Drug interactions
Enalapril-hydrochlorothiazide + Triamterene
Severity: Major
Enalapril-hydrochlorothiazide and Triamterene: 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
Triamterene and enalapril both promote potassium retention, which can cause severe hyperkalemia, particularly in renal impairment, diabetes or older age. The thiazide partly offsets this but does not remove the risk.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Triamterene 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; Triamterene belongs to Cardiovascular.
Why it happens
Additive potassium retention from ENaC blockade and reduced aldosterone via ACE inhibition.
What to do
Avoid unless hypokalemia is documented, and check potassium and creatinine within the first week and regularly thereafter. Stop triamterene if potassium rises above the normal range.
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
Other interactions of Triamterene
- Amiloride + Triamterene Contraindicated
- Eplerenone + Triamterene Contraindicated
- Potassium citrate / citric acid + Triamterene Contraindicated
- Potassium citrate + Triamterene Contraindicated
- Spironolactone + Triamterene Contraindicated
- Aceclofenac + Triamterene Major
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Triamterene?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Triamterene 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. Triamterene and enalapril both promote potassium retention, which can cause severe hyperkalemia, particularly in renal impairment, diabetes or older age. The thiazide partly offsets this but does not remove the risk.
How serious is the interaction between Enalapril-hydrochlorothiazide and Triamterene?
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 unless hypokalemia is documented, and check potassium and creatinine within the first week and regularly thereafter. Stop triamterene if potassium rises above the normal range.
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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