Drug Interaction Report

Using linagliptin together with enalapril may cause angioedema, a condition associated with swelling of the face, eyes, lips, tongue, throat, and occasionally also the hands and feet. Each medication alone can also cause angioedema, but the risk may be increased when they are combined. Angioedema can occur with the first dose of medication or after many doses. You should discontinue the medications and seek immediate medical attention if you develop symptoms of angioedema or have difficulty swallowing or breathing. In addition, enalapril may enhance the effects of linagliptin and increase the risk of hypoglycemia (low blood sugar). Symptoms of low blood sugar include headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, and fast or pounding heartbeats. You may need a dose adjustment or more frequent monitoring of your blood sugar if you have been using linagliptin and are starting treatment with enalapril. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

It is recommended that if you are taking enalapril you should be advised to avoid moderately high or high potassium dietary intake. This can cause high levels of potassium in your blood. Do not use salt substitutes or potassium supplements while taking enalapril, unless your doctor has told you to.

Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Enalapril and ethanol (alcohol) may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.