Drug interactions
Enalapril-hydrochlorothiazide + Salmeterol
Severity: Moderate
Enalapril-hydrochlorothiazide and Salmeterol: 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
Both hydrochlorothiazide and salmeterol can lower serum potassium. Together they may produce clinically relevant hypokalemia, with a risk of arrhythmia especially in patients with hypoxia or cardiac disease. The ACE inhibitor partly offsets this.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Salmeterol 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; Salmeterol belongs to Respiratory.
Why it happens
Additive hypokalemia from renal potassium loss (thiazide) and beta-2 mediated intracellular potassium shift (salmeterol).
What to do
Monitor serum potassium, particularly at initiation and in patients with severe asthma or COPD. Replace potassium if low.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Salmeterol?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Salmeterol 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. Both hydrochlorothiazide and salmeterol can lower serum potassium. Together they may produce clinically relevant hypokalemia, with a risk of arrhythmia especially in patients with hypoxia or cardiac disease. The ACE inhibitor partly offsets this.
How serious is the interaction between Enalapril-hydrochlorothiazide and Salmeterol?
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 serum potassium, particularly at initiation and in patients with severe asthma or COPD. Replace potassium if low.
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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