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Enalapril / hydrochlorothiazide Side Effects

In Summary

Commonly reported side effects of enalapril/hydrochlorothiazide include: increased blood urea nitrogen and increased serum creatinine. Other side effects include: dizziness and headache. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to enalapril / hydrochlorothiazide: oral tablet

In addition to its needed effects, some unwanted effects may be caused by enalapril / hydrochlorothiazide. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking enalapril / hydrochlorothiazide:

Less common:
  • Blurred vision
  • chest pain or discomfort
  • chills
  • cold sweats
  • coma
  • confusion
  • decreased urine output
  • diarrhea
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • fainting
  • fast, slow, or irregular heartbeat
  • headache
  • increased thirst
  • irritability
  • loss of appetite
  • muscle pain or cramps
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • rapid breathing
  • seizures
  • shortness of breath
  • sunken eyes
  • sweating
  • swelling of the face, ankles, or hands
  • thirst
  • unusual tiredness or weakness
  • weak pulse
  • wrinkled skin

Minor Side Effects

Some of the side effects that can occur with enalapril / hydrochlorothiazide may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common:
  • Cough
  • decreased interest in sexual intercourse
  • inability to have or keep an erection
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance

For Healthcare Professionals

Applies to enalapril / hydrochlorothiazide: oral tablet


The most common adverse reactions were dizziness, headache, fatigue, and cough.[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache, syncope
Frequency not reported: Paresthesia, somnolence, vertigo, tinnitus

Postmarketing reports: Cerebrovascular accident, ataxia, peripheral neuropathy, paresthesia, dysesthesia, taste alteration, anosmia[Ref]


Common (1% to 10%): Fatigue, asthenia, orthostatic effects
Frequency not reported: Chest pain

Postmarketing reports: Gynecomastia

Frequency not reported: Weakness, fever[Ref]


Common (1% to 10%): Cough
Frequency not reported: Dyspnea

Postmarketing reports: Pulmonary embolism and infarction, pulmonary edema

Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema[Ref]


Common (1% to 10%): Muscle cramps
Frequency not reported: Back pain, arthralgia

Postmarketing reports: Flank pain

Frequency not reported: Muscle spasm[Ref]


Common (1% to 10%): Nausea, diarrhea
Frequency not reported: Abdominal pain, vomiting, dyspepsia, constipation, flatulence, dry mouth

Postmarketing reports: Ileus, pancreatitis, melena, glossitis, stomatitis, dry mouth

Frequency not reported: Pancreatitis, sialadenitis, cramping, gastric irritation[Ref]


Common (1% to 10%): Impotence
Frequency not reported: Urinary tract infection

Postmarketing reports: Oliguria[Ref]


Common (1% to 10%): Orthostatic hypotension
Uncommon (0.1% to 1%): Hypotension
Frequency not reported: Palpitation, tachycardia

Postmarketing reports: Cardiac arrest, myocardial infarction, rhythm disturbances, atrial tachycardia and bradycardia, atrial fibrillation, hypotension, angina pectoris, Raynaud's phenomenon, flushing

Frequency not reported: Vasculitis[Ref]


Uncommon (0.1% to 1%): BUN increased, serum creatinine increased

Postmarketing reports: Renal failure, renal dysfunction, pulmonary infiltrates, eosinophilic pneumonitis, bronchospasm, pneumonia, bronchitis, rhinorrhea, sore throat and hoarseness, asthma, upper respiratory infection

Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis[Ref]


Frequency not reported: Pruritus, rash, diaphoresis, angioedema

Postmarketing reports: Exfoliative dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, herpes zoster, erythema multiforme, urticaria, pemphigus, alopecia, photosensitivity

Frequency not reported: Purpura, photosensitivity, urticaria, cutaneous vasculitis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, alopecia[Ref]


Frequency not reported: Insomnia, nervousness, libido decreased

Postmarketing reports: Depression, confusion, dream abnormality

Frequency not reported: Restlessness[Ref]


Frequency not reported: Hemoglobin decreased, hematocrit decreased

Postmarketing reports: Neutropenia, thrombocytopenia, bone marrow depression, hemolytic anemia

Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia[Ref]


Frequency not reported: Liver enzymes increased, serum bilirubin increased

Postmarketing reports: Hepatic failure, hepatitis

Frequency not reported: Intrahepatic cholestatic jaundice[Ref]


Frequency not reported: Gout
Postmarketing reports: Anorexia

Frequency not reported: Anorexia[Ref]


Postmarketing reports: Blurred vision, conjunctivitis, dry eyes, tearing

Frequency not reported: Transient blurred vision, xanthopsia[Ref]


Postmarketing reports: Anaphylactoid reactions

Frequency not reported: Anaphylactic reactions[Ref]


1. "Product Information. Vaseretic (enalapril-hydrochlorothiazide)." Merck & Co, Inc, West Point, PA.

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Not all side effects for enalapril / hydrochlorothiazide may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.