Drug interactions
Enalapril-hydrochlorothiazide + Losartan
Severity: Major
Enalapril-hydrochlorothiazide and Losartan: major interaction.
Last updated Sources: US FDA label
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
Combining an ACE inhibitor with an angiotensin receptor blocker gives dual renin-angiotensin system blockade. This increases the risk of hypotension, hyperkalemia and acute kidney injury without clear added cardiovascular benefit in most patients.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Losartan 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; Losartan belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic inhibition of the renin-angiotensin-aldosterone system at two points reduces glomerular filtration pressure and aldosterone-mediated potassium excretion.
What to do
Avoid the combination in routine practice and use a single renin-angiotensin agent. If it is used in specialist care, monitor potassium, creatinine and blood pressure closely.
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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References
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 Losartan
- Aliskiren + Losartan Contraindicated
- Losartan + Sparsentan Contraindicated
- Amifostine + Losartan Major
- Amiloride + Losartan Major
- Amlodipine-benazepril + Losartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Losartan Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Losartan?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Losartan 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. Combining an ACE inhibitor with an angiotensin receptor blocker gives dual renin-angiotensin system blockade. This increases the risk of hypotension, hyperkalemia and acute kidney injury without clear added cardiovascular benefit in most patients.
How serious is the interaction between Enalapril-hydrochlorothiazide and Losartan?
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 the combination in routine practice and use a single renin-angiotensin agent. If it is used in specialist care, monitor potassium, creatinine and blood pressure closely.
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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