Enalapril/hydrochlorothiazide (By mouth)

Introduction

Enalapril Maleate (en-AL-a-pril MAL-ee-ate), Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide)

Treats high blood pressure. This medicine is a combination of an angiotensin-converting enzyme (ACE) inhibitor and a diuretic ("water pill").

Brand Name(s)

Vaseretic

When This Medicine Should Not Be Used

How to Use This Medicine

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.
• Carefully follow your doctor's instructions about any special diet. Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting. Check with your doctor right away if you continue to experience diarrhea or vomiting.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using a gold injections (such as sodium aurothiomalate), lithium (Eskalith®, Lithobid®), or another diuretic or "water pill" (such as amiloride, chlorthalidone, eplerenone, furosemide, spironolactone, triamterene, Aldactazide®, Aldactone®, Inspra®, Dyazide®, Dyrenium®, Lasix®, Maxzide®, Midamor®, Moduretic®, or Thalitone®). Tell your doctor if you are using certain medicines to lower your cholesterol (such as cholestyramine, colestipol, Colestid®, or Questran®).
• Make sure your doctor knows if you are also using allopurinol (Purinol®, Zyloprim®), azathioprine (Imuran®), digoxin (Lanoxin®), insulin or a diabetes medicine that you take by mouth (such as glipizide, metformin, Amaryl®, Actos?, Avandia®, Glipizide®, Glucotrol®, Glucophage®, or Glyburide®), pain or arthritis medicine (such as aspirin, ibuprofen, indomethacin, naproxen, Advil®, Aleve®, Feldene®, Indocin®, Motrin®, Orudis®, Relafen®, or Voltaren®), a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®), tetracycline, or other blood pressure medicines.
• Do not use medicines, supplements, or salt substitutes that contain potassium without checking first with your doctor.
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.

Warnings While Using This Medicine

• Using this medicine while you are pregnant (especially in your second or third trimester) can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you are breastfeeding, or if you have kidney problems, liver disease, dehydration, heart or blood vessel disease, congestive heart failure, low blood pressure, high cholesterol or fats in the blood, or a history of mineral imbalance (such as high or low calcium, magnesium, potassium, or sodium in the blood). Tell your doctor if you have diabetes, gout, lupus, an autoimmune disorder (such as collagen vascular disease), or a history of asthma.
• This medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life.
• This medicine may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.
• Tell your doctor about any allergic reaction you have had to any drug, especially if the reaction caused you to have swelling in your face, lips, tongue, or throat.
• Stop using this medicine and call your doctor right away if you have severe stomach pain. This could be a symptom of a condition called intestinal angioedema.
• This medicine may make you dizzy or lightheaded. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. Dizziness may be worse if you lose too much water from your body because it can cause low blood pressure. You can lose water by sweating, having diarrhea, or vomiting. Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea, vomiting, or diarrhea.
• Stop using this medicine and check with your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
• This medicine may raise your blood sugar. You should check your blood sugar more often during the first month you take this medicine, and then on a regular basis.
• Check with your doctor if you notice any signs of fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cell counts.
• Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. These could be signs of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
• Black patients may be less sensitive to the blood pressure-lowering effects of this medicine. In addition, the risk of a serious allergic reaction involving swelling of the face, mouth, hands, or feet may be increased.
• If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using the medicine without asking your doctor.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood and urine tests may be needed to check for unwanted effects.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision or changes in vision.
• Change in how much or how often you urinate, or problems urinating.
• Chest pain (may be related to your disease and not a side effect).
• Confusion, body weakness, uneven heartbeat, shortness of breath, or numbness or tingling in your hands, feet, or lips.
• Dark-colored urine or pale stools.
• Dry mouth, increased thirst, or muscle cramps.
• Fast, slow, or pounding heartbeat.
• Fever, chills, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting
• Nausea, vomiting, loss of appetite, or upper stomach pain.
• Severe stomach pain.
• Swelling in your hands, ankles, or feet.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea or stomach upset.
• Dry cough.
• Headache.
• Tiredness.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088