Drug interactions
Enalapril + Sirolimus
Severity: Major
Enalapril and Sirolimus: major 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
Combining an ACE inhibitor with an mTOR inhibitor such as sirolimus increases the risk of angioedema. Swelling of the face, lips, tongue or airway can be serious.
What this interaction means in plain words
Enalapril and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Both drugs impair bradykinin breakdown (ACE inhibition and reduced dipeptidyl peptidase IV activity with mTOR inhibition), raising bradykinin levels.
What to do
Counsel patients to seek urgent care for swelling of the face, lips, tongue or throat. Stop enalapril and consider an alternative antihypertensive if angioedema develops.
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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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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Enalapril with Sirolimus?
MediHelp rates the interaction as major. Enalapril and Sirolimus 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 mTOR inhibitor such as sirolimus increases the risk of angioedema. Swelling of the face, lips, tongue or airway can be serious.
How serious is the interaction between Enalapril and Sirolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel patients to seek urgent care for swelling of the face, lips, tongue or throat. Stop enalapril and consider an alternative antihypertensive if angioedema develops.
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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