Drug interactions
Enalapril-hydrochlorothiazide + Lily of the valley
Severity: Major
Enalapril-hydrochlorothiazide and Lily of the valley: 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
Lily of the valley contains cardiac glycosides that behave like digoxin. Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which sensitise the myocardium to glycoside toxicity and may trigger arrhythmias.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Lily of the valley 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.
Why it happens
Diuretic-induced potassium and magnesium depletion enhances the arrhythmogenic effect of cardiac glycoside constituents.
What to do
Avoid lily of the valley products where possible. If used, monitor serum potassium and magnesium and ECG, and correct electrolyte deficits promptly.
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?
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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 Lily of the valley?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Lily of the valley 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. Lily of the valley contains cardiac glycosides that behave like digoxin. Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which sensitise the myocardium to glycoside toxicity and may trigger arrhythmias.
How serious is the interaction between Enalapril-hydrochlorothiazide and Lily of the valley?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid lily of the valley products where possible. If used, monitor serum potassium and magnesium and ECG, and correct electrolyte deficits promptly.
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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