Enalapril + Hydrochlorothiazide
Find more information about this combination medication at the webpages for Enalapril and Hydrochlorothiazide
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Advisory
- This medicine contains a combination of 2 drugs Enalapril and Hydrochlorothiazide.
- Enalapril and Hydrochlorothiazide are both used to treat the same disease or symptom but work in different ways in the body.
- Most doctors will advise making sure that each individual medicine is safe and effective before using a combination form.
Drug Status
Government Approvals
None
WHO Essential Medicine
NO
Known Teratogen
Definite
Pharmaceutical Class
Angiotensin Converting Enzyme Inhibitor and Thiazide Diuretic
Controlled Drug Substance
NO
Enalapril + Hydrochlorothiazide
Summary
Enalapril and Hydrochlorothiazide are used to treat high blood pressure, also known as hypertension. By lowering blood pressure, they help prevent complications like heart disease, heart attacks, strokes, and kidney failure.
Enalapril, an ACE inhibitor, works by relaxing and widening blood vessels, improving blood flow. Hydrochlorothiazide, a diuretic, helps the kidneys remove excess salt and water from the body, reducing blood volume and pressure. Together, they effectively lower blood pressure.
Enalapril is typically prescribed in doses ranging from 10 to 40 mg per day, and Hydrochlorothiazide is usually prescribed in doses of 12.5 to 50 mg daily. They are taken orally, either in a single dose or divided into two doses.
Common side effects include cough, dizziness, headache, and fatigue. Enalapril may cause a persistent dry cough. Hydrochlorothiazide can lead to increased urination, electrolyte imbalances, and muscle cramps. Serious adverse effects include lightheadedness, swelling of the face or throat, difficulty breathing, and signs of infection.
These medications should not be used during pregnancy due to the risk of fetal harm. They should also be avoided by patients with a history of angioedema or those allergic to sulfa drugs. Caution is advised in patients with kidney or liver disease, diabetes, or electrolyte imbalances.
Indications and Purpose
How does combination of Enalapril and Hydrochlorothiazide work?
Enalapril and Hydrochlorothiazide work together to lower blood pressure through complementary mechanisms. Enalapril, an ACE inhibitor, reduces the production of angiotensin II, a substance that narrows blood vessels, thereby relaxing and widening them to improve blood flow. Hydrochlorothiazide, a diuretic, helps the kidneys remove excess salt and water from the body, reducing blood volume and pressure. Together, they provide a more effective approach to managing hypertension by addressing both vascular resistance and fluid retention.
How effective is combination of Enalapril and Hydrochlorothiazide?
The effectiveness of Enalapril and Hydrochlorothiazide in treating hypertension is well-documented through clinical studies. Enalapril, as an ACE inhibitor, has been shown to significantly reduce blood pressure by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Hydrochlorothiazide, a diuretic, enhances this effect by promoting the excretion of excess salt and water, thereby reducing blood volume. Together, they provide an additive effect, leading to a more pronounced and sustained reduction in blood pressure. Clinical trials have demonstrated that this combination is effective in both black and non-black patients, offering a reliable option for managing high blood pressure.
Directions for Use
What is the usual dose of combination of Enalapril and Hydrochlorothiazide?
The usual adult daily dose for the combination of Enalapril and Hydrochlorothiazide varies depending on the specific needs of the patient. Enalapril is typically prescribed in doses ranging from 10 to 40 mg per day, which can be taken in a single dose or divided into two doses. Hydrochlorothiazide is usually prescribed in doses of 12.5 to 50 mg daily. The combination tablets are available in different strengths, such as 5/12.5 mg and 10/25 mg, allowing for flexibility in dosing to achieve optimal blood pressure control. It's important to follow the doctor's prescription and not to adjust the dose without medical advice.
How does one take combination of Enalapril and Hydrochlorothiazide?
Enalapril and Hydrochlorothiazide can be taken with or without food, but it is important to take them at the same time each day to maintain consistent blood levels. Patients should follow their doctor's instructions regarding any dietary restrictions, particularly concerning salt intake. It's advisable to avoid salt substitutes containing potassium unless directed by a healthcare provider, as these can interact with the medication. Staying hydrated is important, but excessive fluid intake should be avoided to prevent electrolyte imbalances.
