enalapril and hydrochlorothiazide, Vaseretic (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
PRESCRIBED FOR: Vaseretic is used for treating high blood pressure.
DOSING: Patients who have not adequately responded to enalapril or HCTZ alone may be started on 10/25 mg/mg of Vaseretic. The dose may be increased after 2-3 weeks if adequate. The maximum dose is 2 tablets of 10/25 mg/mg once daily.
DRUG INTERACTIONS: Enalapril may increase potassium levels (hyperkalemia) in blood. Therefore, there is an increased risk of hyperkalemia when enalapril is given with potassium supplements or drugs that increase potassium levels, for example, spironolactone (Aldactone).
There have been reports of increased lithium levels (Eskalith, Lithobid) when lithium is used in combination with ACE inhibitors. The reason for this interaction is not known, but the increased levels may lead to toxicity from lithium. There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effectiveness of ACE inhibitors in lowering blood pressure.
Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable gold (sodium aurothiomalate [Myochrysine]), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including enalapril.
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