Drug interactions
Enalapril + Eplerenone
Severity: Major
Enalapril and Eplerenone: major 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
Concurrent use of an ACE inhibitor and eplerenone increases the risk of hyperkalemia because both reduce aldosterone-driven potassium excretion. Risk is higher in renal impairment, diabetes, and the elderly.
What this interaction means in plain words
Enalapril and Eplerenone 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.
Enalapril belongs to Cardiovascular; Eplerenone belongs to Cardiovascular.
Why it happens
Additive inhibition of the renin-angiotensin-aldosterone system.
What to do
Monitor potassium and creatinine at baseline, within the first week, and periodically. Avoid potassium supplements and adjust doses if potassium rises.
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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Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
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 Enalapril with Eplerenone?
MediHelp rates the interaction as major. Enalapril and Eplerenone 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. Concurrent use of an ACE inhibitor and eplerenone increases the risk of hyperkalemia because both reduce aldosterone-driven potassium excretion. Risk is higher in renal impairment, diabetes, and the elderly.
How serious is the interaction between Enalapril and Eplerenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor potassium and creatinine at baseline, within the first week, and periodically. Avoid potassium supplements and adjust doses if potassium rises.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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