Drug interactions
Asenapine + Enalapril-hydrochlorothiazide
Severity: Moderate
Asenapine and Enalapril-hydrochlorothiazide: moderate interaction.
Last updated
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
Asenapine can cause orthostatic hypotension through alpha-1 adrenergic blockade. With an ACE inhibitor and a thiazide, the blood pressure lowering can be additive, particularly at initiation or dose increases.
What this interaction means in plain words
Asenapine and Enalapril-hydrochlorothiazide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Asenapine belongs to Central Nervous System; Enalapril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic hypotension from alpha-1 blockade and antihypertensive therapy.
What to do
Monitor blood pressure and orthostatic symptoms when starting or titrating asenapine. Reduce antihypertensive doses if hypotension occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Enalapril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide Major
Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Enalapril-hydrochlorothiazide?
MediHelp rates the interaction as moderate. Asenapine and Enalapril-hydrochlorothiazide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Asenapine can cause orthostatic hypotension through alpha-1 adrenergic blockade. With an ACE inhibitor and a thiazide, the blood pressure lowering can be additive, particularly at initiation or dose increases.
How serious is the interaction between Asenapine and Enalapril-hydrochlorothiazide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and orthostatic symptoms when starting or titrating asenapine. Reduce antihypertensive doses if hypotension occurs.
What other medicines interact with Enalapril-hydrochlorothiazide?
MediHelp also lists interactions of Enalapril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Enalapril-hydrochlorothiazide page.
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