Drug interactions
Enalapril-hydrochlorothiazide + Torsemide
Severity: Moderate
Enalapril-hydrochlorothiazide and Torsemide: 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
Adding a loop diuretic to an ACE inhibitor and thiazide can cause marked volume depletion, hypotension and acute kidney injury. Combined thiazide and loop diuretics also produce profound loss of sodium, potassium and magnesium.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Torsemide 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; Torsemide belongs to Cardiovascular.
Why it happens
Sequential nephron blockade with additive diuresis, and ACE inhibition reduces glomerular filtration in volume-depleted states.
What to do
Monitor blood pressure, renal function and electrolytes including potassium and magnesium. Reduce diuretic doses if hypotension or rising creatinine occurs.
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 Torsemide
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Torsemide?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Torsemide 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. Adding a loop diuretic to an ACE inhibitor and thiazide can cause marked volume depletion, hypotension and acute kidney injury. Combined thiazide and loop diuretics also produce profound loss of sodium, potassium and magnesium.
How serious is the interaction between Enalapril-hydrochlorothiazide and Torsemide?
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 blood pressure, renal function and electrolytes including potassium and magnesium. Reduce diuretic doses if hypotension or rising creatinine 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.
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