Drug interactions
Enalapril + Prazosin
Severity: Moderate
Enalapril and Prazosin: 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
Prazosin commonly causes first-dose orthostatic hypotension, and ACE inhibitors such as enalapril can add to this effect. Dizziness and syncope may occur when either drug is started or the dose is increased.
What this interaction means in plain words
Enalapril and Prazosin 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; Prazosin belongs to Genitourinary.
Why it happens
Additive vasodilation from alpha-1 blockade by prazosin and ACE inhibition by enalapril.
What to do
Start prazosin at a low dose at bedtime and titrate gradually. Monitor blood pressure and orthostatic symptoms, and adjust doses as needed.
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 Prazosin
- Alfuzosin + Prazosin Major
- Amifostine + Prazosin Major
- Avanafil + Prazosin Major
- Doxazosin + Prazosin Major
- Dutasteride-tamsulosin + Prazosin Major
- Phenoxybenzamine + Prazosin Major
Frequently asked questions
Can I take Enalapril with Prazosin?
MediHelp rates the interaction as moderate. Enalapril and Prazosin 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. Prazosin commonly causes first-dose orthostatic hypotension, and ACE inhibitors such as enalapril can add to this effect. Dizziness and syncope may occur when either drug is started or the dose is increased.
How serious is the interaction between Enalapril and Prazosin?
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 prazosin at a low dose at bedtime and titrate gradually. Monitor blood pressure and orthostatic symptoms, and adjust doses as needed.
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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