Anapril/Anapril-S Drug Interactions

Hypotensive Agents and Diuretics: When enalapril is administered with diuretics or other hypotensive drugs, the hypotensive effect of enalapril is increased.
Drugs Increasing Serum Potassium Concentration: Potassium-sparing diuretics (e.g., amiloride, spironolactone, triamterene), potassium supplements, or potassium-containing salt substitutes should be used with caution and serum potassium should be determined frequently in patients receiving enalapril, since hyperkalemia may occur.
Nonsteroidal Anti-inflammatory Agents (i.e., aspirin, ibuprofen): May reduce the blood pressure response to ACE inhibitors, including enalapril.
Lithium: Lithium toxicity has occurred following concomitant administration of enalapril and lithium carbonate and was reversible following discontinuance of both drugs. Serum lithium should be monitored frequently when enalapril and lithium are administered concomitantly.
Other drugs: Enalapril may reduce fasting blood glucose concentrations in nondiabetic individuals and may produce hypoglycemia in diabetic patients whose diabetes has been controlled with insulin or oral antidiabetic agents.
Concomitant use of enalapril and some vasodilating agents (e.g., nitrates) or anesthetic agents may cause an exaggerated hypotensive response.