Enalapril Maleate (en-AL-a-pril MAL-ee-ate), Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide)
Treats high blood pressure. A lower blood pressure can reduce the risk of stroke and heart attack. This medicine is a combination of an angiotensin-converting enzyme (ACE) inhibitor and a diuretic (water pill).
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
Do not use this medicine if you have had an allergic reaction to enalapril, hydrochlorothiazide, or sulfa drugs. Do not use this medicine if you are pregnant, are not able to urinate, have a history of angioedema (swelling of the face, lips, tongue, throat, arms, or legs) that was caused by an ACE inhibitor, or have hereditary or idiopathic angioedema. Do not use this medicine together with aliskiren (Tekturna®) if you have diabetes.
How to Use This Medicine
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- Carefully follow your doctor's instructions about any special diet.Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using aliskiren (Tekturna®), lithium (Eskalith®, Lithobid®), gold injections (such as sodium aurothiomalate), norepinephrine, or a diuretic (water pill, such as amiloride, spironolactone, triamterene, Aldactone®). Tell your doctor if you are using other blood pressure medicine or certain medicines to lower your cholesterol (such as cholestyramine, colestipol, Colestid®, Questran®).
- Make sure your doctor knows if you are also using insulin or a diabetes medicine that you take by mouth (such as glimepiride, glyburide, metformin, Actos®, Janumet®, Januvia®), pain or arthritis medicine (NSAID, such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or a steroid medicine (such as dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, Medrol®).
- Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
- Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine.
Warnings While Using This Medicine
- Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
- Make sure your doctor knows if you are breastfeeding or if you have kidney problems, liver disease, heart or blood vessel disease, congestive heart failure, low blood pressure, high cholesterol, or a mineral imbalance (such as high or low calcium, magnesium, potassium, or sodium in the blood). Tell your doctor if you have glaucoma, gout, or a history of asthma. Tell your doctor if you have diabetes or a collagen vascular disease, such as lupus or scleroderma.
- Call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of intestinal angioedema.
- This medicine could lower your blood pressure too much and cause you to feel dizzy or lightheaded. Stand or sit up slowly if you are dizzy. This is more likely to happen when you begin to use the medicine. It could also happen if you have diarrhea or vomiting, you sweat heavily, or you do not drink enough water and become dehydrated. If you faint, stop using this medicine and call your doctor right away.
- This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous until you know how this medicine affects you.
- Check with your doctor right away if you have upper stomach pain, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
- Check with your doctor if you have a fever, chills, or sore throat. These could be symptoms of an infection caused by low white blood cell counts.
- Check with your doctor immediately if blurred vision, difficulty reading, eye pain, or any other change in vision occurs during or after treatment. These could be signs of a serious eye problem.
- Black patients may have an increased risk of swelling of the hands, arms, face, mouth, or throat.
- Do not stop using the medicine without asking your doctor, even if you feel well. This medicine will not cure your high blood pressure, but it will help keep it in normal range. You may have to take blood pressure medicine for the rest of your life.
- Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blurred vision or changes in vision
- Change in how much or how often you urinate, problems urinating
- Chest pain (may be related to your disease and not a side effect)
- Confusion, weakness, shortness of breath, numbness or tingling in your hands, feet, or lips
- Dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes
- Dry mouth, increased thirst, muscle cramps
- Fast, slow, pounding, or uneven heartbeat
- Fever, chills, sore throat, and body aches
- Lightheadedness, dizziness, fainting
- Severe stomach pain (with or without nausea or vomiting)
- Unusual tiredness or weakness
If you notice these less serious side effects, talk with your doctor:
- Dry cough