enalapril / HCTZ
Vaseretic is a combination medication used to lower high blood pressure in adults. It contains enalapril maleate (an angiotensin-converting enzyme (ACE) inhibitor) and hydrochlorothiazide (a thiazide diuretic). This medication comes as a tablet that's taken by mouth once per day. Possible side effects include dizziness, headache, and tiredness. Vaseretic (enalapril / hydrochlorothiazide) is available as brand name and generic medications.
What is Vaseretic (enalapril / hydrochlorothiazide)?
What is Vaseretic (enalapril / hydrochlorothiazide) used for?
- High blood pressure in adults
How Vaseretic (enalapril / hydrochlorothiazide) works
Vaseretic is a combination of two medications that lowers blood pressure in different ways:
- Enalapril is an angiotensin-converting enzyme (ACE) inhibitor. It lowers blood pressure by relaxing your blood vessels and telling the body to hold on to less salt and fluid.
- Hydrochlorothiazide is a thiazide diuretic, which is a water pill. It lowers blood pressure by helping the kidneys get rid of extra salt and water.
Drug facts
Side effects of Vaseretic (enalapril / hydrochlorothiazide)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (9%)
- Headache (6%)
- Tiredness (4%)
- Cough (4%)
Less Common Side Effects
- Muscle cramps
- Nausea
- Diarrhea
- Feeling weak
- Difficulty getting or maintaining an erection
- Sudden low blood pressure when standing from sitting or lying down
Vaseretic (enalapril / hydrochlorothiazide) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema (severe swelling): stomach pain, nausea, vomiting, swelling of the face, arms or legs, lips, tongue, or throat
- Severe allergic reaction: swelling of your lips, tongue, throat, or face, trouble breathing, rash
- Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
- Serious kidney problems: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
- Liver problems: yellowing of the skin or eyes, stomach pain, nausea, vomiting, confusion
- Inflammation of the pancreas (pancreatitis): pain, swelling, or tenderness in the stomach, fever, nausea, vomiting, fast heartbeat
The following Vaseretic (enalapril / hydrochlorothiazide) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Blurred vision
chest pain, discomfort, or tightness
chills
cold sweats
coma
confusion
decreased urine output
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness
fainting
fast, slow, or irregular heartbeat
headache
increased thirst
irritability
large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
loss of appetite
lower back or side pain
muscle pain or cramps
nausea or vomiting
numbness or tingling in the hands, feet, or lips
rapid breathing
seizures
sunken eyes
sweating
swelling of the face, ankles, or hands
thirst
trouble breathing
unusual tiredness or weakness
weak pulse
wrinkled skin
Rare
Persistent non-healing sore
pink growth
reddish patch or irritated area
shiny bump
white, yellow or waxy scar-like area
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Ankle, knee, or great toe joint pain
decreased interest in sexual intercourse
difficulty in moving
inability to have or keep an erection
itching skin
joint stiffness or swelling
lack or loss of strength
loss in sexual ability, desire, drive, or performance
pain in the joints
trouble sleeping
unable to sleep
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Vaseretic (enalapril / hydrochlorothiazide)
Pros
- Combines two blood pressure medications in one tablet
- Taken by mouth once per day
- Can be taken with or without food
- Tablets can be split in half because they're scored
Cons
- Takes a few weeks before seeing maximum benefit on blood pressure
- Only available as a tablet
- Can make you urinate more
- Not safe to take while pregnant
Pharmacist tips for Vaseretic (enalapril / hydrochlorothiazide)
- You might notice your blood pressure improving within hours of starting Vaseretic (enalapril / hydrochlorothiazide). But it can take several weeks to see the maximum blood pressure-lowering effects of the medication.
- Take Vaseretic (enalapril / hydrochlorothiazide) at any time of day. But you might consider taking it in the morning since hydrochlorothiazide in Vaseretic can make you urinate more.
- You can take Vaseretic (enalapril / hydrochlorothiazide) with or without food. If the medication hurts your stomach, taking it with food might help.
- Be sure to check your blood pressure at home and write down your readings. Share this log with your prescriber at your follow-up visits. This will help your prescriber see how well Vaseretic (enalapril / hydrochlorothiazide) is working for you and see whether you need any changes to your treatment plan.
