ENALAPRIL-HYDROCHLOROTHIAZIDE (ENALAPRIL MALEATE/HYDROCHLOROTHIAZIDE)

Moderate

• acarbose

• Added Strength Headache Relief

• Added Strength Pain Reliever

• Alka-seltzer

• Alka-seltzer Extra Strength

• Alka-seltzer Original

• Alka-seltzer Plus C/c(pe,dm)

• Alka-seltzer Plus Cold (pe)

• Alka-seltzer Plus Day-night

• Alka-seltzer Plus Night

• Alka-seltzer Pm

• Amaryl

• Anacin

• Anacin Maximum Strength

• Analgesic

• Angeliq

• Antacid & Pain Relief

• Apidra

• Apidra Solostar

• ASA-acetaminophen-caff-buffers

• ASA-acetaminophen-salicyl-caff

• Ascomp With Codeine

• Aspir-trin

• aspirin

• aspirin, buffered

• aspirin-acetaminophen-caffeine

• aspirin-caffeine

• aspirin-diphenhydramine

• aspirin-diphenhydramine citrat

• aspirin-sod bicarb-citric acid

• Azasan

• azathioprine

• azathioprine sodium

• Back & Body Pain Reliever

• Bactrim

• Bactrim Ds

• Bayer Advanced

• Bayer Aspirin

• Bayer Aspirin (with Caffeine)

• Bayer Back & Body

• Bayer Plus Extra Strength

• Bayer Pm

• Bc

• Bc Arthritis

• Beyaz

• Buffered Aspirin

• Bufferin

• bumetanide

• Butalbital Compound W/codeine

• Butalbital Compound-codeine

• butalbital-aspirin-caffeine

• carisoprodol-ASA-codeine

• carisoprodol-aspirin

• chlorphen-phenyleph-DM-aspirin

• chlorphenir-phenylephrn-aspirn

• cholestyramine (with sugar)

• Cholestyramine Light

• cholestyramine-aspartame

• codeine-butalbital-ASA-caff

• Cold Relief

• Cold Relief Plus

• Colestid

• Colestid Flavored

• colestipol

• Demadex

• Diabeta

• diazoxide

• Digox

• digoxin

• dihydrocodeine-aspirin-caff

• doxylamine-phenylep-DM-aspirin

• drospirenone-e.estradiol-lm.FA

• drospirenone-estradiol

• drospirenone-ethinyl estradiol

• Duetact

• E.c. Prin

• Ecotrin

• Efferves Pain Relief Antacid

• Effervescent Antacid

• Effervescent Pain Relief

• Effervescent Pain Reliever

• Endodan

• ethacrynate sodium

• Excedrin Extra Strength

• Excedrin Migraine

• Extra Strength Bayer

• Fiorinal

• Fiorinal-codeine #3

• furosemide

• Gianvi (28)

• glimepiride

• glipizide

• glipizide-metformin

• Glucotrol

• Glucotrol Xl

• Glucovance

• glyburide

• glyburide micronized

• glyburide-metformin

• Glynase

• Glyset

• Goody's Extra Strength

• Goody's Migraine Relief

• Headache Formula

• Headache Formula Added Str

• Headache Relief

• Humalog

• Humalog Kwikpen

• Humalog Mix 50-50

• Humalog Mix 50-50 Kwikpen

• Humalog Mix 75-25

• Humalog Mix 75-25 Kwikpen

• Humulin 70/30

• Humulin N

• Humulin N Kwikpen

• Humulin R

• Humulin R U-500 "Concentrated"

• Imuran

• insulin asp prt-insulin aspart

• insulin aspart

• insulin detemir

• insulin glargine

• insulin glulisine

• insulin lispro

• insulin lispro protam-lispro

• insulin NPH and regular human

• insulin regular hum U-500 conc

• insulin regular human

• Lanoxin

• Lanoxin Pediatric

• Lantus

• Lantus Solostar

• Lasix

• Levacet

• Levemir

• Levemir Flexpen

• Lite Coat Aspirin

• Loryna (28)

