Compatibility «Enalapril» and «Amlodipine+Telmisartan»

• Interactions Enalapril with Amlodipine+Telmisartan

  • Dangerous interactions
    • ⓘ Double blockade of the RAAS (for example, the combined use of an ACE inhibitor or aliskiren, a direct renin inhibitor, with ARAII) is not recommended due to possible renal dysfunction (including acute renal failure).
    • ⓘ Double blockade of RAAS with the use of ARA II, ACE inhibitors or aliskiren (renin inhibitor) is associated with an increased risk of arterial hypotension, syncope, hyperkalemia and renal dysfunction (including acute renal failure) compared with monotherapy.
    • ⓘ 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.
    • ⓘ ACE inhibitors (C09A) + angiotensin ii receptor antagonists => Are associated with an increased risk of arterial hypotension, syncope, hyperkalemia and impaired renal function (in pm acute renal failure) compared with monotherapy.
    • ⓘ With the simultaneous use of lithium preparations and ACE inhibitors or ARA II, including telmisartan, there was a reversible increase in the concentration of lithium in blood plasma, accompanied by toxic effects.
    • ⓘ Clinical studies have shown that double blockade of the renin-angiotensin-aldosterone system (RAAS) due to the combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren is associated with a higher frequency of adverse reactions such as hypotension, hyperkalemia and decreased renal function (including acute renal failure) compared with the use of a single agent acting on RAAS (see sections 'Contraindications', 'Special instructions' and 'Pharmacodynamics').
  • Negative interactions
    • ⓘ Other antihypertensive agents.
    • ⓘ There was a reversible increase in the concentration of lithium in the blood, accompanied by toxic effects when taking ACE inhibitors.
    • ⓘ With the simultaneous use of NSAIDs and antihypertensive drugs like telmisartan, a decrease in the antihypertensive effect has been reported by inhibiting the vasodilating effect of PG.
    • ⓘ The safety of the combined use of amlodipine with thiazide diuretics, beta-blockers, ACE inhibitors, long-acting nitrates, nitroglycerin (used sublingually), NSAIDs, antibiotics and hypoglycemic agents for oral administration has been established.
    • ⓘ The simultaneous use of enalapril with beta‑blockers, methyldopa or blockers of 'slow' calcium channels increased the severity of the antihypertensive effect.
    • ⓘ Other antihypertensive and antianginal drugs.
    • ⓘ Amlodipine can be safely used to treat hypertension together with thiazide diuretics, beta-blockers or ACE inhibitors.
    • ⓘ The possibility of hypotensive effects when using enalapril can be minimized by stopping the diuretic or increasing salt intake before starting treatment with enalapril.
    • ⓘ Concomitant use of ACE inhibitors with angiotensin II receptor antagonists.
    • ⓘ (ARA II) is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.
    • ⓘ Concomitant use of enalapril with potassium-sparing diuretics (such as spironolactone, eplerenone, triamterene, amiloride), potassium preparations, potassium-containing salt substitutes and other drugs capable of increasing serum potassium content (including angiotensin II receptor antagonists, heparin, tacrolimus, cyclosporine; drugs containing co‑trimoxazole [trimethoprim + sulfamethoxazole]) can lead to a significant increase in the potassium content in blood plasma.
    • ⓘ 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.
    • ⓘ 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.
    • ⓘ Blood pressure should be carefully monitored and, if necessary, the dose of antihypertensive drugs should be adjusted.
    • ⓘ The risk may increase when combined with other medications that can also provoke hyperkalemia (salt substitutes containing potassium, potassium‑sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, nonsteroidal anti‑inflammatory drugs (NSAIDs, including selective COX-2 inhibitors), heparin, immunosuppressants (cyclosporine or tacrolimus) and co-trimoxazole (trimethoprim + sulfamethoxazole).
    • ⓘ Concomitant use with ACE inhibitors or NSAIDs, including selective COX‑2 inhibitors, is accompanied by a lower risk of hyperkalemia, provided careful observance of precautions.
    • ⓘ The effect of telmisartan on lowering blood pressure can be enhanced by simultaneous administration of other antihypertensive medications.
    • ⓘ Based on their pharmacological properties, it can be expected that the following drugs can enhance the antihypertensive effect of all antihypertensive agents, including telmisartan: baclofen, amifostin.
  • No interactions
    • ⓘ Enalapril was used simultaneously with beta-blockers, methyldopa, nitrates, BCG, hydralazine, prazosin and digoxin without signs of clinically significant adverse interaction.
  • Positive interactions
    • ⓘ When used concomitantly with other antihypertensive drugs, the antihypertensive effect of the combination of amlodipine + telmisartan may increase.
    • ⓘ It can be expected that some drugs, such as baclofen and amifostine, due to their pharmacological properties, will enhance the antihypertensive effect of all antihypertensive agents, including the combination of amlodipine + telmisartan.
    • ⓘ It is possible to enhance the antianginal and antihypertensive effects of BMCC when combined with thiazide and loop diuretics, ACE inhibitors, beta-blockers and nitrates.

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.
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: 170,037,924 possible combinations of drugs and their components were found 412,574 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-05-07

Category - medicine