Drug interactions
Enalapril + Tolbutamide
Severity: Moderate
Enalapril and Tolbutamide: 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 increase insulin sensitivity and enhance the effect of tolbutamide. This can cause hypoglycemia, particularly early in ACE inhibitor therapy.
What this interaction means in plain words
Enalapril and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
ACE inhibition increases bradykinin and improves insulin sensitivity, adding to sulfonylurea-induced insulin secretion.
What to do
Monitor blood glucose when enalapril is started or changed. Reduce the tolbutamide dose if hypoglycemia occurs.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Enalapril with Tolbutamide?
MediHelp rates the interaction as moderate. Enalapril and Tolbutamide 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 increase insulin sensitivity and enhance the effect of tolbutamide. This can cause hypoglycemia, particularly early in ACE inhibitor therapy.
How serious is the interaction between Enalapril and Tolbutamide?
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 when enalapril is started or changed. Reduce the tolbutamide dose if hypoglycemia occurs.
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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