Drug interactions
Digoxin + Enalapril-hydrochlorothiazide
Severity: Moderate
Digoxin 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
Thiazide-induced hypokalemia and hypomagnesemia sensitize the heart to digoxin and can precipitate arrhythmias and digoxin toxicity. ACE inhibition and renal function changes may also raise digoxin levels.
What this interaction means in plain words
Digoxin 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.
Digoxin belongs to Cardiovascular; Enalapril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Diuretic-induced hypokalemia and hypomagnesemia enhance digoxin cardiac effects, and reduced renal clearance may raise digoxin concentrations.
What to do
Monitor serum potassium, magnesium, renal function and digoxin levels, and keep potassium in the normal range. Watch for signs of digoxin toxicity.
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 Digoxin
- Digoxin + Lily of the valley Contraindicated
- Digoxin + Squill Contraindicated
- Adagrasib + Digoxin Major
- Amiodarone + Digoxin Major
- Amlodipine-hydrochlorothiazide-valsartan + Digoxin Major
- Amphotericin b deoxycholate + Digoxin Major
Frequently asked questions
Can I take Digoxin with Enalapril-hydrochlorothiazide?
MediHelp rates the interaction as moderate. Digoxin 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. Thiazide-induced hypokalemia and hypomagnesemia sensitize the heart to digoxin and can precipitate arrhythmias and digoxin toxicity. ACE inhibition and renal function changes may also raise digoxin levels.
How serious is the interaction between Digoxin 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 serum potassium, magnesium, renal function and digoxin levels, and keep potassium in the normal range. Watch for signs of digoxin toxicity.
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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