monitor for these effects and consult a healthcare provider if they occur.
Enalapril should not be used by people with a history of angioedema, which is a severe allergic reaction causing swelling. Hydrochlorothiazide is contraindicated in individuals with severe kidney disease or an inability to urinate. Both medicines should be used cautiously in people with kidney problems or electrolyte imbalances. It's important to avoid using these medications during pregnancy due to potential harm to the fetus. Regular monitoring of blood pressure, kidney function, and electrolytes is essential.
Indications and Purpose
How does combination of enalapril and hydrochlorothiazide work?
Enalapril works by blocking an enzyme that narrows blood vessels, which helps to relax and widen them, lowering blood pressure. Hydrochlorothiazide acts as a diuretic, which means it helps the body get rid of excess salt and water through urine, reducing fluid buildup and lowering blood pressure. Together, they provide a dual approach to managing high blood pressure by relaxing blood vessels and reducing fluid volume. This combination helps improve blood flow and reduces the workload on the heart, making it easier for the heart to pump blood.
How does combination of Enalapril and Hydrochlorothiazide work?
Enalapril and Hydrochlorothiazide work together to lower blood pressure through complementary mechanisms. Enalapril, an ACE inhibitor, reduces the production of angiotensin II, a substance that narrows blood vessels, thereby relaxing and widening them to improve blood flow. Hydrochlorothiazide, a diuretic, helps the kidneys remove excess salt and water from the body, reducing blood volume and pressure. Together, they provide a more effective approach to managing hypertension by addressing both vascular resistance and fluid retention.
How effective is combination of enalapril and hydrochlorothiazide?
Clinical studies have shown that enalapril effectively lowers blood pressure by inhibiting the enzyme that narrows blood vessels. Hydrochlorothiazide has been proven to reduce blood pressure by promoting the excretion of excess salt and water. Together, they provide a complementary effect, enhancing blood pressure control more effectively than either drug alone. The combination is supported by evidence showing reduced risks of heart-related events in patients with hypertension. Both medicines are well-studied and widely used, with a long history of effectiveness in managing high blood pressure.
How effective is combination of Enalapril and Hydrochlorothiazide?
The effectiveness of Enalapril and Hydrochlorothiazide in treating hypertension is well-documented through clinical studies. Enalapril, as an ACE inhibitor, has been shown to significantly reduce blood pressure by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Hydrochlorothiazide, a diuretic, enhances this effect by promoting the excretion of excess salt and water, thereby reducing blood volume. Together, they provide an additive effect, leading to a more pronounced and sustained reduction in blood pressure. Clinical trials have demonstrated that this combination is effective in both black and non-black patients, offering a reliable option for managing high blood pressure.
Directions for Use
What is the usual dose of combination of enalapril and hydrochlorothiazide?
The usual adult dose for enalapril ranges from 5 to 40 mg per day, depending on the individual's response and medical condition. Hydrochlorothiazide is typically prescribed at 12.5 to 50 mg per day. The combination of these medicines is often adjusted based on blood pressure control and tolerance. It's important to follow the healthcare provider's instructions and not to adjust the dose without consulting them. Regular monitoring of blood pressure and kidney function helps determine the appropriate dose for each individual, ensuring effective and safe treatment.
What is the usual dose of combination of Enalapril and Hydrochlorothiazide?
The usual adult daily dose for the combination of Enalapril and Hydrochlorothiazide varies depending on the specific needs of the patient. Enalapril is typically prescribed in doses ranging from 10 to 40 mg per day, which can be taken in a single dose or divided into two doses. Hydrochlorothiazide is usually prescribed in doses of 12.5 to 50 mg daily. The combination tablets are available in different strengths, such as 5/12.5 mg and 10/25 mg, allowing for flexibility in dosing to achieve optimal blood pressure control. It's important to follow the doctor's prescription and not to adjust the dose without medical advice.
How does one take combination of enalapril and hydrochlorothiazide?
Enalapril and hydrochlorothiazide can be taken with or without food, but it's important to take them consistently at the same time each day. Drinking plenty of water is recommended to prevent dehydration, especially with hydrochlorothiazide. Avoiding excessive salt intake can enhance the effectiveness of these medications. It's important to follow the healthcare provider's instructions and not to make any dietary changes without consulting them. Regular monitoring of blood pressure and kidney function is essential to ensure the medications are working effectively.
