Drug interactions
Enalapril-hydrochlorothiazide + Potassium citrate / citric acid
Severity: Moderate
Enalapril-hydrochlorothiazide and Potassium citrate / citric acid: 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
Potassium supplements add to the potassium retention caused by ACE inhibitors. Hyperkalemia can develop, particularly in patients with renal impairment or diabetes. The thiazide component partly offsets this by promoting potassium loss, but the net risk remains.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Potassium citrate / citric acid 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.
Why it happens
Enalapril lowers aldosterone and reduces renal potassium excretion, so added potassium intake accumulates.
What to do
Check serum potassium and renal function at baseline and periodically during combined use. Reduce or stop the potassium salt if potassium rises.
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
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Potassium citrate / citric acid?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Potassium citrate / citric acid 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. Potassium supplements add to the potassium retention caused by ACE inhibitors. Hyperkalemia can develop, particularly in patients with renal impairment or diabetes. The thiazide component partly offsets this by promoting potassium loss, but the net risk remains.
How serious is the interaction between Enalapril-hydrochlorothiazide and Potassium citrate / citric acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and renal function at baseline and periodically during combined use. Reduce or stop the potassium salt if potassium rises.
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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