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:
Blood sugar levels can be elevated by HCTZ necessitating adjustment in the doses of medications that are used for treating diabetes.
Combining HCTZ with corticosteroids may increase the risk for low levels of blood potassium (hypokalemia) and other electrolytes. Low blood potassium can increase the toxicity of digoxin (Lanoxin). Cholestyramine (Questran, Questran Light) and colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by 43% to 85%.
PREGNANCY: When used in the second or third trimester of pregnancy ACE inhibitors can cause injury and even death to the fetus. Vaseretic should not be used during pregnancy.
NURSING MOTHERS: ACE inhibitors, including enalapril, should be avoided in nursing mothers.
SIDE EFFECTS: The side effects of the Vaseretic are similar to the side effects of the individual component drugs. A dry, persistent cough has been reported commonly with the use of ACE inhibitors. Coughing resolves after discontinuing the medication. Other side effects include abdominal pain, diarrhea, dizziness, fatigue, headache, loss of appetite, nausea and vomiting, chest pain, fainting, sexual dysfunction, increased potassium levels, numbness or tingling in the hands or feet, rash, and a sore or swollen throat. In rare instances, liver dysfunction and skin yellowing (jaundice) have been reported with ACE inhibitors. In susceptible individuals ACE inhibitors may reduce kidney function. Enalapril may cause hypersensitivity (allergic) reactions and angioedema (swelling of face, lips, tongue, throat). Side effects of HCTZ include weakness, low blood pressure, sunlight sensitivity, impotence, nausea, abdominal pain, electrolyte disturbances, pancreatitis, jaundice, anaphylaxis, and rashes, both mild and severe. Patients allergic to sulfa may also be allergic to HCTZ because of the similarity in the chemical structure of the medications.
Reference: FDA Prescribing Information
Last Editorial Review: 3/8/2013
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