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Generic Name:

enalapril-hydrochlorothiazide, Oral tablet

All Brands

  • Vaseretic
SECTION 1 of 4

Highlights for enalapril-hydrochlorothiazide

Oral tablet
1

Enalapril/hydrochlorothiazide is a combination of two drugs in a single form. These drugs work in different ways to treat high blood pressure.

2

This medication is available as the brand-name drug Vaseretic. It’s also available as a generic drug.

3

Common side effects include dizziness, headache, fatigue, and cough.

4

You shouldn’t take this drug if you’re pregnant or plan to become pregnant. It can harm or be fatal to your fetus.

5

Enalapril/hydrochlorothiazide may cause a severe allergic reaction. Symptoms can include trouble breathing or swallowing, tightness of your chest, hives, rash, swelling, itching, dizziness, vomiting, or stomach pain.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Use during pregnancy warning. You shouldn’t take this drug if you’re pregnant or plan to become pregnant. It can harm or be fatal to your fetus. You should stop taking this drug as soon as possible if you become pregnant.

Swelling

This drug can cause sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines (angioedema). This is serious and can sometimes be fatal. Tell your doctor right away if you have swelling or stomach pain. Your doctor will have you stop taking this drug, and you may be given medication to reduce the swelling.

Low blood pressure

This drug can cause low blood pressure, especially during the first few days of starting treatment. Tell your doctor if you feel lightheaded or have any fainting spells. You may have a higher risk of low blood pressure if you:

  • aren’t drinking enough fluids
  • sweat heavily
  • have diarrhea or are vomiting
  • have heart failure
  • are on dialysis
  • take diuretics

Dry cough

This drug may cause a dry cough. This cough will last for as long as you take the medication. If you develop this cough and it becomes a problem for you, your doctor may take you off this medication.

What is enalapril/hydrochlorothiazide?

This drug is a prescription drug. It’s available as a tablet you take by mouth.

This medication is available as the brand-name drug Vaseretic. It’s also available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug is a combination of two drugs in a single form. It’s important to know about all the drugs in the combination because they each may have unique traits. 

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

This drug is used to treat high blood pressure.

How it works

This drug belongs to a class of drugs called ACE inhibitor/thiazide diuretics.

More Details

How it works

This drug belongs to a class of drugs called ACE inhibitor/thiazide diuretics. A class of drugs refers to medications that work similarly. They’re often used to treat similar conditions.

Enalapril helps your blood vessels relax and widen. Hydrochlorothiazide lowers the amount of salt and water in your body. Each of these actions lowers your blood pressure.

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SECTION 2 of 4

enalapril-hydrochlorothiazide Side Effects

Oral tablet

Most Common Side Effects

The more common side effects that can occur with enalapril/hydrochlorothiazide include:

  • dizziness

  • headache

  • fatigue

  • cough

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Severe allergic reactions. Symptoms can include:

    • trouble breathing or swallowing
    • chest tightness
    • hives
    • skin rash
    • swelling
    • itching
    • dizziness
    • vomiting
    • stomach pain
  • Swelling (angioedema). Symptoms can include:

    • swelling of the face, lips, tongue, throat, arms and legs, or your whole body
  • Low blood pressure. Symptoms can include:

    • dizziness or feeling like you might faint
    • lightheadedness
    • tiredness
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

enalapril-hydrochlorothiazide May Interact with Other Medications

Oral tablet

Enalapril/hydrochlorothiazide can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

  • Your body processes alcohol and this drug in similar ways. That means that if you drink alcohol, this drug might take longer to leave your body. You could have worse side effects.
  • Using alcohol while taking this drug can cause a sedative effect. You may have slowed reflexes, poor judgment, and sleepiness. This can be dangerous.