- Vaseretic (enalapril / hydrochlorothiazide) can cause dizziness or headaches, especially when you first start taking the medication or whenever your healthcare team raises your dose. These side effects should get better as you continue taking the medication. Stand up slowly after sitting or lying down to prevent falls.
- Dry cough is a well-known side effect of ACE-inhibitors, like enalapril. It's possible for you to get a cough from taking Vaseretic (enalapril / hydrochlorothiazide). This side effect can appear at any time during treatment. If you get a cough from Vaseretic (enalapril / hydrochlorothiazide) and it's bothersome, talk to your prescriber. They might switch you to a different blood pressure medication.
- Take Vaseretic (enalapril / hydrochlorothiazide) exactly as prescribed. Don't change your dose or stop taking the medication suddenly without talking to your prescriber first. Doing so can cause your blood pressure to rise quickly. You might need to lower your dose slowly over time before you can completely stop taking it.
- Stay hydrated while taking Vaseretic (enalapril / hydrochlorothiazide). Taking this medication when you're dehydrated can lead to very low blood pressure that might cause you to faint. If you lose a lot of fluids from sweating, diarrhea, or vomiting, ask your healthcare team how much fluids you need to drink to recover.
- Hydrochlorothiazide in Vaseretic can make you more sensitive to the sun. Wear protective clothing when going outside to lower your risk of sunburns, and ask your healthcare team about getting your skin checked regularly for skin cancer.
- Both enalapril and hydrochlorothiazide can interact with many other medications, such as lithium (Lithobid) and non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen (Advil, Motrin)). Make sure to tell your care team about all the medications you're taking before and during treatment with Vaseretic (enalapril / hydrochlorothiazide).
- Vaseretic (enalapril / hydrochlorothiazide) isn't safe to take during pregnancy. If you're pregnant or thinking of getting pregnant, contact your prescriber right away. Your prescriber will likely recommend a different medication that's safe during pregnancy.
Common questions about Vaseretic (enalapril / hydrochlorothiazide)
Enalapril in Vaseretic can start to lower your blood pressure within an hour. And hydrochlorothiazide can cause you to urinate more after a few hours. But it can take several weeks to see the full blood pressure-lowering effect of Vaseretic (enalapril / hydrochlorothiazide). It can also take some time before your prescriber finds a dose that works best for you, and they might need to adjust your dose depending on your blood pressure readings. Keep track of your blood pressure numbers and bring them to your appointments to help your healthcare team understand how well the medication is working for you.
It takes just a little over 2 days for enalapril and hydrochlorothiazide to leave your body after a dose of Vaseretic (enalapril / hydrochlorothiazide). This time frame is estimated based on the half-life of these medications. It can take longer for the medication to leave the body in people with kidney problems because Vaseretic (enalapril / hydrochlorothiazide) is removed by the kidneys. Talk with your healthcare team if you have any specific concerns related to how long this medication stays in your body.
Yes, hydrochlorothiazide is a thiazide diuretic, which is a water pill. It helps with swelling and lowers blood pressure by releasing extra fluid from your body. Because diuretics make you urinate more, it's recommended to take Vaseretic (enalapril / hydrochlorothiazide) in the morning so that you don't need to wake up to go to the bathroom.
Vaseretic is FDA-approved to lower blood pressure in adults. It might help with swelling (edema) if your symptoms are caused by a build up of fluids. This medication contains hydrochlorothiazide, which is a thiazide diuretic that works by removing extra fluids through the kidneys. On its own, hydrochlorothiazide is approved to ease swelling, such as leg swelling. Talk with your healthcare team if you're concerned about swelling.
Hair loss wasn't a reported side effect in people taking Vaseretic (enalapril / hydrochlorothiazide) during clinical studies. However, there were some reports of hair loss after Vaseretic (enalapril / hydrochlorothiazide) was released into the market. But it's unclear whether the hair loss was caused by Vaseretic (enalapril / hydrochlorothiazide) or other factors. If you notice hair loss while you're taking Vaseretic (enalapril / hydrochlorothiazide), contact a healthcare professional so they can help you figure out what might be the cause.
Yes, Vaseretic (enalapril / hydrochlorothiazide) tablets can be cut in half because they have a score-line down the middle of the tablet. The score-line is to help you split the pills in half evenly. If you'd rather not cut Vaseretic (enalapril / hydrochlorothiazide) tablets, talk to your prescriber about switching you to a different blood pressure medication.
