Summary
Commonly reported side effects of enalapril/hydrochlorothiazide include: increased blood urea nitrogen and increased serum creatinine. Other side effects include: dizziness and headache. Continue reading for a comprehensive list of adverse effects.
Applies to enalapril / hydrochlorothiazide: oral tablet.
Warning
Oral route (Tablet)
Discontinue enalapril maleate/hydrochlorothiazide as soon as possible when pregnancy is detected, since fetal toxicity, including injury and death to the developing fetus, can be caused by drugs that act directly on the renin-angiotensin system.
Serious side effects
Along with its needed effects, enalapril / hydrochlorothiazide 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 while taking enalapril / hydrochlorothiazide:
Less common
- Blurred vision
- chest pain, discomfort, or tightness
- chills
- cold sweats
- coma
- confusion
- decreased urine output
- diarrhea
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- drowsiness
- dry mouth
- 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
Other side effects
Some side effects of enalapril / hydrochlorothiazide 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
- cough
- 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
For Healthcare Professionals
Applies to enalapril / hydrochlorothiazide: oral tablet.
General
The most common adverse reactions were dizziness, headache, fatigue, and cough.[Ref]
Nervous system
Common (1% to 10%): Dizziness, headache, syncope
Frequency not reported: Paresthesia, somnolence, vertigo, tinnitus
Enalapril:
Postmarketing reports: Cerebrovascular accident, ataxia, peripheral neuropathy, paresthesia, dysesthesia, taste alteration, anosmia[Ref]
Other
Common (1% to 10%): Fatigue, asthenia, orthostatic effects
Frequency not reported: Chest pain
Enalapril:
Postmarketing reports: Gynecomastia
Hydrochlorothiazide:
Frequency not reported: Weakness, fever[Ref]
Respiratory
Common (1% to 10%): Cough
Frequency not reported: Dyspnea
Enalapril:
Postmarketing reports: Pulmonary embolism and infarction, pulmonary edema
Hydrochlorothiazide:
Frequency not reported: Respiratory distress, pneumonitis, pulmonary edema[Ref]
Musculoskeletal
Common (1% to 10%): Muscle cramps
Frequency not reported: Back pain, arthralgia
Enalapril:
Postmarketing reports: Flank pain
Hydrochlorothiazide:
Frequency not reported: Muscle spasm[Ref]
Gastrointestinal
Common (1% to 10%): Nausea, diarrhea
Frequency not reported: Abdominal pain, vomiting, dyspepsia, constipation, flatulence, dry mouth
Enalapril:
Postmarketing reports: Ileus, pancreatitis, melena, glossitis, stomatitis, dry mouth
Hydrochlorothiazide:
Frequency not reported: Pancreatitis, sialadenitis, cramping, gastric irritation[Ref]
Genitourinary
Common (1% to 10%): Impotence
Frequency not reported: Urinary tract infection
Enalapril:
Postmarketing reports: Oliguria[Ref]
Cardiovascular
Common (1% to 10%): Orthostatic hypotension
Uncommon (0.1% to 1%): Hypotension
Frequency not reported: Palpitation, tachycardia
Enalapril:
Postmarketing reports: Cardiac arrest, myocardial infarction, rhythm disturbances, atrial tachycardia and bradycardia, atrial fibrillation, hypotension, angina pectoris, Raynaud's phenomenon, flushing
Hydrochlorothiazide:
Frequency not reported: Vasculitis[Ref]
Renal
Uncommon (0.1% to 1%): BUN increased, serum creatinine increased
Enalapril:
Postmarketing reports: Renal failure, renal dysfunction, pulmonary infiltrates, eosinophilic pneumonitis, bronchospasm, pneumonia, bronchitis, rhinorrhea, sore throat and hoarseness, asthma, upper respiratory infection
Hydrochlorothiazide:
Frequency not reported: Renal failure, renal dysfunction, interstitial nephritis[Ref]
Dermatologic
Frequency not reported: Pruritus, rash, diaphoresis, angioedema
Enalapril:
Postmarketing reports: Exfoliative dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, herpes zoster, erythema multiforme, urticaria, pemphigus, alopecia, photosensitivity
Hydrochlorothiazide:
Frequency not reported: Purpura, photosensitivity, urticaria, cutaneous vasculitis, erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, alopecia[Ref]
Psychiatric
Frequency not reported: Insomnia, nervousness, libido decreased
Enalapril:
Postmarketing reports: Depression, confusion, dream abnormality
Hydrochlorothiazide:
Frequency not reported: Restlessness[Ref]
Hematologic
Frequency not reported: Hemoglobin decreased, hematocrit decreased
Enalapril:
Postmarketing reports: Neutropenia, thrombocytopenia, bone marrow depression, hemolytic anemia
Hydrochlorothiazide:
Frequency not reported: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia[Ref]
Hepatic
Frequency not reported: Liver enzymes increased, serum bilirubin increased
Enalapril:
Postmarketing reports: Hepatic failure, hepatitis
Hydrochlorothiazide:
Frequency not reported: Intrahepatic cholestatic jaundice[Ref]
Metabolic
Frequency not reported: Gout
Postmarketing reports: Anorexia
Hydrochlorothiazide:
Frequency not reported: Anorexia[Ref]
Ocular
Enalapril:
Postmarketing reports: Blurred vision, conjunctivitis, dry eyes, tearing
Hydrochlorothiazide:
Frequency not reported: Transient blurred vision, xanthopsia[Ref]
Immunologic
Enalapril:
Postmarketing reports: Anaphylactoid reactions
Hydrochlorothiazide:
Frequency not reported: Anaphylactic reactions[Ref]
