Drug interactions
Enalapril-hydrochlorothiazide + Voclosporin
Severity: Major
Enalapril-hydrochlorothiazide and Voclosporin: 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
Voclosporin is a calcineurin inhibitor that causes hyperkalemia and nephrotoxicity. With an ACE inhibitor, the risks of hyperkalemia and reduced glomerular filtration rise, and a thiazide may add volume depletion.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
Calcineurin inhibition reduces renal potassium secretion and afferent vasoconstriction, adding to ACE inhibitor effects on efferent tone and aldosterone.
What to do
Monitor serum potassium and eGFR frequently, especially at initiation and dose changes. Adjust or stop voclosporin or the ACE inhibitor if hyperkalemia or renal decline occurs.
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 Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Voclosporin?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Voclosporin 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. Voclosporin is a calcineurin inhibitor that causes hyperkalemia and nephrotoxicity. With an ACE inhibitor, the risks of hyperkalemia and reduced glomerular filtration rise, and a thiazide may add volume depletion.
How serious is the interaction between Enalapril-hydrochlorothiazide and Voclosporin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and eGFR frequently, especially at initiation and dose changes. Adjust or stop voclosporin or the ACE inhibitor if hyperkalemia or renal decline 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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