Medications that might interact with this drug

Blood pressure drugs

These medications may increase the effect of enalapril/hydrochlorothiazide. This can cause low blood pressure. Taking these drugs with enalapril/hydrochlorothiazide may also harm your kidneys or raise your potassium levels. These drugs include:

  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril
    • captopril
    • clizapril
    • enalapril
    • enalaprilat
    • fosniopril
    • imidapril
    • moexipril
    • perindopril
    • quinapril
    • ramipril
    • trandolapril
  • angiotensin receptor blockers (ARBs), such as:
    • irbesartan
    • losartan
    • olmesartan
    • telmisartan
    • valsartan
  • beta-blockers, such as:
    • acebutolol
    • arotinolol
    • atenolol
    • betaxolol
    • bisoprolol
    • esmolol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • timolol (systemic)
  • calcium channel blockers, such as:
    • amlodipine
    • felodipine
    • nicardipine
    • nifedipine
  • loop diuretics, such as:
    • bumetanide
    • furosemide
    • indapamide
    • torsemide
  • potassium-sparing diuretics, such as:
    • eplerenone
    • spironolactone
    • triamterene
    • amiloride
  • renin inhibitors, such as:
    • aliskiren
  • thiazide diuretics, such as:
    • chlorothiazide
    • chlorthalidone
    • hydrochlorothiazide
    • methylclothiazide
    • metolazone

Cholesterol drugs

Certain drugs used to lower cholesterol levels may decrease the effect of enalapril/hydrochlorothiazide. This can cause high blood pressure.

These drugs include:

  • cholestyramine
  • colestipol resins

Diabetes drugs

Your doctor may need to change your dose of these diabetes medications if you take them with enalapril/hydrochlorothiazide. These drugs include:

  • pramlintide
  • metformin
  • exenatide
  • liraglutide
  • lixisenatide
  • saxagliptin
  • sitagliptin
  • insulin
  • nateglinide
  • repaglinide
  • glimepiride
  • glipizide
  • glyburide
  • canagliflozin
  • dapagliflozin
  • empagliflozin
  • pioglitazone
  • rosiglitazone

Mood stabilizers

Lithium can be used to treat manic-depressive disorder. When it’s used with enalapril/hydrochlorothiazide, the amount of lithium in your body can be increased. This means you may have more side effects.

Pain drugs

Pain medications called narcotics may increase the effect of enalapril/hydrochlorothiazide. This can cause low blood pressure. These drugs include:

  • codeine
  • dihydrocodeine
  • fentanyl
  • hydrocodone
  • hydromorphone
  • levorphanol
  • mepiridine
  • methadone
  • morphine
  • opium
  • oxycodone
  • oxymorphone
  • tramadol

Certain types of nonsteroidal anti-inflammatory drugs (NSAIDs) may damage your kidneys if taken with enalapril/hydrochlorothiazide. These drugs include:

  • indomethacin
  • sulindac

Supplements

Certain supplements may increase your potassium levels if you take them with enalapril/hydrochlorothiazide. These supplements include:

  • potassium-containing supplements
  • certain salt substitutes

Other drugs

Barbiturates can increase the effect of enalapril/hydrochlorothiazide. This can cause low blood pressure. These drugs include:

  • amobarbital
  • butabarbital
  • butalbital
  • methohextal
  • pentobarbital
  • phenobarbital
  • secobarbital
  • thiopental

Celecoxib is a type of drug called a COX-2 inhibitor. It may damage your kidneys if taken with enalapril/hydrochlorothiazide.

Corticosteroids may decrease your potassium levels when taken with enalapril/hydrochlorothiazide. These drugs include:

  • betamethasone
  • corticotropin
  • cortisone
  • dexamethasone
  • hydrocortisone
  • methylprednisolone; prednisolone
  • prednisone
  • triamcinolone

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
sulfonamide allergy
People with a sulfonamide allergy

Hydrochlorothiazide is a sulfonamide drug. If you are allergic to sulfonamides, you shouldn’t take this drug. Tell your doctor about all of your allergies.

congestive heart failure
People with congestive heart failure

If you have congestive heart failure, your blood pressure may drop to a dangerously low level while you take this drug.

kidney disease
People with kidney disease or who receive dialysis

You have a higher risk of serious side effects from this medication. These include low blood pressure. Your doctor will monitor your kidney function and adjust your medication as needed.

liver disease
People with liver disease

Use this drug with caution if you have liver problems. This drug may affect your electrolyte levels.

systemic lupus erythematosus
People with systemic lupus erythematosus (SLE)