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Risks and warnings for Vaseretic (enalapril / hydrochlorothiazide)
Vaseretic (enalapril / hydrochlorothiazide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not for use during pregnancy
Don't take Vaseretic (enalapril / hydrochlorothiazide) if you're pregnant. Enalapril in Vaseretic can cause severe and sometimes life-threatening harm to unborn babies, so it shouldn't be taken during pregnancy. If you find out that you're pregnant while taking Vaseretic (enalapril / hydrochlorothiazide), stop and let your prescriber know right away. If you're pregnant before starting Vaseretic (enalapril / hydrochlorothiazide) or thinking of becoming pregnant during treatment, discuss with your healthcare professional (HCP) about safer options to treat your blood pressure.
Angioedema (swelling)
- Risk factors: Black people | Having angioedema in the past
Enalapril in Vaseretic can trigger a rare, but life-threatening side effect called angioedema. This involves swelling in different parts of the body, including the face and tongue, and can cause trouble breathing. Sometimes, angioedema affects he gut and can cause stomach pain, nausea, and vomiting. Angioedema can happen at any time during treatment. The risk for this side effect is higher in Black people than in non-Black people. Get medical attention immediately if you experience swelling in any of the areas mentioned above, stomach pain, or difficulty breathing. You'll have to stop taking Vaseretic (enalapril / hydrochlorothiazide) if this happens.
Allergic reaction
- Risk factors: History allergies or asthma | Allergy to sulfa
Vaseretic (enalapril / hydrochlorothiazide) can cause allergic reactions. Your risk is higher if you have a history of allergies, asthma, or a sulfa allergy, though it can happen to anyone. Let your prescriber know if you have a rash, itchiness, hives, trouble breathing, or swelling in the face.
Low blood pressure
- Risk factors: Not enough fluid in your body | Receiving dialysis | Having diarrhea or vomiting for a long time | Eating low-salt diet | Taking diuretic medications for a long time | Heart failure
Vaseretic (enalapril / hydrochlorothiazide) can cause your blood pressure to drop too much, which can make you feel dizzy, tired, or lightheaded. This side effect is more common if you're dehydrated from diarrhea or vomiting, or if you have heart failure. Before you start Vaseretic (enalapril / hydrochlorothiazide), your care team will check to see if your fluid and salt levels are balanced. They will instructed you to stay well-hydrated to avoid having blood pressure that's too low. Sit down slowly while holding onto something if you feel dizzy from low blood pressure. Let your care team know if your blood pressure drops too much. Get medical help immediately if you fall and hit your head.
Kidney damage
- Risk factors: Severe heart failure | Kidney problems | Not enough fluid in your body | Taking other medications that can cause kidney damage | History of narrow heart valves (aortic stenosis)
Sometimes, Vaseretic (enalapril / hydrochlorothiazide) can affect your kidneys and cause them to not work as well. The risk is higher for people who have certain types of kidney problems, such as renal artery stenosis or very severe heart failure. Your prescriber might order lab tests every so often to make sure your kidneys are healthy and working properly. If you develop kidney problems, or if your kidney problems worsen while taking Vaseretic (enalapril / hydrochlorothiazide), your prescriber might recommend that you stop taking this medication. Let your prescriber know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Liver failure
Rarely, people who took ACE inhibitors like enalapril in Vaseretic have developed a blocked bile duct. This condition can lead to liver problems or liver failure. Your prescriber might order blood tests to check your liver health from time to time. If you notice symptoms of liver problems, such as tiredness, stomach pain, or yellowing of your skin, let your care team know right away.
Changes in electrolyte, blood sugar, and cholesterol levels
Vaseretic (enalapril / hydrochlorothiazide) can affect the level of certain electrolytes in your body, including sodium, potassium, and magnesium. Your prescriber might order blood work regularly while you're taking this medication to make sure your electrolyte levels are in a safe range. Let your care team know if you experience a fast heart beat, weakness, low energy, muscle pain or cramps, less urination than usual, nausea, or vomiting. These can be signs of electrolyte changes in your body.
