Drug interactions
Enalapril-hydrochlorothiazide + Insulin degludec / insulin aspart
Severity: Moderate
Enalapril-hydrochlorothiazide and Insulin degludec / insulin aspart: 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
Hydrochlorothiazide can raise blood glucose and reduce insulin effectiveness, while enalapril may enhance insulin sensitivity and increase the risk of hypoglycemia. The net effect on glucose control is variable.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Insulin degludec / insulin aspart 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.
Why it happens
Thiazide-induced insulin resistance and hypokalemia oppose insulin, whereas ACE inhibition improves insulin sensitivity.
What to do
Monitor blood glucose more frequently when starting or changing either antihypertensive, and adjust insulin doses as needed. Counsel patients on hypoglycemia symptoms.
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
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Insulin degludec / insulin aspart?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Insulin degludec / insulin aspart 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. Hydrochlorothiazide can raise blood glucose and reduce insulin effectiveness, while enalapril may enhance insulin sensitivity and increase the risk of hypoglycemia. The net effect on glucose control is variable.
How serious is the interaction between Enalapril-hydrochlorothiazide and Insulin degludec / insulin aspart?
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 more frequently when starting or changing either antihypertensive, and adjust insulin doses as needed. Counsel patients on hypoglycemia symptoms.
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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