For how long is combination of Enalapril and Hydrochlorothiazide taken?
Enalapril and Hydrochlorothiazide are typically used as long-term treatments for managing high blood pressure. While they help control blood pressure, they do not cure hypertension, so continuous use is often necessary to maintain the desired blood pressure levels. Patients are advised to take these medications consistently, even if they feel well, and should not stop taking them without consulting their doctor. Regular monitoring by a healthcare provider is essential to ensure the medication remains effective and to adjust the dosage if needed.
How long does it take for combination of Enalapril and Hydrochlorothiazide to work?
Enalapril and Hydrochlorothiazide work together to lower blood pressure, but they have different mechanisms and onset times. Enalapril, an ACE inhibitor, begins to lower blood pressure within about one hour after ingestion, with peak effects occurring around four to six hours. Hydrochlorothiazide, a diuretic, starts to work within two hours, with its peak diuretic effect occurring around four hours after ingestion. The combination of these two medications provides a more comprehensive approach to managing high blood pressure, with enalapril reducing the constriction of blood vessels and hydrochlorothiazide helping to eliminate excess fluid and salt from the body. Together, they offer a sustained blood pressure-lowering effect throughout the day.
Warnings and Precautions
Are there harms and risks from taking combination of Enalapril and Hydrochlorothiazide?
Common side effects of Enalapril and Hydrochlorothiazide include cough, dizziness, headache, and fatigue. Enalapril may cause a persistent dry cough due to its effect on bradykinin levels. Hydrochlorothiazide can lead to increased urination, electrolyte imbalances, and muscle cramps. Serious adverse effects include lightheadedness, swelling of the face or throat, difficulty breathing, and signs of infection. Both medications can cause changes in kidney function and electrolyte levels, so regular monitoring is important. Patients should report any severe or persistent side effects to their healthcare provider immediately.
Can I take combination of Enalapril and Hydrochlorothiazide with other prescription drugs?
Enalapril and Hydrochlorothiazide can interact with several prescription medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the effectiveness of both medications in lowering blood pressure. Combining these drugs with other blood pressure medications, such as beta-blockers or calcium channel blockers, can enhance the blood pressure-lowering effect, which may require dosage adjustments. Enalapril should not be used with aliskiren in patients with diabetes due to increased risk of kidney problems. Additionally, lithium levels can be increased when taken with these medications, leading to toxicity. It's crucial to inform healthcare providers of all medications being taken to manage potential interactions.
Can I take combination of Enalapril and Hydrochlorothiazide if I am pregnant?
Enalapril and Hydrochlorothiazide are not recommended during pregnancy, particularly in the second and third trimesters, due to the risk of fetal harm. Enalapril can affect fetal kidney development and lead to complications such as low amniotic fluid levels and developmental issues. Hydrochlorothiazide can cause electrolyte imbalances and affect fetal growth. If pregnancy is detected, these medications should be discontinued immediately, and alternative treatments should be considered. It's crucial for women of childbearing age to discuss potential risks with their healthcare provider before starting these medications.
Can I take combination of Enalapril and Hydrochlorothiazide while breastfeeding?
Enalapril and Hydrochlorothiazide are present in breast milk, but the concentrations are generally low. While these levels are not typically considered harmful, caution is advised when using these medications during breastfeeding, especially in newborns or preterm infants. The decision to use these medications should consider the importance of the drug to the mother and the potential risks to the infant. If used, monitoring the infant for any adverse effects is recommended. Consulting with a healthcare provider is essential to weigh the benefits and risks of continuing these medications while breastfeeding.
Who should avoid taking combination of Enalapril and Hydrochlorothiazide?
Key warnings for Enalapril and Hydrochlorothiazide include the risk of fetal toxicity, so they should not be used during pregnancy. Patients with a history of angioedema or those allergic to sulfa drugs should avoid these medications. Caution is advised in patients with kidney or liver disease, diabetes, or electrolyte imbalances. Enalapril can cause a persistent cough, and Hydrochlorothiazide may lead to dehydration and electrolyte disturbances. Regular monitoring of blood pressure, kidney function, and electrolytes is essential to ensure safe use. Patients should inform their healthcare provider of any other medications or supplements they are taking.
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