Enalapril and hydrochlorothiazide and Lithium interaction
Enalapril and hydrochlorothiazide and Lithium: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Enalapril and hydrochlorothiazide (Vaseretic) label · effective 2020-08-31
Lithium generally should not be given with thiazides (see PRECAUTIONS, Drug Interactions, Enalapril Maleate and Hydrochlorothiazide ).
Lithium Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs which cause elimination of sodium, including ACE inhibitors.
A few cases of lithium toxicity have been reported in patients receiving concomitant enalapril and lithium and were reversible upon discontinuation of both drugs.
It is recommended that serum lithium levels be monitored frequently if enalapril is administered concomitantly with lithium.
Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity.
From the Lithium (Lithium Carbonate) label · effective 2026-08-16
• Diuretics, NSAID, renin-angiotensin system antagonists, or metronidazole may increase lithium serum concentrations.
Drugs Having Clinically Important Interactions with Lithium Table 4: Clinically Important Drug Interactions with Lithium Diuretics Clinical Impact: Diuretic-induced sodium loss may reduce lithium clearance and increase serum lithium concentrations .
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.