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- What is enalapril and hydrochlorothiazide, and how does it work (mechanism of action)?
- What brand names are available for enalapril and hydrochlorothiazide?
- Is enalapril and hydrochlorothiazide available as a generic drug?
- Do I need a prescription for enalapril and hydrochlorothiazide?
- What are the side effects of enalapril and hydrochlorothiazide?
- What is the dosage for enalapril and hydrochlorothiazide?
- Is enalapril and hydrochlorothiazide safe to take if I'm pregnant or breastfeeding?
- What else should I know about enalapril and hydrochlorothiazide?
What is enalapril and hydrochlorothiazide, and how does it work (mechanism of action)?
Vaseretic is a combination of enalapril and hydrochlorothiazide (HCTZ) and is used for treating high blood pressure (hypertension). It is in a class of drugs called angiotensin converting enzyme (ACE) inhibitors. ACE is an enzyme in the body that causes the formation of angiotensin II. Angiotensin II causes the muscles surrounding the arteries in the body to contract, thereby narrowing the arteries and elevating the blood pressure. ACE inhibitors such as enalapril (Vasotec) lower blood pressure by preventing the formation of angiotensin II thereby relaxing the arteries.
HCTZ is a diuretic (water pill) used for treating high blood pressure and accumulation of fluid. It works by blocking salt and water reabsorption in the kidneys, thus causing increased urine output (diuresis). The mechanism of its action in lowering high blood pressure is not well understood. The combination of enalapril and HCTZ reduces blood pressure better than either drug alone. The FDA approved Vaseretic in October 1986.
What are the side effects of enalapril and hydrochlorothiazide?
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 of ACE inhibitors 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.
Quick GuideHow to Lower Blood Pressure: Exercise Tips
What is the dosage for enalapril and hydrochlorothiazide?
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.
Is enalapril and hydrochlorothiazide safe to take if I'm pregnant or breastfeeding?
ACE inhibitors, including enalapril, should be avoided in nursing mothers.
What else should I know about enalapril and hydrochlorothiazide?
What preparations of enalapril and hydrochlorothiazide are available?
Tablets (mg enalapril/mg HCTZ): 5/12.5 and 10/25
How should I keep enalapril and hydrochlorothiazide stored?
Vaseretic should be stored at 15C to 30 C (59 F to 86 F) and protected from excessive light and humidity.
Summary
Enalapril and hydrochlorothiazide (Vaseretic) is a drug prescribed for the treatment of high blood pressure. Side effects, drug interactions, pregnancy safety, and warnings and precautions should be reviewed prior to taking this medication.
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Medications & Supplements
- ACE Inhibitors (Side Effects, List of Names, Uses, and Dosage)
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Prevention & Wellness
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top enalapril and hydrochlorothiazide Related Articles
ACE Inhibitors
ACE inhibitors, or angiotensin (generic name) converting enzyme inhibitors, is a class of drugs that interact with blood enzymes to enlarge or dilate blood vessels and reduce blood pressure. These drugs are used to:
- Control high blood pressure (hypertension)
- Treat of heart failure and ventricular dysfunction
- Prevent and treat of kidney disease in people with diabetes or hypertension.
These drugs also improve the survival rate of people who have survived heart attacks and they prevent early death of people from heart attacks, high blood pressure, and heart failure. Sometimes ACE inhibitors are combined with other drugs for treating a condition. Examples of ACE inhibitors include:
- benazepril (Lotensin)
- captopril (Capoten)
- enalapril (Vasotec)
- fosinopril (Monopril)
- ramipril (Altace)
Examples of the most common side effects of this class of drugs are:
- dizziness,
- headache,
- cough,
- rash,
- chest pain,
- and rash.
There are serious side effects of this drug like
- kidney failure,
- severe allergic reactions,
- and liver dysfunction or failure.
ACE inhibitors all are similar in the way they work; however, they differ in how the body eliminates doses of the drug. Drug interactions, dosage, and pregnancy and safety information should be reviewed prior to taking this medication.
benazepril
Benazepril (Lotensin) is a medication prescribed alone or in combination with hydrochlorothiazide for treating high blood pressure. Off label uses for Lotensin include treatment for heart failure or diabetic neuropathy. Side effects, drug interactions, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking this medication.Congestive Heart Failure (CHF) Overview
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.Diabetes Mellitus
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.Drug Interactions
Drug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.Drugs: What You Should Know About Your Drugs
Important information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.Heart Attack
A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Heart Attack and Atherosclerosis Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience:
- Extreme fatigue
- Pain in the upper abdomen
- Dizziness
- Fainting
Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
High Blood Pressure Hypertension
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms.
Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
High Blood Pressure Treatment
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.Kidney Failure
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis.
Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones.Treatment options included diet, medications, or dialysis.
lisinopril
Lisinopril (Zestril, Prinivil, Qbrelis) is an ACE inhibitor prescribed for the treatment of:
- High blood pressure
- Heart failure
- Heart attack survival
- Preventing kidney failure due to high blood pressure
Side effects are, nasal congestion, anxiety, headaches, insomnia, drowsiness, and nausea. ACE inhibitors may cause a nonproductive cough that resolves once you stop taking the drug. Drug interactions include potassium supplements or derivatives of potassium, lithium (Eskalith, Lithobid), nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen), and symptoms of flushing; high blood pressure; nausea; and vomiting. Warnings and precautions, pregnancy information, and other safety information should be reviewed prior to taking any medication.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Parathyroidectomy
Parathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
- and recurrence of the tumor.
Pregnancy Drug Dangers
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.Sun-Sensitive Drugs (Photosensitivity to Drugs)
Sun sensitivity (photosensitivity) is an inflammation of the skin induced by the combination of medications or substances and sunlight. The effect on the skin is redness, which looks similar to a sunburn. Generally, these reactions are either phototoxic or photoallergic. Phototoxic drugs are more common than photoallergic drugs.Symptoms of phototoxic reactions are a burning and stinging sensation and then redness. Symptoms of photoallergic reactions are itching, redness, swelling, and blisters of the affected area.
Treatment generally is discontinuation of the medication and topical application of creams.
