Drug interactions
Enalapril-hydrochlorothiazide + Metformin
Severity: Moderate
Enalapril-hydrochlorothiazide and Metformin: 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
ACE inhibitors may increase insulin sensitivity and rarely cause hypoglycemia, while thiazides can raise glucose. Both agents may reduce renal function, which can reduce metformin clearance and increase lactic acidosis risk if kidney injury occurs.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Metformin 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; Metformin belongs to Endocrine.
Why it happens
Variable pharmacodynamic effects on glucose, plus renal function impairment from the ACE inhibitor-diuretic combination reducing metformin elimination.
What to do
Monitor glucose and renal function regularly. Hold metformin during acute illness with dehydration or if renal function deteriorates.
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 Metformin
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Metformin?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Metformin 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. ACE inhibitors may increase insulin sensitivity and rarely cause hypoglycemia, while thiazides can raise glucose. Both agents may reduce renal function, which can reduce metformin clearance and increase lactic acidosis risk if kidney injury occurs.
How serious is the interaction between Enalapril-hydrochlorothiazide and Metformin?
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 glucose and renal function regularly. Hold metformin during acute illness with dehydration or if renal function deteriorates.
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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