Drug interactions
Amlodipine-olmesartan-hydrochlorothiazide + Enalapril
Severity: Major
Amlodipine-olmesartan-hydrochlorothiazide and Enalapril: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining an angiotensin receptor blocker with an ACE inhibitor produces dual blockade of the renin-angiotensin system. This raises the risk of hypotension, hyperkalemia and acute kidney injury, and outcome trials showed no cardiovascular benefit over a single agent in most patients.
What this interaction means in plain words
Amlodipine-olmesartan-hydrochlorothiazide and Enalapril can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amlodipine-olmesartan-hydrochlorothiazide belongs to Cardiovascular; Enalapril belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic inhibition of the renin-angiotensin-aldosterone system at two sites, which reduces glomerular filtration pressure and aldosterone-mediated potassium excretion.
What to do
Avoid the combination and use only one RAS blocker. If it is unavoidable, monitor serum potassium, creatinine and blood pressure closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Amlodipine-olmesartan-hydrochlorothiazide
- Aliskiren + Amlodipine-olmesartan-hydrochlorothiazide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Aldesleukin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Amifostine + Amlodipine-olmesartan-hydrochlorothiazide Major
Other interactions of Enalapril
- Aliskiren + Enalapril Contraindicated
- Enalapril + Protein a column Contraindicated
- Enalapril + Sacubitril / valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Amifostine + Enalapril Major
- Amiloride + Enalapril Major
Frequently asked questions
Can I take Amlodipine-olmesartan-hydrochlorothiazide with Enalapril?
MediHelp rates the interaction as major. Amlodipine-olmesartan-hydrochlorothiazide and Enalapril can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining an angiotensin receptor blocker with an ACE inhibitor produces dual blockade of the renin-angiotensin system. This raises the risk of hypotension, hyperkalemia and acute kidney injury, and outcome trials showed no cardiovascular benefit over a single agent in most patients.
How serious is the interaction between Amlodipine-olmesartan-hydrochlorothiazide and Enalapril?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use only one RAS blocker. If it is unavoidable, monitor serum potassium, creatinine and blood pressure closely.
What other medicines interact with Amlodipine-olmesartan-hydrochlorothiazide?
MediHelp also lists interactions of Amlodipine-olmesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-olmesartan-hydrochlorothiazide page.
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