Drug interactions
Enalapril-hydrochlorothiazide + Furosemide
Severity: Moderate
Enalapril-hydrochlorothiazide and Furosemide: 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 a loop diuretic to an ACE inhibitor and thiazide can cause profound diuresis with hypotension, volume depletion, acute kidney injury and electrolyte losses, including potassium, sodium and magnesium. This is most likely after initiation or dose increases.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Furosemide 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-hydrochlorothiazide belongs to Cardiovascular; Furosemide belongs to Cardiovascular.
Why it happens
Sequential nephron blockade with diuretics produces additive natriuresis and potassium loss, while ACE inhibition reduces glomerular filtration pressure in volume-depleted states.
What to do
Monitor blood pressure, renal function, potassium, sodium and magnesium, and adjust diuretic doses to volume status. Hold diuretics during acute dehydrating illness.
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-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 Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Furosemide?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Furosemide 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 a loop diuretic to an ACE inhibitor and thiazide can cause profound diuresis with hypotension, volume depletion, acute kidney injury and electrolyte losses, including potassium, sodium and magnesium. This is most likely after initiation or dose increases.
How serious is the interaction between Enalapril-hydrochlorothiazide and Furosemide?
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, renal function, potassium, sodium and magnesium, and adjust diuretic doses to volume status. Hold diuretics during acute dehydrating illness.
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.
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