Compatibility «Enap» and «Lozap plus»

• Interactions Enap with Lozap plus

  • Dangerous interactions
    • ⓘ There is evidence that the simultaneous use of ACE inhibitors, ARA II or aliskiren increases the risk of arterial hypotension, hyperkalemia and impaired renal function (including acute renal failure) when compared with the use of a single drug affecting RAAS.
    • ⓘ The use of a combination of hydrochlorothiazide + losartan in combination with ACE inhibitors is contraindicated in patients with diabetic nephropathy and is not recommended for other patients (see 'Contraindications').
    • ⓘ There is evidence that the simultaneous use of ACE inhibitors, ARA II or aliskiren increases the risk of arterial hypotension, hyperkalemia and impaired renal function (including acute renal failure) compared with the use of a single drug that affects the RAAS.
    • ⓘ Concomitant use of losartan with ACE inhibitors is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.
    • ⓘ 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.
    • ⓘ It should be used with caution with hypotensive drugs (their effect is potentiated, dose adjustment may be necessary), cardiac glycosides (hypokalemia and hypomagnesemia associated with the action of thiazide diuretics may increase the toxicity of digitalis), amiodarone (its use simultaneously with thiazide diuretics may lead to an increased risk of arrhythmias associated with hypokalemia), hypoglycemic oral medications (their effectiveness decreases, hyperglycemia may develop), corticosteroids, calcitonin (increase potassium excretion), NSAIDs (may weaken the diuretic and hypotensive effects of thiazides), non-depolarizing muscle relaxants (their effect may be enhanced), amantadine (clearance of amantadine may decrease with hydrochlorothiazide, which leads to an increase in plasma concentration of amantadine and possible toxicity), colestyramine (reduces absorption of hydrochlorothiazide), ethanol, barbiturates and narcotic analgesics, which enhance the effect of orthostatic hypotension.
    • ⓘ 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.
    • ⓘ 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.
    • ⓘ Double blockade of RAAS with angiotensin receptor blockers, ACE inhibitors or aliskiren is associated with an increased risk of hypotension, syncope, hyperkalemia and changes in renal function (including acute renal failure) compared to monotherapy.
  • Negative interactions
    • ⓘ Other antihypertensive agents.
    • ⓘ Other antihypertensive drugs.
    • ⓘ It may be necessary to adjust the dose of simultaneously prescribed antihypertensive drugs.
    • ⓘ It is recommended to stop taking hydrochlorothiazide 2-3 days before the start of therapy with ACE inhibitors to prevent the development of symptomatic arterial hypotension.
    • ⓘ Reversible increases in serum lithium concentrations have been reported with concomitant use of lithium preparations with ACE inhibitors, in very rare cases with ARA II.
    • ⓘ 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.
    • ⓘ 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.
    • ⓘ 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.
    • ⓘ 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.
  • Positive interactions
    • ⓘ The antihypertensive effect of enalapril is enhanced by drugs that cause the release of renin (for example, diuretics).
  • Unclear interactions
    • ⓘ If this is not possible, then the initial dose of ACE inhibitors should be reduced.
    • ⓘ Diuretics.
    • ⓘ Potassium-sparing (thiazide and 'loop') diuretics.
    • ⓘ hydrochlorothiazide, furosemide, digoxin, timolol, methyldopa, warfarin, indomethacin, sulindac and cimetidine.
    • ⓘ Enalapril + Hydrochlorothiazide analgin and citramon are used together in 16 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.
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.
• Why do I need to
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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