Drug interactions
Enalapril-hydrochlorothiazide + Midodrine
Severity: Moderate
Enalapril-hydrochlorothiazide and Midodrine: 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
Midodrine raises blood pressure through alpha-1 agonism and directly opposes the antihypertensive effect of enalapril and hydrochlorothiazide. Combining them is usually pointless, though occasionally encountered in patients with orthostatic hypotension and hypertension.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism between alpha-1 vasoconstriction and the antihypertensive actions of an ACE inhibitor and thiazide.
What to do
Review the need for each agent and monitor supine and standing blood pressure if both are required.
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 Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Midodrine?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Midodrine 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. Midodrine raises blood pressure through alpha-1 agonism and directly opposes the antihypertensive effect of enalapril and hydrochlorothiazide. Combining them is usually pointless, though occasionally encountered in patients with orthostatic hypotension and hypertension.
How serious is the interaction between Enalapril-hydrochlorothiazide and Midodrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Review the need for each agent and monitor supine and standing blood pressure if both are required.
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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