Compatibility «Enalapril» and «Indapamide+Perindopril»

• Interactions Enalapril with Indapamide+Perindopril

  • Dangerous interactions
    • ⓘ In patients receiving diuretics, especially with the recent appointment of diuretic therapy, there may be an excessive decrease in blood pressure after the start of enalapril.
    • ⓘ In the elderly, patients with hypovolemia (including those receiving diuretics) or impaired renal function, the simultaneous use of enalapril and NSAIDs, including selective COX-2 inhibitors, may lead to deterioration of renal function, including the development of acute renal failure.
    • ⓘ The excessive antihypertensive effect of enalapril can be reduced either by discontinuing the diuretic, or by increasing the BCC or using table salt, as well as by reducing the dose of enalapril.
    • ⓘ In some patients with impaired renal function (for example, in elderly patients or patients with dehydration, including those taking diuretics) receiving NSAID therapy (including selective COX‑2 inhibitors), the simultaneous use of ACE inhibitors or ARA II may cause further deterioration of renal function, including the development of acute renal failure, and hyperkalemia.
    • ⓘ The administration of ACE inhibitors to patients with hyponatremia (especially patients with renal artery stenosis) is accompanied by a risk of developing sudden arterial hypotension and/or acute renal failure.
    • ⓘ In chronic heart failure, treatment with ACE inhibitors should begin with the lowest doses, with a possible preliminary reduction in doses of diuretics.
  • Negative interactions
    • ⓘ The possibility of hypotensive effects when using enalapril can be minimized by stopping the diuretic or increasing salt intake before starting treatment with enalapril.
    • ⓘ If it is necessary to continue taking a diuretic, careful medical monitoring should be provided after taking the initial dose for at least 2 hours and one additional hour before blood pressure stabilizes.
    • ⓘ Enalapril reduces potassium loss caused by thiazide diuretics.
    • ⓘ The use of potassium-sparing diuretics in high doses can lead to hypovolemia (due to a decrease in BCC), and the addition of enalapril to therapy leads to a marked decrease in blood pressure.
    • ⓘ With the simultaneous use of enalapril with potassium-sparing (thiazide or 'loop') diuretics, hypokalemia caused by the action of diuretics, as a rule.
    • ⓘ Other antihypertensive drugs.
    • ⓘ When using enalapril simultaneously with other antihypertensive agents, especially with diuretics, an increased antihypertensive effect may be observed.
    • ⓘ NSAIDs, including selective COX‑2 inhibitors and acetylsalicylic acid in doses of 3 g/day and above, can reduce the antihypertensive effect of diuretics and other antihypertensive agents.
    • ⓘ Blood pressure should be carefully monitored and, if necessary, the dose of antihypertensive drugs should be adjusted.
    • ⓘ The use of indapamide can sum up or potentiate the effect of other antihypertensive drugs.
    • ⓘ In limited controlled studies comparing the effects of indapamide in combination with other antihypertensive drugs with the effects of other antihypertensive drugs used as monotherapy, there were no noticeable changes in the nature or frequency of adverse reactions associated with combination therapy.
    • ⓘ 3 days before the start of treatment with an ACE inhibitor, stop taking diuretics; in the future, if necessary, taking a non-potassium-sparing diuretic can be resumed;.
    • ⓘ if discontinuation of diuretics is not possible, then ACE inhibitor therapy should be started at low doses, followed by a gradual increase in the dose if necessary.
    • ⓘ In all cases, in the first week of taking ACE inhibitors in patients, it is necessary to monitor renal function (creatinine concentration in blood plasma).
    • ⓘ Blood pressure should be monitored and, if necessary, the doses of antihypertensive drugs should be adjusted.
    • ⓘ Enalapril and Perindopril belong to the same pharmaceutical group: ACE inhibitors.
  • Positive interactions
    • ⓘ The antihypertensive effect of enalapril is enhanced by drugs that cause the release of renin (for example, diuretics).
  • Unclear interactions
    • ⓘ Diuretics.
    • ⓘ Potassium-sparing (thiazide and 'loop') diuretics.
    • ⓘ Enalapril + Indapamide analgin and citramon are used together in 4 preparations.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine