Drug interactions
Enalapril-hydrochlorothiazide + Tolvaptan
Severity: Moderate
Enalapril-hydrochlorothiazide and Tolvaptan: 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
Tolvaptan is a potent aquaretic and, with a thiazide and ACE inhibitor, may worsen volume depletion, hypotension and renal function. Electrolyte shifts, especially in sodium, also require attention because rapid sodium rise is dangerous.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Additive fluid loss from aquaresis and diuresis, with altered electrolyte handling.
What to do
Monitor serum sodium, potassium, volume status and renal function closely, especially during initiation. Reduce or hold the diuretic if volume depletion 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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Tolvaptan?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Tolvaptan 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. Tolvaptan is a potent aquaretic and, with a thiazide and ACE inhibitor, may worsen volume depletion, hypotension and renal function. Electrolyte shifts, especially in sodium, also require attention because rapid sodium rise is dangerous.
How serious is the interaction between Enalapril-hydrochlorothiazide and Tolvaptan?
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 sodium, potassium, volume status and renal function closely, especially during initiation. Reduce or hold the diuretic if volume depletion 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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