Drug interactions
Enalapril-hydrochlorothiazide + Xipamide
Severity: Major
Enalapril-hydrochlorothiazide and Xipamide: 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
Xipamide is a thiazide-like diuretic, so combining it with hydrochlorothiazide duplicates therapy. This enhances diuresis and raises the risk of hypotension, hypokalemia, hyponatremia and renal impairment, particularly with the added ACE inhibitor.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Xipamide 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.
Why it happens
Additive inhibition of distal tubular sodium reabsorption with volume depletion, which potentiates ACE inhibitor hypotension.
What to do
Avoid duplicate thiazide-type therapy. If combined deliberately, monitor electrolytes, renal function and blood pressure closely.
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
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Xipamide?
MediHelp rates the interaction as major. Enalapril-hydrochlorothiazide and Xipamide 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. Xipamide is a thiazide-like diuretic, so combining it with hydrochlorothiazide duplicates therapy. This enhances diuresis and raises the risk of hypotension, hypokalemia, hyponatremia and renal impairment, particularly with the added ACE inhibitor.
How serious is the interaction between Enalapril-hydrochlorothiazide and Xipamide?
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 duplicate thiazide-type therapy. If combined deliberately, monitor electrolytes, renal function and blood pressure closely.
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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