Drug interactions
Enalapril-hydrochlorothiazide + Sacubitril / valsartan
Severity: Contraindicated
Enalapril-hydrochlorothiazide and Sacubitril / valsartan: contraindicated 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
Combining an ACE inhibitor with sacubitril/valsartan markedly raises the risk of angioedema due to reduced bradykinin breakdown. Additive hypotension, hyperkalemia and renal effects from RAS blockade also occur.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Concurrent inhibition of neprilysin and ACE reduces bradykinin degradation, causing bradykinin-mediated angioedema.
What to do
Do not coadminister; separate by at least 36 hours when switching in either direction.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide Major
- Azathioprine + Enalapril-hydrochlorothiazide Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Sacubitril / valsartan?
MediHelp rates the interaction as contraindicated. Enalapril-hydrochlorothiazide and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining an ACE inhibitor with sacubitril/valsartan markedly raises the risk of angioedema due to reduced bradykinin breakdown. Additive hypotension, hyperkalemia and renal effects from RAS blockade also occur.
How serious is the interaction between Enalapril-hydrochlorothiazide and Sacubitril / valsartan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; separate by at least 36 hours when switching in either direction.
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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