How does one take combination of Enalapril and Hydrochlorothiazide?
Enalapril and Hydrochlorothiazide can be taken with or without food, but it is important to take them at the same time each day to maintain consistent blood levels. Patients should follow their doctor's instructions regarding any dietary restrictions, particularly concerning salt intake. It's advisable to avoid salt substitutes containing potassium unless directed by a healthcare provider, as these can interact with the medication. Staying hydrated is important, but excessive fluid intake should be avoided to prevent electrolyte imbalances.
For how long is combination of enalapril and hydrochlorothiazide taken?
Enalapril and hydrochlorothiazide are typically used for long-term management of high blood pressure. The duration of use depends on the individual's response and medical condition. These medications are often taken indefinitely to maintain blood pressure control and reduce the risk of heart-related complications. Regular follow-ups with a healthcare provider are important to monitor effectiveness and adjust the treatment as needed. It's crucial not to stop taking these medications without consulting a healthcare provider, as this could lead to a rebound increase in blood pressure.
For how long is combination of Enalapril and Hydrochlorothiazide taken?
Enalapril and Hydrochlorothiazide are typically used as long-term treatments for managing high blood pressure. While they help control blood pressure, they do not cure hypertension, so continuous use is often necessary to maintain the desired blood pressure levels. Patients are advised to take these medications consistently, even if they feel well, and should not stop taking them without consulting their doctor. Regular monitoring by a healthcare provider is essential to ensure the medication remains effective and to adjust the dosage if needed.
How long does it take for combination of enalapril and hydrochlorothiazide to work?
Enalapril, which is an ACE inhibitor, typically starts working within an hour, but it may take a few weeks to see the full effect on blood pressure. Hydrochlorothiazide, which is a diuretic, usually begins to work within two hours, helping to reduce fluid retention and lower blood pressure. Together, these medicines work to lower blood pressure by relaxing blood vessels and reducing fluid buildup. The combination may take a few weeks to show the full benefits in terms of blood pressure control.
How long does it take for combination of Enalapril and Hydrochlorothiazide to work?
Enalapril and Hydrochlorothiazide work together to lower blood pressure, but they have different mechanisms and onset times. Enalapril, an ACE inhibitor, begins to lower blood pressure within about one hour after ingestion, with peak effects occurring around four to six hours. Hydrochlorothiazide, a diuretic, starts to work within two hours, with its peak diuretic effect occurring around four hours after ingestion. The combination of these two medications provides a more comprehensive approach to managing high blood pressure, with enalapril reducing the constriction of blood vessels and hydrochlorothiazide helping to eliminate excess fluid and salt from the body. Together, they offer a sustained blood pressure-lowering effect throughout the day.
Warnings and Precautions
Are there harms and risks from taking combination of enalapril and hydrochlorothiazide?
Common side effects of enalapril include dizziness, headache, and fatigue, which are related to its blood pressure-lowering effects. Hydrochlorothiazide may cause increased urination, dizziness, and electrolyte imbalances, such as low potassium levels. Both medicines can cause dizziness, especially when standing up quickly, due to their effects on blood pressure. Significant adverse effects include allergic reactions, severe low blood pressure, and kidney problems. It's important to monitor for these effects and consult a healthcare provider if they occur. Both medicines require regular monitoring to ensure safety and effectiveness.
Are there harms and risks from taking combination of Enalapril and Hydrochlorothiazide?
Common side effects of Enalapril and Hydrochlorothiazide include cough, dizziness, headache, and fatigue. Enalapril may cause a persistent dry cough due to its effect on bradykinin levels. Hydrochlorothiazide can lead to increased urination, electrolyte imbalances, and muscle cramps. Serious adverse effects include lightheadedness, swelling of the face or throat, difficulty breathing, and signs of infection. Both medications can cause changes in kidney function and electrolyte levels, so regular monitoring is important. Patients should report any severe or persistent side effects to their healthcare provider immediately.
Can I take combination of enalapril and hydrochlorothiazide with other prescription drugs?
Enalapril can interact with other blood pressure medications, increasing the risk of low blood pressure. It also interacts with potassium-sparing diuretics, raising potassium levels. Hydrochlorothiazide can interact with lithium, increasing the risk of lithium toxicity. Both medicines can interact with NSAIDs, reducing their effectiveness. It's important to inform healthcare providers about all prescription medications being taken to avoid interactions. Regular monitoring of blood pressure and blood tests for kidney function and electrolytes can help manage these interactions. Consulting with a healthcare provider ensures safe use of these medications.
