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Enalapril / hydrochlorothiazide Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 5, 2020.

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

Warning

Oral route (Tablet)

Discontinue enalapril maleate/hydrochlorothiazide as soon as possible when pregnancy is detected, since fetal toxicity, including injury and death to the developing fetus, can be caused by drugs that act directly on the renin-angiotensin system.

Side effects requiring immediate medical attention

Along with its needed effects, enalapril / hydrochlorothiazide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking enalapril / hydrochlorothiazide:

Less common

  • Blurred vision
  • chest pain, discomfort, or tightness
  • 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
  • large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
  • loss of appetite
  • lower back or side pain
  • muscle pain or cramps
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • rapid breathing
  • seizures
  • sunken eyes
  • sweating
  • swelling of the face, ankles, or hands
  • thirst
  • trouble breathing
  • unusual tiredness or weakness
  • weak pulse
  • wrinkled skin

Rare

  • Persistent non-healing sore
  • pink growth
  • reddish patch or irritated area
  • shiny bump
  • white, yellow or waxy scar-like area

Side effects not requiring immediate medical attention

Some side effects of enalapril / hydrochlorothiazide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  • Ankle, knee, or great toe joint pain
  • cough
  • decreased interest in sexual intercourse
  • difficulty in moving
  • inability to have or keep an erection
  • itching skin
  • joint stiffness or swelling
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance
  • pain in the joints
  • trouble sleeping
  • unable to sleep

For Healthcare Professionals

Applies to enalapril / hydrochlorothiazide: oral tablet

General

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

Enalapril:

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

Other

Common (1% to 10%): Fatigue, asthenia, orthostatic effects

Frequency not reported: Chest pain

Enalapril:

Postmarketing reports: Gynecomastia

Hydrochlorothiazide:

Frequency not reported: Weakness, fever[Ref]

Respiratory

Common (1% to 10%): Cough

Frequency not reported: Dyspnea

Enalapril:

Postmarketing reports: Pulmonary embolism and infarction, pulmonary edema

Hydrochlorothiazide:

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

Musculoskeletal

Common (1% to 10%): Muscle cramps

Frequency not reported: Back pain, arthralgia

Enalapril:

Postmarketing reports: Flank pain

Hydrochlorothiazide:

Frequency not reported: Muscle spasm[Ref]

Gastrointestinal

Common (1% to 10%): Nausea, diarrhea

Frequency not reported: Abdominal pain, vomiting, dyspepsia, constipation, flatulence, dry mouth

Enalapril:

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

Hydrochlorothiazide:

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

Genitourinary

Common (1% to 10%): Impotence

Frequency not reported: Urinary tract infection

Enalapril:

Postmarketing reports: Oliguria[Ref]

Cardiovascular

Common (1% to 10%): Orthostatic hypotension

Uncommon (0.1% to 1%): Hypotension

Frequency not reported: Palpitation, tachycardia

Enalapril:

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

Hydrochlorothiazide:

Frequency not reported: Vasculitis[Ref]

Renal

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

Enalapril:

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

Hydrochlorothiazide:

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

Dermatologic

Frequency not reported: Pruritus, rash, diaphoresis, angioedema

Enalapril:

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

Hydrochlorothiazide:

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

Psychiatric

Frequency not reported: Insomnia, nervousness, libido decreased

Enalapril:

Postmarketing reports: Depression, confusion, dream abnormality

Hydrochlorothiazide:

Frequency not reported: Restlessness[Ref]

Hematologic

Frequency not reported: Hemoglobin decreased, hematocrit decreased

Enalapril:

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

Hydrochlorothiazide:

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

Hepatic

Frequency not reported: Liver enzymes increased, serum bilirubin increased

Enalapril:

Postmarketing reports: Hepatic failure, hepatitis

Hydrochlorothiazide:

Frequency not reported: Intrahepatic cholestatic jaundice[Ref]

Metabolic

Frequency not reported: Gout

Postmarketing reports: Anorexia

Hydrochlorothiazide:

Frequency not reported: Anorexia[Ref]

Ocular

Enalapril:

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

Hydrochlorothiazide:

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

Immunologic

Enalapril:

Postmarketing reports: Anaphylactoid reactions

Hydrochlorothiazide:

Frequency not reported: Anaphylactic reactions[Ref]

References

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

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

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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.