• Medi-seltzer

• mercaptopurine

• miglitol

• Migraine Formula

• Migraine Pain Reliever

• Migraine Relief

• nateglinide

• Novolin 70/30

• Novolin N

• Novolin R

• Novolog

• Novolog Flexpen

• Novolog Mix 70-30

• Novolog Mix 70-30 Flexpen

• Novolog Penfill

• NPH insulin human recomb

• Ocella

• Orphenadrine Compound Forte

• Orphenadrine Compound-ds

• orphenadrine-ASA-caffeine

• oxycodone-aspirin

• Pain Relief

• Pain Relief Extra Strength

• Pain Reliever

• Pain Reliever Extra Strength

• Pain Reliever Plus

• Pain-off

• Pamprin Max

• PE-DM-ASA/doxyla-PE-DM-ASA

• Percodan

• pioglitazone-glimepiride

• Precose

• Prevalite

• Primsol

• Proglycem

• Purinethol

• Questran

• Questran Light

• Safyral

• Sodium Edecrin

• Starlix

• sulfamethoxazole-trimethoprim

• Sulfatrim

• Super Pain Relief

• Syeda

• Synalgos-dc

• tolazamide

• tolbutamide

• torsemide

• Tri-buffered Aspirin

• trimethoprim

• Vanquish

• Vestura (28)

• Yasmin (28)

• Yaz 28

• Zarah

Moderate

• Aortic valve stenosis

• Basal cell carcinoma of skin

• Bone marrow depression

• Cerebrovascular insufficiency

• Diabetes mellitus

• Disease of liver

• Hypercalcemia

• Hypercholesterolemia

• Hyperparathyroidism

• Hypertrophic cardiomyopathy

• Immunosuppression

• Neutropenic disorder

• Squamous cell carcinoma of skin

• Sympathectomy

• Systemic lupus erythematosus

Enalapril

• Severity Level:

  1

• Additional Notes: Fetal death/morbidity w/use in 2nd & 3rd trimester, stop when pregnancy detected

Hydrochlorothiazide

• Severity Level:

  B

• Additional Notes: Not recommended in pre-eclampsia and other pregnancy-induced hypertension.

Contraindicated

None

General	Excretion Potential	Effect on Infant	Notes
			None

Precaution Exists

Enalapril

Limited data suggest minimal excretion resulting in no adv effects in infant

Limited amounts excreted with no known adverse effects in infant.

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Not known; no or inclusive data	Limited data suggest minimal excretion resulting in no adv effects in infant

Hydrochlorothiazide

Limited data suggest minimal excretion resulting in no adv effects in infant

Limited amounts excreted with no known adverse effects in infant.

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Not known; no or inclusive data	Limited amounts excreted with no known adverse effects in infant.

No Known Risk

None

General	Excretion Potential	Effect on Infant	Notes
			None

Contraindicated

None

Precaution Exists

Enalapril

Cardiovascular-Monitor for hypotension. Renal-May increase serum creatinine. Hyperkalemia risk increases with renal insufficiency. Adjust dose for CrCL <31 mL/minute.

Cardiovascular-Increased sensitivity to effects on blood pressure. Metabolic-More likely to develop hypokalemia, hypomagnesemia, or hyponatremia. Endocrine-May exacerbate SIADH. May worsen glucose control in patients with diabetes. Renal-Not effective with CrCL < 30mL/min.

Organ / System	HEP	REN	CARD	ENDO	NEURO / PSYCH	PULM
Increased Risk / Adverse Effects	Y	N	Y	N	N	N

BEERS: N     HEDIS: N     STOPP: Y

Hydrochlorothiazide

Cardiovascular-Monitor for hypotension. Renal-May increase serum creatinine. Hyperkalemia risk increases with renal insufficiency. Adjust dose for CrCL <31 mL/minute.

Cardiovascular-Increased sensitivity to effects on blood pressure. Metabolic-More likely to develop hypokalemia, hypomagnesemia, or hyponatremia. Endocrine-May exacerbate SIADH. May worsen glucose control in patients with diabetes. Renal-Not effective with CrCL < 30mL/min.

Organ / System	HEP	REN	CARD	ENDO	NEURO / PSYCH	PULM
Increased Risk / Adverse Effects	Y	N	Y	N	N	Y

BEERS: Y     HEDIS: N     STOPP: Y

No Known Risk

None

0-9	A-Z
I10	Essential (primary) hypertension
I11	Hypertensive heart disease
I11.0	Hypertensive heart disease with heart failure
I11.9	Hypertensive heart disease without heart failure
I12	Hypertensive chronic kidney disease
I12.0	Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
I12.9	Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13	Hypertensive heart and chronic kidney disease
I13.0	Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.1	Hypertensive heart and chronic kidney disease without heart failure
I13.10	Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.11	Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
I13.2	Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I15.1	Hypertension secondary to other renal disorders