Can I take combination of Enalapril and Hydrochlorothiazide with other prescription drugs?
Enalapril and Hydrochlorothiazide can interact with several prescription medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the effectiveness of both medications in lowering blood pressure. Combining these drugs with other blood pressure medications, such as beta-blockers or calcium channel blockers, can enhance the blood pressure-lowering effect, which may require dosage adjustments. Enalapril should not be used with aliskiren in patients with diabetes due to increased risk of kidney problems. Additionally, lithium levels can be increased when taken with these medications, leading to toxicity. It's crucial to inform healthcare providers of all medications being taken to manage potential interactions.
Can I take combination of enalapril and hydrochlorothiazide if I am pregnant?
Enalapril is not recommended during pregnancy, especially in the second and third trimesters, as it can harm the developing baby, potentially causing birth defects or complications. Hydrochlorothiazide is generally avoided during pregnancy due to potential risks to the fetus, such as electrolyte imbalances. Both medicines are typically replaced with safer alternatives during pregnancy. If a woman becomes pregnant while taking these medications, she should contact her healthcare provider immediately to discuss alternative treatments. It's crucial to manage blood pressure during pregnancy with medications that are safe for both mother and baby.
Can I take combination of Enalapril and Hydrochlorothiazide if I am pregnant?
Enalapril and Hydrochlorothiazide are not recommended during pregnancy, particularly in the second and third trimesters, due to the risk of fetal harm. Enalapril can affect fetal kidney development and lead to complications such as low amniotic fluid levels and developmental issues. Hydrochlorothiazide can cause electrolyte imbalances and affect fetal growth. If pregnancy is detected, these medications should be discontinued immediately, and alternative treatments should be considered. It's crucial for women of childbearing age to discuss potential risks with their healthcare provider before starting these medications.
Can I take combination of enalapril and hydrochlorothiazide while breastfeeding?
Enalapril is generally considered safe during breastfeeding, as only small amounts pass into breast milk and are unlikely to harm the baby. Hydrochlorothiazide is also considered safe in low doses, but higher doses may reduce milk production. Both medicines should be used with caution, and it's important to monitor the baby for any signs of side effects, such as unusual sleepiness or feeding difficulties. Mothers should discuss with their healthcare provider the risks and benefits of continuing these medications while breastfeeding to ensure the safety of both mother and child.
Can I take combination of Enalapril and Hydrochlorothiazide while breastfeeding?
Enalapril and Hydrochlorothiazide are present in breast milk, but the concentrations are generally low. While these levels are not typically considered harmful, caution is advised when using these medications during breastfeeding, especially in newborns or preterm infants. The decision to use these medications should consider the importance of the drug to the mother and the potential risks to the infant. If used, monitoring the infant for any adverse effects is recommended. Consulting with a healthcare provider is essential to weigh the benefits and risks of continuing these medications while breastfeeding.
Who should avoid taking combination of enalapril and hydrochlorothiazide?
Enalapril should not be used by people with a history of angioedema, which is a severe allergic reaction causing swelling. Hydrochlorothiazide is contraindicated in individuals with severe kidney disease or an inability to urinate. Both medicines should be used cautiously in people with kidney problems or electrolyte imbalances. It's important to avoid using these medications during pregnancy due to potential harm to the fetus. Regular monitoring of blood pressure, kidney function, and electrolytes is essential. Patients should inform their healthcare provider of any allergies or medical conditions before starting these medications.
Who should avoid taking combination of Enalapril and Hydrochlorothiazide?
Key warnings for Enalapril and Hydrochlorothiazide include the risk of fetal toxicity, so they should not be used during pregnancy. Patients with a history of angioedema or those allergic to sulfa drugs should avoid these medications. Caution is advised in patients with kidney or liver disease, diabetes, or electrolyte imbalances. Enalapril can cause a persistent cough, and Hydrochlorothiazide may lead to dehydration and electrolyte disturbances. Regular monitoring of blood pressure, kidney function, and electrolytes is essential to ensure safe use. Patients should inform their healthcare provider of any other medications or supplements they are taking.