Drug interactions
Enalapril + Furosemide
Severity: Moderate
Enalapril and Furosemide: 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
Adding enalapril to a patient on furosemide may cause abrupt hypotension and reduced renal function, especially in volume-depleted patients or those with renal artery stenosis. The combination is widely used and beneficial when initiated carefully.
What this interaction means in plain words
Enalapril and Furosemide 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.
Enalapril belongs to Cardiovascular; Furosemide belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effect: diuretic-induced volume depletion and renin activation combined with ACE inhibition reduces blood pressure and glomerular filtration pressure.
What to do
Start enalapril at a low dose and consider reducing or holding the furosemide dose beforehand. Check blood pressure, creatinine and potassium within one to two weeks.
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 Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide 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 Enalapril with Furosemide?
MediHelp rates the interaction as moderate. Enalapril and Furosemide 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. Adding enalapril to a patient on furosemide may cause abrupt hypotension and reduced renal function, especially in volume-depleted patients or those with renal artery stenosis. The combination is widely used and beneficial when initiated carefully.
How serious is the interaction between Enalapril and Furosemide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start enalapril at a low dose and consider reducing or holding the furosemide dose beforehand. Check blood pressure, creatinine and potassium within one to two weeks.
What other medicines interact with Furosemide?
MediHelp also lists interactions of Furosemide with, for example, Amifostine, Amikacin, Carbenoxolone. The full list is on the Furosemide page.
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