Enalapril maleate/Hydrochlorothiazide patient information

# Why is this medication prescribed?
The combination of enalapril and hydrochlorothiazide is used to treat high blood pressure. Enalapril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly. Hydrochlorothiazide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

# How should this medicine be used?
The combination of enalapril and hydrochlorothiazide comes as a tablet to take by mouth. It is usually taken with or without food once or twice a day. To help you remember to take enalapril and hydrochlorothiazide, take it around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take enalapril and hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Enalapril and hydrochlorothiazide controls high blood pressure but does not cure it. Continue to take enalapril and hydrochlorothiazide even if you feel well. Do not stop taking enalapril and hydrochlorothiazide without talking to your doctor.

# Other uses for this medicine
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This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow?
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Before taking enalapril and hydrochlorothiazide,
- tell your doctor and pharmacist if you are allergic to enalapril (Vasotec), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik), sulfa drugs, or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as indomethacin (Indocin); cholestyramine (Questran); colestipol (Colestid); diuretics ('water pills'); insulin or oral medications for diabetes; lithium (Eskalith, Lithobid); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); other medications for high blood pressure; pain medications; phenobarbital (Luminal, Solfoton); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had heart, parathyroid, liver, or kidney disease; lupus; diabetes; allergies; asthma; gout; or angioedema, a condition that causes hives, difficulty breathing, and painful swelling of the face, lips, throat, tongue, hands, or feet.
- tell your doctor if you plan to become pregnant or are breast-feeding.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking enalapril and hydrochlorothiazide.
ask your doctor about the safe use of alcoholic beverages while you are taking enalapril and hydrochlorothiazide. Alcohol can make the side effects from enalapril and hydrochlorothiazide worse.
- you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

# What special dietary instructions should I follow?
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Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

# What should I do if I forget a dose?
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Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# What side effects can this medication cause?
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Enalapril and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- cough
- dizziness
- headache
- excessive tiredness
- muscle cramps
- decrease in sexual ability
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- lightheadedness
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
- difficulty breathing or swallowing
- fever, sore throat, chills, and other signs of infection
- yellowing of the skin or eyes
- dry mouth
- thirst
- weakness
- infrequent urination
- upset stomach
- vomiting
- fainting
- chest pain
- fast or irregular heartbeat
Enalapril and hydrochlorothiazide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What should I know about storage and disposal of this medication?
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Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
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In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# What other information should I know?
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Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to enalapril and hydrochlorothiazide. Your doctor may order certain lab tests to check your body's response to enalapril and hydrochlorothiazide.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

# Brand names of combination products
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Vaseretic (containing Enalapril, Hydrochlorothiazide)