Generic Name: enalapril/hydrochlorothiazide (en-AL-a-pril/HYE-droe-KLOR-oh-THYE-a-zide)
Brand Name: Vaseretic
Enalapril/hydrochlorothiazide may cause injury or death to the fetus if taken during pregnancy. If you think you may be pregnant, contact your doctor right away. If you are planning to become pregnant, talk with your doctor about other treatment options.
Enalapril/ hydrochlorothiazide is used for:
Treating high blood pressure. It may also be used for other conditions as determined by your doctor.
Enalapril/hydrochlorothiazide is an angiotensin-converting enzyme (ACE) inhibitor and thiazide diuretic combination. It works by removing excess fluid from the body and helping to relax blood vessels. This helps to lower blood pressure.
Do NOT use enalapril/ hydrochlorothiazide if:
- you are allergic to any ingredient in enalapril/hydrochlorothiazide or any other sulfonamide medicine (eg, glyburide, probenecid, sulfamethoxazole)
- you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; hoarseness), including angioedema caused by treatment with an ACE inhibitor
- you are unable to urinate
- you are pregnant
- you are also taking aliskiren and you have either diabetes or kidney problems
- you are taking dofetilide or ketanserin
Contact your doctor or health care provider right away if any of these apply to you.
Before using enalapril/ hydrochlorothiazide:
Some medical conditions may interact with enalapril/hydrochlorothiazide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are able to become pregnant
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have bone marrow suppression, blood vessel problems (eg, in the brain or heart), gout, blood electrolyte problems (eg, high blood potassium levels), heart problems (eg, heart failure), an autoimmune disease (eg, scleroderma, lupus), high blood cholesterol or lipid levels, diabetes, or severe immune system problems
- if you have low blood sodium levels or low blood volume, you are on a low-salt (sodium) diet, or you are dehydrated
- if you have a history of asthma or liver problems
- if you are scheduled to have major surgery or to receive anesthesia
- if you have a history of kidney problems (eg, renal artery stenosis), are on dialysis, or have had a kidney transplant
- if you have recently had nerve surgery
- if you have never taken another medicine for high blood pressure
Some MEDICINES MAY INTERACT with enalapril/hydrochlorothiazide. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Eplerenone, potassium-sparing diuretics (eg, amiloride, spironolactone), potassium supplements, or salt substitutes containing potassium because the risk of high blood potassium levels may be increased
- Everolimus or sirolimus because the risk of angioedema may be increased
- Aliskiren or angiotensin receptor blockers (eg, losartan) because the risk of certain side effects (eg, kidney problems, high blood potassium levels, low blood pressure) may be increased
- Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur
- Adrenocorticotropic hormone (ACTH), barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), dextran sulfate, diazoxide, diuretics (eg, furosemide, hydrochlorothiazide), narcotic pain medicine (eg, codeine), trimethoprim, or other medicines for blood pressure because they may increase the risk of enalapril/hydrochlorothiazide's side effects
- Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, celecoxib, ibuprofen, naproxen) because they may decrease enalapril/hydrochlorothiazide's effectiveness and increase the risk of serious kidney problems.
- Digitalis glycosides (eg, digoxin), dofetilide, ketanserin, lithium, or thiopurines (eg, azathioprine) because their actions and the risk of their side effects may be increased by enalapril/hydrochlorothiazide
- Diabetes medicine (eg, glipizide, metformin) or insulin because their effectiveness may be decreased by enalapril/hydrochlorothiazide
This may not be a complete list of all interactions that may occur. Ask your health care provider if enalapril/hydrochlorothiazide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use enalapril/ hydrochlorothiazide:
Use enalapril/hydrochlorothiazide as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take enalapril/hydrochlorothiazide by mouth with or without food.
- If you take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with enalapril/hydrochlorothiazide.
- Taking enalapril/hydrochlorothiazide at the same time each day will help you remember to take it.
- Take enalapril/hydrochlorothiazide on a regular schedule to get the most benefit from it.
- Continue to take enalapril/hydrochlorothiazide even if you feel well. Do not miss any doses.
- If you miss a dose of enalapril/hydrochlorothiazide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use enalapril/hydrochlorothiazide.
Important safety information:
- Enalapril/hydrochlorothiazide may cause dizziness, light-headedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use enalapril/hydrochlorothiazide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Report any light-headedness or fainting to your doctor immediately. Your risk of light-headedness or fainting may be increased if you experience diarrhea, vomiting, or excessive sweating; if you do not drink enough fluids; or if you are on a low-salt (sodium) diet.
- Enalapril/hydrochlorothiazide may cause a serious side effect called angioedema. Black patients may be at greater risk of developing this side effect. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.
- Enalapril/hydrochlorothiazide has a sulfonamide called hydrochlorothiazide in it. Hydrochlorothiazide can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting enalapril/hydrochlorothiazide. Contact your doctor right away if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.
- Enalapril/hydrochlorothiazide may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Check with your doctor before you use a salt substitute or a product that has potassium in it.
- If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
- Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
- Tell your doctor or dentist that you take enalapril/hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery.
- Enalapril/hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to enalapril/hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Diabetes patients - Enalapril/hydrochlorothiazide may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Enalapril/hydrochlorothiazide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
- Enalapril/hydrochlorothiazide may interfere with certain lab tests, including parathyroid function. Be sure your doctor and lab personnel know you are taking enalapril/hydrochlorothiazide.
- Lab tests, including blood electrolytes, blood pressure, complete blood cell counts, and kidney function, may be performed while you take enalapril/hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use enalapril/hydrochlorothiazide with caution in the ELDERLY; they may be more sensitive to its effects.
- Enalapril/hydrochlorothiazide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Enalapril/hydrochlorothiazide may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. Enalapril/hydrochlorothiazide is found in breast milk. Do not breast-feed while taking enalapril/hydrochlorothiazide.
Possible side effects of enalapril/ hydrochlorothiazide:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; dizziness; headache; light-headedness; nausea; persistent, dry cough; tiredness; vomiting.
Severe allergic reactions (rash; hives; itching; difficulty swallowing or breathing; tightness in the chest; swelling of the hands, mouth, face, lips, eyes, throat, or tongue; unusual hoarseness); burning, numbness, or tingling; chest pain; confusion; decreased, difficult, or painful urination; dry mouth; fainting; fast, slow, or irregular heartbeat; fever, chills, or sore throat; mental or mood changes; muscle cramps, pain, or weakness; red, swollen, blistered, or peeling skin; restlessness; seizures; severe dizziness, drowsiness, or light-headedness; severe or persistent nausea or vomiting; shortness of breath; sluggishness; stomach pain (with or without nausea or vomiting); unusual bruising or bleeding; unusual thirst, tiredness, or weakness; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include dizziness; fainting; weakness.Proper storage of enalapril/hydrochlorothiazide:
Store enalapril/hydrochlorothiazide at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Keep in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep enalapril/hydrochlorothiazide out of the reach of children and away from pets.
- If you have any questions about enalapril/hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider.
- Enalapril/hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take enalapril/hydrochlorothiazide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about enalapril/hydrochlorothiazide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to enalapril/hydrochlorothiazide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using enalapril/hydrochlorothiazide.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.