Compatibility «Enalapril» and «Acetylsalicylic acid+Magnesium hydroxide»

• Interactions Enalapril with Acetylsalicylic acid+Magnesium hydroxide

  • Dangerous interactions
    • ⓘ 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.
    • ⓘ 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.
    • ⓘ Concomitant use of ACE inhibitors and NSAIDs should be carried out with caution (especially in elderly patients and in patients with impaired renal function).
    • ⓘ The use of enalapril in combination with acetylsalicylic acid as an antiplatelet agent is not contraindicated.
  • Negative interactions
    • ⓘ Acetylsalicylic acid weakens the effect of uricosuric drugs - benzbromarone, probenicide (reduction of uricosuric effect due to competitive suppression of renal tubular excretion of uric acid), ACE inhibitors (there is a dose-dependent decrease in GFR as a result of inhibition of PG having a vasodilating effect, and, accordingly, a weakening of the hypotensive effect), diuretics (when combined with acetylsalicylic acid in high doses there is a decrease in GFR as a result of a decrease in the synthesis of PG in the kidneys).
    • ⓘ It is necessary to periodically monitor renal function in patients receiving enalapril and NSAIDs together.
    • ⓘ However, other studies suggest that NSAIDs may reduce the antihypertensive effect of ACE inhibitors.
    • ⓘ 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.
    • ⓘ As a result, the antihypertensive effect of ARA II antagonists or ACE inhibitors may be weakened when used concomitantly with NSAIDs, including selective COX inhibitors‑2.
    • ⓘ Increases the toxicity of methotrexate, reducing its renal clearance, the effects of narcotic analgesics (codeine), oral antidiabetic drugs, heparin, indirect anticoagulants, thrombolytics and inhibitors of platelet aggregation, reduces the effect of uricosuric drugs (benzbromarone, sulfinpyrazone), hypotensive agents, diuretics (spironolactone, furosemide).
  • No interactions
    • ⓘ Enalapril can be used simultaneously with acetylsalicylic acid (as an antiplatelet agent), thrombolytics and beta‑blockers.
  • Positive interactions
    • ⓘ Nonsteroidal anti‑inflammatory drugs (NSAIDs), including selective cyclooxygenase‑2 (COX-2) inhibitors and high doses of acetylsalicylic acid (>3 g/day).
    • ⓘ ACE inhibitors in combination with acetylsalicylic acid in higher doses.
  • Unclear interactions
    • ⓘ NSAIDs, including selective COX-2 inhibitors.
    • ⓘ Acetylsalicylic acid, thrombolytics and beta‑blockers.
    • ⓘ Antacids.

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

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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