Drug interactions
Enalapril-hydrochlorothiazide + Sirolimus
Severity: Major
Enalapril-hydrochlorothiazide and Sirolimus: major 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
Sirolimus combined with an ACE inhibitor increases the risk of angioedema. Reactions can involve the face, lips or airway and may be serious.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Both reduce bradykinin degradation (ACE inhibition and mTOR inhibitor effect on dipeptidyl peptidase IV), increasing bradykinin-mediated angioedema.
What to do
Counsel patients to report swelling of the face, lips or tongue at once. Stop the ACE inhibitor and use another antihypertensive class if angioedema occurs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Enalapril-hydrochlorothiazide and Sirolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Sirolimus?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Sirolimus 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. Sirolimus combined with an ACE inhibitor increases the risk of angioedema. Reactions can involve the face, lips or airway and may be serious.
How serious is the interaction between Enalapril-hydrochlorothiazide and Sirolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel patients to report swelling of the face, lips or tongue at once. Stop the ACE inhibitor and use another antihypertensive class if angioedema occurs.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
