Drug interactions
Enalapril-hydrochlorothiazide + Squill
Severity: Major
Enalapril-hydrochlorothiazide and Squill: 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
Squill contains cardiac glycosides with digoxin-like activity. Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which sensitize the heart to glycoside toxicity and may provoke arrhythmias.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Squill 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.
Why it happens
Diuretic-induced potassium and magnesium depletion increases myocardial sensitivity to cardiac glycosides.
What to do
Avoid the combination where possible; if used, monitor serum potassium and magnesium and correct deficits, and watch for arrhythmia symptoms or ECG changes.
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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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 Squill?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Squill 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. Squill contains cardiac glycosides with digoxin-like activity. Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which sensitize the heart to glycoside toxicity and may provoke arrhythmias.
How serious is the interaction between Enalapril-hydrochlorothiazide and Squill?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible; if used, monitor serum potassium and magnesium and correct deficits, and watch for arrhythmia symptoms or ECG changes.
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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