Enalapril + Hydrochlorothiazide - Oral

Enalapril and Hydrochlorothiazide are combined in this medicine.

Enalapril + Hydrochlorothiazide helps to keep your blood pressure under control.

Take Enalapril + Hydrochlorothiazide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food. Try to take it at the same time each day.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your response to the medication.

Enalapril + Hydrochlorothiazide must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor immediately if you are allergic to a certain group of medicines called sulfonamides.

Alert your doctor if you have the following conditions:

• unable to pass urine
• history of angioedema (swelling of the deep layers of the skin usually around the face, throat, and lips) due to previous treatment with similar medicines for high blood pressure belonging to a group called ACE inhibitors
• angioedema that is inherited or due to an unknown reason

as Enalapril + Hydrochlorothiazide may not be suitable for you.

Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Enalapril + Hydrochlorothiazide, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods while taking Enalapril + Hydrochlorothiazide.

Do not take Enalapril + Hydrochlorothiazide with aliskiren (medicine for high blood pressure) if you have diabetes or kidney disease.

Do not take this medicine if you are currently taking or have taken sacubitril (medicine used to treat heart failure [weakness and inability of the heart to pump blood]) in the last 36 hours.

Inform your doctor if you have the following conditions:

• low volume of circulating fluids in the body
• heart disease e.g. heart failure (weakness and inability of the heart to pump blood), hypertrophic cardiomyopathy (abnormally thick heart muscle)
• disease of the blood vessels supplying the brain
• autoimmune disease (a condition wherein your immune system mistakenly attacks and destroys healthy body tissues)
• diabetes
• history of angioedema due to previous treatment with other drugs other than ACE inhibitors
• kidney disease
• liver disease

Let your doctor know if you are breastfeeding.

Be sure to check with your doctor or pharmacist before giving Enalapril + Hydrochlorothiazide to the elderly. Elderly people may be more sensitive to the side effects.

If you are of a Black race, Enalapril + Hydrochlorothiazide may be less effective. Inform your doctor if you are taking this medicine.

If you are going to have a major operation and other procedures (e.g. desensitisation treatment [to reduce the effect of allergy] to wasp or bee stings, LDL apheresis [a nonsurgical therapy that removes bad cholesterol in the blood], or dialysis with high flux membranes), inform your doctor that you are taking this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. kidney function, electrolyte levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.

What lifestyle changes can I make to improve my blood pressure?

Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.

If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.

Enalapril + Hydrochlorothiazide may cause any of the following side effects: headache, dizziness, drowsiness, nausea, vomiting, diarrhoea, indigestion, constipation, dry mouth, stomach wind, weakness, excessive sweating, muscle cramps, joint pain, and back pain.

This medicine may also make your skin more sensitive to sunlight. Apply sunscreen when going outdoors and avoid prolonged exposure to sunlight and UV lamps.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• dry cough that does not go away
• muscle weakness, cramping or numbness; fast or irregular heartbeat, severe dizziness or passing out, increased thirst, fits or seizures, loss of appetite
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
• rashes, breathlessness, swelling of the face, eyes or mouth

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Enalapril + Hydrochlorothiazide with aliskiren (medicine for high blood pressure) if you have diabetes or kidney disease.

Do not take this medicine if you are currently taking or have taken sacubitril (medicine used to treat heart failure) in the last 36 hours.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for high blood pressure e.g. losartan
• NSAIDs (medicines for pain and inflammation) e.g. ibuprofen, diclofenac
• medicines for diabetes e.g. insulin
• certain water pills or medicines for water retention e.g. spironolactone, furosemide
• medicines used in organ transplants or certain immune disorders e.g. sirolimus
• strong painkillers e.g. morphine
• medicines for cancer e.g. cyclophosphamide, methotrexate
• medicines for irregular heartbeat e.g. sotalol, amiodarone
• anti-inflammatory medicines e.g. prednisolone
• cholesterol-lowering medicines e.g. colestyramine, colestipol
• lithium (medicine for mood disorder)
• potassium supplements

This list does not include all medicines that may interact with this medicine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Avoid taking too much food that is high in potassium, such as orange juice, bananas, or prunes.

Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.

Store in a cool, dry place away from the reach of children.

Protect from moisture.

Medicines must not be used past the expiry date.