Drug interactions
Enalapril-hydrochlorothiazide + Ethacrynic acid
Severity: Major
Enalapril-hydrochlorothiazide and Ethacrynic acid: 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
Ethacrynic acid is a potent loop diuretic that adds to the thiazide's sodium, water and potassium losses. With enalapril, the resulting volume depletion can cause marked hypotension and acute kidney injury, plus hypokalemia and hypomagnesemia.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Ethacrynic acid 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-hydrochlorothiazide belongs to Cardiovascular; Ethacrynic acid belongs to Cardiovascular.
Why it happens
Sequential nephron blockade with additive diuresis and electrolyte loss, combined with ACE inhibitor reduction of angiotensin II-dependent glomerular perfusion.
What to do
Start with low doses and monitor blood pressure, renal function and electrolytes closely, especially in volume-depleted patients. Consider temporarily reducing diuretic doses when starting the combination.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Enalapril-hydrochlorothiazide and Ethacrynic acid, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Enalapril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide Major
Other interactions of Ethacrynic acid
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Ethacrynic acid?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Ethacrynic acid 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. Ethacrynic acid is a potent loop diuretic that adds to the thiazide's sodium, water and potassium losses. With enalapril, the resulting volume depletion can cause marked hypotension and acute kidney injury, plus hypokalemia and hypomagnesemia.
How serious is the interaction between Enalapril-hydrochlorothiazide and Ethacrynic acid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and monitor blood pressure, renal function and electrolytes closely, especially in volume-depleted patients. Consider temporarily reducing diuretic doses when starting the combination.
What other medicines interact with Enalapril-hydrochlorothiazide?
MediHelp also lists interactions of Enalapril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Enalapril-hydrochlorothiazide page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
