hydrochlorothiazide and enalapril

What is the most important information I should know about hydrochlorothiazide and enalapril?

If you have diabetes, do not use hydrochlorothiazide and enalapril together with any medication that contains aliskiren (a blood pressure medicine).

What is hydrochlorothiazide and enalapril?

Hydrochlorothiazide is a thiazide diuretic (water pill) and enalapril is an ACE inhibitor (ACE stands for angiotensin converting enzyme).

Hydrochlorothiazide and enalapril is a combination medicine used to treat hypertension (high blood pressure).

Hydrochlorothiazide and enalapril may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking hydrochlorothiazide and enalapril?

• you are unable to urinate;
• you have ever had angioedema;
• you recently took a heart medicine called sacubitril;
• you are allergic to sulfa drugs; or
• you are allergic to any ACE inhibitor (benazepril, captopril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril).

Do not take hydrochlorothiazide and enalapril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use hydrochlorothiazide and enalapril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking hydrochlorothiazide and enalapril with aliskiren if you have kidney disease.

Tell your doctor if you have ever had:

• asthma or allergies;
• kidney disease (or if you are on dialysis);
• cirrhosis or other liver disease;
• glaucoma;
• congestive heart failure;
• gout;
• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
• lupus;
• if you are allergic to penicillin; or
• if you are on a low salt diet.

How should I take hydrochlorothiazide and enalapril?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Your blood pressure will need to be checked often. Your kidney function may also need to be checked. Your blood and urine may also be tested if you have been vomiting or are dehydrated.

If you need surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and enalapril.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include increased thirst, feeling light-headed, or fainting.

What should I avoid while taking hydrochlorothiazide and enalapril?

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink.

What are the possible side effects of hydrochlorothiazide and enalapril?

You may be more likely to have an allergic reaction if you are African-American.

• a light-headed feeling, like you might pass out;
• jaundice (yellowing of the skin or eyes);
• blurred vision, tunnel vision, eye pain, or seeing halos around lights;
• fever, chills, flu-like symptoms, sore throat, mouth sores;
• signs of an electrolyte imbalance --leg cramps, constipation, muscle pain or weakness, irregular heartbeats, feeling jittery, increased thirst or urination, numbness or tingling, loss of movement;
• kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
• new or worsening symptoms of lupus --joint pain, and a skin rash on your cheeks or arms that worsens in sunlight.

Common side effects may include:

• dizziness;
• cough;
• headache; or
• nausea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect hydrochlorothiazide and enalapril?

Tell your doctor about all your current medicines. Many drugs can affect hydrochlorothiazide and enalapril, especially:

• other blood pressure medications, including another diuretic or "water pill";
• digoxin;
• lithium;
• cancer medicine;
• gold injections to treat arthritis;
• insulin or oral diabetes medicine;
• a muscle relaxer;
• medicine to prevent organ transplant rejection --cyclosporine, everolimus, sirolimus, tacrolimus; or
• NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete and many other drugs may affect hydrochlorothiazide and enalapril. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about hydrochlorothiazide and enalapril.