hydrochlorothiazide and enalapril

Generic Name: hydrochlorothiazide and enalapril (HYE droe KLOR oh THYE a zide and en AL e pril)Brand Names: Vaseretic 10-25, Vaseretic 5-12.5

 

What is hydrochlorothiazide and enalapril?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Enalapril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Enalapril lowers blood pressure and also relieves symptoms of fluid retention.

The combination of hydrochlorothiazide and enalapril is used to treat hypertension (high blood pressure).

Hydrochlorothiazide and enalapril may also be used for purposes not listed in this medication guide.

What is the most important information I should know about hydrochlorothiazide and enalapril?

You should not use this medication if you are unable to urinate.

You should not use this medication if you are allergic to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

Before taking hydrochlorothiazide and enalapril, tell your doctor if you have kidney disease (or are on dialysis), liver disease, glaucoma, congestive heart failure, asthma, gout, lupus, diabetes, or an allergy to sulfa drugs or penicillin.

Do not use hydrochlorothiazide and enalapril if you are pregnant. It could harm the unborn baby.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and enalapril, unless your doctor has told you to.

Conditions that may cause very low blood pressure include: vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low-salt diet, or taking diuretics (water pills). Follow your doctor's instructions about the type and amount of liquids you should drink while taking hydrochlorothiazide and enalapril. Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and enalapril?

You should not use this medication if you are allergic to hydrochlorothiazide or enalapril, or if you are unable to urinate.

You should not use this medication if you are allergic to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

To make sure you can safely take hydrochlorothiazide and enalapril, tell your doctor if you have any of these other conditions:

  • kidney disease (or if you are on dialysis)-
  • liver disease-
  • glaucoma-

  • congestive heart failure-

  • asthma-

  • gout-

  • lupus-

  • diabetes- or

  • an allergy to sulfa drugs or penicillin.

FDA pregnancy category D. Do not use hydrochlorothiazide and enalapril if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. Hydrochlorothiazide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take hydrochlorothiazide and enalapril?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Take each dose with a full glass of water.

Conditions that may cause very low blood pressure include: vomiting, diarrhea, heavy sweating, heart disease, dialysis, a low-salt diet, or taking diuretics (water pills). Follow your doctor's instructions about the type and amount of liquids you should drink while taking hydrochlorothiazide and enalapril. Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting.

Your blood pressure will need to be checked often. Your blood and urine may also be tested if you have been vomiting or are dehydrated. Visit your doctor regularly.

Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using a thiazide diuretic.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from heat and moisture.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, weakness, dizziness, dry mouth, thirst, muscle pain or weakness, or feeling like you might pass out.

What should I avoid while taking hydrochlorothiazide and enalapril?

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and enalapril.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and enalapril, unless your doctor has told you to.

Hydrochlorothiazide and enalapril side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives- severe stomach pain- difficulty breathing- swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
  • eye pain, vision problems-

  • high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling)-

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling)-

  • dry mouth, thirst, nausea, vomiting-

  • feeling weak, drowsy, restless, or light-headed-

  • a red, blistering, peeling skin rash-

  • jaundice (yellowing of the skin or eyes)-

  • urinating less than usual or not at all-

  • swelling, weight gain, feeling short of breath- or

  • fever, chills, body aches, flu symptoms.

Less serious side effects may include:

  • cough-

  • dizziness, headache, tired feeling-

  • blurred vision-

  • diarrhea, constipation, upset stomach- or

  • mild skin rash, increased sweating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Hydrochlorothiazide and enalapril Dosing Information

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 1 tablet of (enalapril-hydrochlorothiazide 5 mg/12.5 mg) once a day. Determine dosage by individual titration.Maintenance dose: May increase up to a maximum dose of 2 tablets of (enalapril-hydrochlorothiazide 10 mg/25 mg) in 1-2 divided doses a day.

Usual Adult Dose for Hypertension:

Initial dose: 1 tablet of (enalapril-hydrochlorothiazide 5 mg/12.5 mg) once a day. Determine dosage by individual titration.Maintenance dose: May increase up to a maximum dose of 2 tablets of (enalapril-hydrochlorothiazide 10 mg/25 mg) in 1-2 divided doses a day.

What other drugs will affect hydrochlorothiazide and enalapril?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to the side effects of hydrochlorothiazide and enalapril. Tell your doctor if you regularly use any of these medicines, or any other blood pressure medications.

Tell your doctor about all other medicines you use, especially:

  • other diuretics (water pills) or blood pressure medications-

  • gold injections to treat arthritis-

  • lithium (Lithobid, Eskalith)-

  • digoxin (Lanoxin)-

  • cholestyramine (Prevalite, Questran) or colestipol (Colestid)-

  • steroids (prednisone and others)-

  • NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others- or

  • insulin or diabetes medicine taken by mouth.

This list is not complete and other drugs may interact with hydrochlorothiazide and enalapril. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about hydrochlorothiazide and enalapril.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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