Drug interactions
Enalapril-hydrochlorothiazide + Toremifene
Severity: Major
Enalapril-hydrochlorothiazide and Toremifene: major interaction.
Last updated Sources: US FDA label
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
Toremifene can cause hypercalcemia, especially in patients with bone metastases. Thiazides reduce urinary calcium excretion and can worsen this. Hypercalcemia may cause arrhythmias and QT risk in a patient taking toremifene.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Toremifene 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; Toremifene belongs to Endocrine.
Why it happens
Thiazide reduction of renal calcium excretion adds to toremifene-associated hypercalcemia.
What to do
Avoid thiazides where possible, using another antihypertensive class. If combined, monitor serum calcium regularly, particularly early in therapy.
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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References
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 Toremifene
- Amiodarone + Toremifene Contraindicated
- Dronedarone + Toremifene Contraindicated
- Nilotinib + Toremifene Contraindicated
- Pimozide + Toremifene Contraindicated
- Quinidine + Toremifene Contraindicated
- Ribociclib + Toremifene Contraindicated
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Toremifene?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Toremifene 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. Toremifene can cause hypercalcemia, especially in patients with bone metastases. Thiazides reduce urinary calcium excretion and can worsen this. Hypercalcemia may cause arrhythmias and QT risk in a patient taking toremifene.
How serious is the interaction between Enalapril-hydrochlorothiazide and Toremifene?
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 thiazides where possible, using another antihypertensive class. If combined, monitor serum calcium regularly, particularly early in therapy.
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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