Drug interactions
Enalapril + Torsemide
Severity: Moderate
Enalapril and Torsemide: 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
Adding enalapril to a loop diuretic can cause a pronounced drop in blood pressure, especially at initiation or in volume-depleted patients. Renal function may worsen because glomerular filtration pressure falls.
What this interaction means in plain words
Enalapril and Torsemide 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; Torsemide belongs to Cardiovascular.
Why it happens
Diuretic-induced volume depletion activates the renin-angiotensin system, and ACE inhibition blocks this compensation, causing additive hypotension and reduced glomerular filtration.
What to do
Monitor blood pressure, creatinine and potassium after starting or changing doses, and consider reducing the diuretic dose before initiating enalapril in volume-depleted patients.
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 Torsemide
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
Frequently asked questions
Can I take Enalapril with Torsemide?
MediHelp rates the interaction as moderate. Enalapril and Torsemide 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. Adding enalapril to a loop diuretic can cause a pronounced drop in blood pressure, especially at initiation or in volume-depleted patients. Renal function may worsen because glomerular filtration pressure falls.
How serious is the interaction between Enalapril and Torsemide?
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 pressure, creatinine and potassium after starting or changing doses, and consider reducing the diuretic dose before initiating enalapril in volume-depleted patients.
What other medicines interact with Torsemide?
MediHelp also lists interactions of Torsemide with, for example, Amikacin, Amiodarone, Carbenoxolone. The full list is on the Torsemide page.
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