enalapril maleate + hydrochlorothiazide at a glance
Medicine class
ACE inhibitor plus thiazide diuretic
Licensed use
Essential hypertension not adequately controlled by enalapril alone
Administration
Swallow with water; it may be taken with or without food
Important checks
Blood pressure, kidney function, sodium and potassium
What is enalapril maleate + hydrochlorothiazide used for?
Licensed uses include:
Essential hypertension not adequately controlled by enalapril alone.
Replacement of separate enalapril and hydrochlorothiazide tablets in someone stabilised on the same component proportions.
This fixed combination is not suitable as initial treatment.
How does enalapril maleate + hydrochlorothiazide work?
Enalapril is converted to enalaprilat, which inhibits angiotensin-converting enzyme and helps blood vessels relax. Hydrochlorothiazide increases kidney excretion of sodium and water. Their complementary actions lower blood pressure.
enalapril maleate + hydrochlorothiazide preparations and strengths
Tablet
Route: Oral
Strengths: 20 mg + 12.5 mg
How to take enalapril maleate + hydrochlorothiazide
Take exactly as prescribed. It can be taken with or without food.
Swallow with water.
The score line allows the tablet to be divided into equal parts; divide it only if instructed.
Do not drive or use machinery if dizziness affects you.
Contact a healthcare professional if vomiting, diarrhoea or poor fluid intake occurs because these can increase dehydration, low blood pressure and kidney risks.
enalapril maleate + hydrochlorothiazide side effects
Common or expected effects
- Dizziness or light-headedness
- Blurred vision
- Dry cough
- Nausea, diarrhoea or abdominal discomfort
- Headache or altered taste
- Tiredness or weakness
- Muscle cramps
- Low blood pressure, including on standing
- Changes in potassium, uric acid, cholesterol or kidney-test results
- Rash
Get urgent medical advice
- Swelling of the face, lips, tongue or throat, with or without breathing difficulty
- Sudden eye pain or reduced vision
- Severe dehydration, fainting or markedly reduced urine
- Chest pressure, heart attack or stroke symptoms
- Severe abdominal pain
- Yellow skin or eyes, dark urine or other signs of liver injury
- Severe blistering or peeling skin
- Fever, persistent sore throat, unusual bruising or bleeding
enalapril maleate + hydrochlorothiazide in pregnancy
This combination is not recommended during pregnancy and is contraindicated during the second and third trimesters. Discuss alternatives when planning pregnancy and contact the prescriber promptly if pregnancy occurs. Exposure from around 20 weeks can impair fetal kidney function and reduce amniotic fluid.
enalapril maleate + hydrochlorothiazide while breastfeeding
The fixed combination is generally not recommended while breastfeeding, particularly for premature or very young infants. Enalapril alone is a preferred ACE inhibitor during breastfeeding, but hydrochlorothiazide passes into milk and intensive diuresis may reduce milk production. A prescriber should assess the options.
enalapril maleate + hydrochlorothiazide interactions
Tell the prescriber or pharmacist about all medicines, supplements and salt substitutes. Important interactions include:
Sacubitril/valsartan
Concomitant use is contraindicated because it substantially increases angioedema risk.
Lithium
Both components can increase lithium concentrations and toxicity; use is generally not recommended and requires close monitoring if unavoidable.
NSAIDs, including ibuprofen and COX-2 inhibitors
Regular use can weaken treatment effects and increase kidney impairment and high-potassium risks.
Common questions about enalapril maleate + hydrochlorothiazide
Answers are fully visible for fast scanning and source review.
Can it be taken with food?
Yes. Swallow the tablet with water.
Can I take ibuprofen with it?
Regular NSAID use can reduce its effect and increase kidney and potassium risks. Check with a pharmacist or prescriber first.
Can I use potassium salt substitutes?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.