Drug interactions
Enalapril-hydrochlorothiazide + Tizanidine
Severity: Moderate
Enalapril-hydrochlorothiazide and Tizanidine: 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
Tizanidine is a central alpha-2 agonist that lowers blood pressure and can add to the effects of enalapril and hydrochlorothiazide. Hypotension, dizziness and bradycardia may occur, particularly at treatment start or after dose increases.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Tizanidine 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; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive hypotensive effect from central alpha-2 agonism combined with ACE inhibition and diuresis.
What to do
Start tizanidine at a low dose and titrate slowly while monitoring blood pressure and heart rate. Reduce the antihypertensive dose if symptomatic hypotension develops.
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 Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Tizanidine?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Tizanidine 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. Tizanidine is a central alpha-2 agonist that lowers blood pressure and can add to the effects of enalapril and hydrochlorothiazide. Hypotension, dizziness and bradycardia may occur, particularly at treatment start or after dose increases.
How serious is the interaction between Enalapril-hydrochlorothiazide and Tizanidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start tizanidine at a low dose and titrate slowly while monitoring blood pressure and heart rate. Reduce the antihypertensive dose if symptomatic hypotension develops.
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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