In addition, Vaseretic (enalapril / hydrochlorothiazide) might affect your blood sugar levels and cholesterol levels. Your prescriber might also check your blood sugar and cholesterol levels regularly while you're taking this medication.
Vision problems
- Risk factors: Sulfa or penicillin allergies
Although rare, some people experience vision changes or eye pain within hours or weeks of starting taking hydrochlorothiazide, an ingredient in Vaseretic. Tell your prescriber right away about any vision changes and stop taking Vaseretic (enalapril / hydrochlorothiazide), as untreated symptoms could lead to permanent vision loss.
Lupus
In some rare cases, Vaseretic (enalapril / hydrochlorothiazide) can cause worsening of or new lupus. Let your prescriber know if you notice a rash across your cheeks and nose or feel very tired.
Vaseretic (enalapril / hydrochlorothiazide) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg/12.5mg | 90 tablets | $28.11 | $0.31 |
| 10mg/25mg | 90 tablets | $26.69 | $0.30 |
Typical dosage for Vaseretic (enalapril / hydrochlorothiazide)
Your prescriber will pick a starting dose based on factors like how high your blood pressure is, which other blood pressure medications you're currently taking or have recently taken, and how high your risk for side effects is.
In general, the typical dose ranges from 5 mg/12.5 mg (enalapril/hydrochlorothiazide) to 20 mg/50 mg (enalapril/hydrochlorothiazide) by mouth once daily.
Interactions between Vaseretic (enalapril / hydrochlorothiazide) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aliskiren
- Dofetilide
- Sacubitril
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Allopurinol
- Alteplase, Recombinant
- Amiloride
- Amphetamine
- Amtolmetin Guacil
- Arsenic Trioxide
- Aspirin
- Azathioprine
- Azilsartan
- Azilsartan Medoxomil
- Benzphetamine
- Bromfenac
- Bufexamac
- Candesartan Cilexetil
- Canrenoate
- Celecoxib
- Choline Salicylate
- Clonixin
- Deslanoside
- Desmopressin
- Dexibuprofen
- Dexketoprofen
- Dextroamphetamine
- Diclofenac
- Diflunisal
- Digitalis
- Digitoxin
- Digoxin
- Dipyrone
- Droperidol
- Droxicam
- Eplerenone
- Eprosartan
- Etodolac
- Etofenamate
- Etoricoxib
- Everolimus
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Flecainide
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Ibuprofen
- Indomethacin
- Interferon Alfa-2a
- Irbesartan
- Ketanserin
- Ketoprofen
- Ketorolac
- Levomethadyl
- Lisdexamfetamine
- Lithium
- Lornoxicam
- Losartan
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Mercaptopurine
- Methamphetamine
- Methotrexate
- Metildigoxin
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Olmesartan Medoxomil
- Ouabain
- Oxaprozin
- Oxyphenbutazone
- Oxypurinol
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Porfimer
- Potassium Phosphate
- Proglumetacin
- Propyphenazone
- Proquazone
- Proscillaridin
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sirolimus
- Sodium Salicylate
- Sotalol
- Spironolactone
- Sulindac
- Telmisartan
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Triamterene
- Trimethoprim
- Valdecoxib
- Valsartan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aminolevulinic Acid
- Aspirin
- Azosemide
- Bepridil
- Bromfenac
- Bufexamac
- Bumetanide
- Bupivacaine
- Bupivacaine Liposome
- Capsaicin
- Carbamazepine
- Celecoxib
- Cholestyramine
- Choline Salicylate
- Clomipramine
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Furosemide
- Ginkgo
- Gold Sodium Thiomalate
- Gossypol
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Licorice
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Nesiritide
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piretanide
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rifampin
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Topiramate
- Torsemide
- Valdecoxib
How much does Vaseretic (enalapril / hydrochlorothiazide) cost?
Vaseretic (enalapril / hydrochlorothiazide) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Vaseretic (enalapril / hydrochlorothiazide) will not be safe for you to take.
- Taking at the same time as aliskiren (Tekturna) in people with diabetes (high blood sugar)
- Taking at the same time or within 36 hours of neprilysin inhibitors, such as Entresto (sacubitril / valsartan)
- Not producing urine
- Allergy to sulfa medications
- Allergy to ACE inhibitors
- History of angioedema (severe swelling)
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