Enalapril Maleate And Hydrochlorothiazide

Contraindicated in patients with diabetes; avoid in patients with renal impairment (GFR <60 mL/min). Associated with increased risks of hypotension, hyperkalemia, and acute renal failure.

Dual blockade of RAS associated with increased risks of hypotension, hyperkalemia, and acute renal failure compared to monotherapy.

May cause excessive reduction of blood pressure after initiation of enalapril therapy, particularly if diuretic therapy was recently instituted.

Closely monitor blood pressure, renal function and electrolytes in patients on enalapril maleate and hydrochlorothiazide and other agents that affect the RAS. Do not coadminister aliskiren with enalapril maleate and hydrochlorothiazide in patients with diabetes. Avoid use of aliskiren with enalapril maleate and hydrochlorothiazide in patients with renal impairment (GFR <60 mL/min).

May result in deterioration of renal function, including acute renal failure, especially in elderly, volume-depleted, or renally compromised patients.

Lithium toxicity has been reported in patients receiving enalapril concomitantly with lithium; effects are reversible upon discontinuation.

Concomitant neprilysin inhibitors may increase risk for angioedema in patients taking enalapril.

Nitritoid reactions including facial flushing, nausea, vomiting, and hypotension have been reported rarely with concomitant enalapril and injectable gold therapy.

Potassium-sparing diuretic; enalapril attenuates diuretic-induced potassium loss, increasing hyperkalemia risk.

May result in deterioration of renal function, including acute renal failure, especially in elderly, volume-depleted, or renally compromised patients.

Potassium-sparing diuretic; enalapril attenuates diuretic-induced potassium loss, increasing hyperkalemia risk.

Potassium-sparing diuretic may lead to significant increases in serum potassium when used concomitantly with enalapril; requires frequent monitoring.

Enalapril Maleate Dual Blockade of the Renin-Angiotensin System (RAS) Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Closely monitor blood pressure, renal function and electrolytes in patients on enalapril maleate and hydrochlorothiazide and other agents that affect the RAS. Do not coadminister aliskiren with enalapril maleate and hydrochlorothiazide in patients with diabetes.

Potassium supplements may lead to significant increases in serum potassium when used concomitantly with enalapril; requires frequent monitoring.

mTOR (mammalian target of rapamycin) inhibitors: Patients receiving coadministration of ACE inhibitor and mTOR inhibitor (e.g., temsirolimus, sirolimus, everolimus) therapy may be at increased risk for angioedema (see WARNINGS ).

Enalapril has been used concomitantly without evidence of clinically significant adverse interactions.

Enalapril has been used concomitantly without evidence of clinically significant adverse interactions.

Enalapril has been used concomitantly without evidence of clinically significant adverse interactions.

Enalapril has been used concomitantly without evidence of clinically significant adverse interactions.

Enalapril has been used concomitantly without evidence of clinically significant adverse interactions.

Enalapril has been used concomitantly without evidence of clinically significant adverse interactions.