Drug interactions
Enalapril + Finerenone
Severity: Major
Enalapril and Finerenone: major interaction.
Last updated Sources: UK SmPC
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
Both drugs raise serum potassium, and combined use increases the risk of hyperkalemia, particularly in patients with chronic kidney disease or diabetes. Severe hyperkalemia can cause dangerous arrhythmias.
What this interaction means in plain words
Enalapril and Finerenone 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; Finerenone belongs to Cardiovascular.
Why it happens
Additive hyperkalemia from ACE inhibition reducing aldosterone and mineralocorticoid receptor blockade by finerenone.
What to do
Check serum potassium and renal function before and during treatment, and adjust or withhold finerenone according to potassium thresholds in its labeling. Avoid additional potassium supplements or other potassium-raising agents.
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
- Aqumeldi 0.25 mg orodispersible tablets - SmPC sections 4.3/4.5 (class statement: Potassium sparing diuretics; "Potassium sparing diuretics (e.g., spironolactone, eplerenone, triamterene or amiloride), potassium supplements, potassium-containing salt substitutes, or other") — electronic medicines compendium (UK SmPC)
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
Other interactions of Finerenone
- Carbamazepine + Finerenone Contraindicated
- Clarithromycin + Finerenone Contraindicated
- Ensitrelvir + Finerenone Contraindicated
- Finerenone + Itraconazole Contraindicated
- Finerenone + Ketoconazole Contraindicated
- Finerenone + Posaconazole Contraindicated
Frequently asked questions
Can I take Enalapril with Finerenone?
MediHelp rates the interaction as major. Enalapril and Finerenone 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. Both drugs raise serum potassium, and combined use increases the risk of hyperkalemia, particularly in patients with chronic kidney disease or diabetes. Severe hyperkalemia can cause dangerous arrhythmias.
How serious is the interaction between Enalapril and Finerenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and renal function before and during treatment, and adjust or withhold finerenone according to potassium thresholds in its labeling. Avoid additional potassium supplements or other potassium-raising agents.
What other medicines interact with Enalapril?
MediHelp also lists interactions of Enalapril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Enalapril page.
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