Drug interactions
Enalapril + Olmesartan
Severity: Major
Enalapril and Olmesartan: major interaction.
Last updated Sources: US FDA label
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
Combining an ACE inhibitor with an angiotensin receptor blocker produces dual renin-angiotensin system blockade. This raises the risk of symptomatic hypotension, hyperkalemia and acute kidney injury without a meaningful outcome benefit in most patients.
What this interaction means in plain words
Enalapril and Olmesartan 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; Olmesartan belongs to Cardiovascular.
Why it happens
Additive inhibition of the renin-angiotensin-aldosterone system at two levels reduces glomerular filtration pressure and aldosterone-mediated potassium excretion.
What to do
Avoid the combination in routine practice and use a single RAS blocker. If used in specialist care, monitor serum potassium, creatinine and blood pressure closely.
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
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 Olmesartan
- Aliskiren + Olmesartan Contraindicated
- Olmesartan + Sparsentan Contraindicated
- Aldesleukin + Olmesartan Major
- Amifostine + Olmesartan Major
- Amiloride + Olmesartan Major
- Amlodipine-benazepril + Olmesartan Major
Frequently asked questions
Can I take Enalapril with Olmesartan?
MediHelp rates the interaction as major. Enalapril and Olmesartan 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. Combining an ACE inhibitor with an angiotensin receptor blocker produces dual renin-angiotensin system blockade. This raises the risk of symptomatic hypotension, hyperkalemia and acute kidney injury without a meaningful outcome benefit in most patients.
How serious is the interaction between Enalapril and Olmesartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in routine practice and use a single RAS blocker. If used in specialist care, monitor serum potassium, creatinine and blood pressure closely.
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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