Drug interactions
Enalapril + Metformin
Severity: Moderate
Enalapril and Metformin: 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
ACE inhibitors may improve insulin sensitivity and slightly enhance glucose lowering with metformin, though metformin alone rarely causes hypoglycemia. If enalapril causes acute kidney injury, metformin accumulation can raise the risk of lactic acidosis.
What this interaction means in plain words
Enalapril and Metformin 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; Metformin belongs to Endocrine.
Why it happens
Improved insulin sensitivity adds to glucose lowering, and ACE inhibitor-related reduction in renal function can reduce metformin clearance.
What to do
Monitor blood glucose and renal function, especially after starting enalapril or in dehydration. Hold metformin if renal function deteriorates significantly.
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
- 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 Metformin
Frequently asked questions
Can I take Enalapril with Metformin?
MediHelp rates the interaction as moderate. Enalapril and Metformin 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. ACE inhibitors may improve insulin sensitivity and slightly enhance glucose lowering with metformin, though metformin alone rarely causes hypoglycemia. If enalapril causes acute kidney injury, metformin accumulation can raise the risk of lactic acidosis.
How serious is the interaction between Enalapril and Metformin?
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 glucose and renal function, especially after starting enalapril or in dehydration. Hold metformin if renal function deteriorates significantly.
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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