Drug interactions
Enalapril-hydrochlorothiazide + Potassium citrate
Severity: Major
Enalapril-hydrochlorothiazide and Potassium citrate: 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
Enalapril reduces aldosterone and potassium excretion, so added potassium supplementation can cause hyperkalemia, especially in renal impairment or diabetes. Hydrochlorothiazide promotes potassium loss and may partly offset this, but the net effect is unpredictable.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Potassium citrate 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; Potassium citrate belongs to Gastrointestinal Tract.
Why it happens
ACE inhibitor-induced reduction in aldosterone and renal potassium excretion adds to the exogenous potassium load, partly opposed by thiazide kaliuresis.
What to do
Monitor serum potassium and renal function at baseline and regularly during therapy. Reduce or stop potassium citrate if potassium rises.
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 Potassium citrate
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Potassium citrate?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Potassium citrate 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 reduces aldosterone and potassium excretion, so added potassium supplementation can cause hyperkalemia, especially in renal impairment or diabetes. Hydrochlorothiazide promotes potassium loss and may partly offset this, but the net effect is unpredictable.
How serious is the interaction between Enalapril-hydrochlorothiazide and Potassium citrate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and renal function at baseline and regularly during therapy. Reduce or stop potassium citrate 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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