Drug interactions
Enalapril-hydrochlorothiazide + Lofexidine
Severity: Moderate
Enalapril-hydrochlorothiazide and Lofexidine: 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
Lofexidine lowers blood pressure and heart rate, and combining it with enalapril and hydrochlorothiazide can add to hypotension and bradycardia. Dizziness, syncope and falls are the main clinical concerns, particularly during opioid withdrawal when patients may also be volume-depleted.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Lofexidine 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; Lofexidine belongs to Central Nervous System.
Why it happens
Additive blood pressure lowering from central alpha-2 agonism with ACE inhibition and diuretic-induced volume reduction.
What to do
Monitor blood pressure and pulse during initiation and dose changes, and counsel patients about orthostatic symptoms. Reduce the antihypertensive dose or lofexidine dose if symptomatic hypotension or bradycardia occurs.
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 Lofexidine
- Adagrasib + Lofexidine Major
- Alfuzosin + Lofexidine Major
- Amiodarone + Lofexidine Major
- Amisulpride + Lofexidine Major
- Anagrelide + Lofexidine Major
- Apomorphine + Lofexidine Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Lofexidine?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Lofexidine 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. Lofexidine lowers blood pressure and heart rate, and combining it with enalapril and hydrochlorothiazide can add to hypotension and bradycardia. Dizziness, syncope and falls are the main clinical concerns, particularly during opioid withdrawal when patients may also be volume-depleted.
How serious is the interaction between Enalapril-hydrochlorothiazide and Lofexidine?
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 and pulse during initiation and dose changes, and counsel patients about orthostatic symptoms. Reduce the antihypertensive dose or lofexidine dose if symptomatic hypotension or bradycardia occurs.
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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