This drug can cause new or worsening symptoms of lupus. Call your doctor right away if this happens.

glaucoma
People with glaucoma

This drug may increase your risk of developing glaucoma. Your risk may be higher if you have a history of a sulfonamide or penicillin allergy. Tell your doctor about your allergies and if you have a history of glaucoma.

autoimmune disorders
People with autoimmune disorders

If you have an autoimmune disorder, you may be more likely to have low white blood cells while taking this drug. This means that you may be more likely to get an infection. If you have an infection, it may be harder for your body to recover. Tell your doctor if you get sick while taking this drug.

diabetes
People with diabetes

Your doctor may adjust your diabetes medications while you’re taking this drug. They’ll tell you how often to test your blood sugar levels.

pregnant women
Pregnant women

This drug is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breastfeeding
Women who are breast-feeding

This drug may pass into breast milk and cause serious effects in a child who is breast-fed.

You and your doctor may need to decide if you’ll take this drug or breast-feed.

for seniors
For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

for children
For children

This medication hasn’t been studied in children. It shouldn’t be used in people under the age of 18 years.

call doctor
When to call the doctor

Tell your doctor right away if you get pregnant while taking this drug. This drug can harm or be fatal to your fetus.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it or other sulfonamide drugs. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take enalapril-hydrochlorothiazide (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

High blood pressure

Brand: Vaseretic

Form: Oral tablet
Strengths:
  • 10 mg enalapril/25 mg hydrochlorothiazide

Generic: enalapril/hydrochlorothiazide

Form: Oral tablet
Strengths:
  • 10 mg enalapril/25 mg hydrochlorothiazide
  • 5 mg enalapril/12.5 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)
  • The standard dosage is 10 mg enalapril/25 mg hydrochlorothiazide taken by mouth once per day.
  • The maximum dose per day is two tablets of 10 mg enalapril/25 mg hydrochlorothiazide.
Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in children under the age of 18 years.

Senior dosage (ages 65 years and older)

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal. If you’re a senior, you may need a lower dose or a different schedule.

Special considerations

Kidney disease: You shouldn’t take this drug if your creatinine clearance (CrCl) is less than 30 mL/min.

Warnings

The maximum dose per day is two tablets of 10 mg enalapril/25 mg hydrochlorothiazide.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your blood pressure will stay high. This can lead to stroke, heart attack, heart failure, kidney failure, or vision problems.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • low blood pressure, with symptoms such as dizziness or lightheadedness
  • increased urination
  • nausea
  • vomiting
  • weakness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time. Never try to catch up by taking two doses at once. This could cause dangerous side effects.

How to tell if the drug is working

Your blood pressure should go down. Your doctor can check your blood pressure, or you can check it at home using a blood pressure monitor.

This drug is used for long-term treatment.

Important considerations for taking this drug

Take this medication at the same time every day

Hydrochlorothiazide, one of the drugs in this combination, is a diuretic. This means that it may make you urinate more often. It’s a good idea to take this medication in the morning so you don’t have to wake up at night to use the bathroom.

Store this drug carefully

  • Keep this drug at room temperature from 59–86°F (15–30°C).
  • Don’t freeze enalapril/hydrochlorothiazide.
  • Keep it away from light.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Don’t leave this medication in the car, especially when the temperature is hot or freezing.

Self-management

You may need to check your blood pressure and heart rate at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this log with you to your doctor appointments.

You may need to buy a blood pressure monitor. These are available at most pharmacies.

Clinical monitoring

Your doctor will do blood tests. These will be done throughout your treatment with this drug to check your:

  • kidney function
  • liver function
  • electrolytes (the salts in your body)

Your doctor will also check your blood pressure and heart rate while you’re taking this drug.

Hidden costs

You may need to buy a blood pressure monitor, so that you can check your blood pressure at home.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

  • Valeant Pharmaceuticals North America LLC. (2015). Vaseretic – enalapril maleate and hydrochlorothiazide package insert. Bridgewater, NJ: Author.
  • Apotex Corp. (2015). Enalapril maleate and hydrochlorothiazide package insert. Weston, FL: Author.

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 10, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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