Enalapril hydrochlorothiazide is a medication combining an angiotensin-converting enzyme (ACE) inhibitor with a diuretic, and it is used to treat high pressure or, occasionally, conditions like congestive heart failure. Though this medication can be highly effective, it is not appropriate for all individuals and may interact with certain drugs or medical conditions. It also has mild to severe side effects.
ACE inhibitors lower blood pressure by preventing the conversion of angiotensin I to angiotensin II. This lowers the number of signals the blood vessels receive to contract. Hydrochlorothiazide assists the kidneys in removing excess water from the body, which also lowers blood pressure. In a combined form, enalapril hydrochlorothiazide may have greater effect than if either of these medications are used alone.
Still, this drug is not appropriate for all people. Children rarely use it, and elderly adults sometimes have more side effects when they take it. Pregnant or nursing women or those who are planning to get pregnant are cautioned not to take enalapril hydrochlorothiazide. It is associated with severe birth defects and it crosses into breastmilk, which makes it unsafe for nursing babies. Caution is additionally advised if diabetics, patients with kidney disorders, or those planning to have surgery use this drug.
There are also a number of medications that may interact with enalapril hydrochlorothiazide. Among them are other blood pressure medications or diuretics. The drug can also interact with insulin and metformin, which may, in turn, affect diabetes. Medicines like non-steroidal anti-inflammatory drugs (NSAIDs), certain steroids, and barbiturates could be affected by the ACE inhibitor/diuretic, too. For safety, patients should present doctors with a complete list of medications they use before they accept a prescription for this drug.
Like all medications, enalapril hydrochlorothiazide has side effects that will affect some percentage of its users. Many of these are benign, and include reactions such as headache, lightheadedness, dizziness, and drowsiness. Older patients who use this drug may find that these symptoms are more pronounced.
Other less serious adverse reactions are photosensitivity, and cough. ACE inhibitors are generally known for causing cough. Many patients tolerate this well, but a few people develop a severe cough and require a different blood pressure medication type.
Rare but extremely severe side effects may sometimes occur with enalapril hydrochlorothiazide and they require immediate medical attention. They include allergic reaction to either drug, which may manifest as hives; difficulty breathing; and swelling of the face, lips, and tongue. Alternately, some patients develop chest pain or irregular heartbeats when they use this medication. Other serious adverse effects are jaundice, severe changes in mood, very high blood sugar, or extremely low blood pressure.
