A fixed-dose combination (FDC) of an ACE inhibitor (Enalapril) and an ARB (Losartan) used for synergistic blood pressure control and organ protection in hypertension. This combination is particularly relevant in Indian patients with moderate to severe hypertension or those with proteinuric chronic kidney disease where dual RAAS blockade may be considered, though with caution due to increased risk of hyperkalemia and acute kidney injury.
Adult: One tablet (Enalapril 5mg + Losartan 25mg) once daily. Dose may be titrated up to a maximum of Enalapril 20mg + Losartan 100mg per day, based on response and tolerability, under medical supervision. Usually started at this low dose.
Note: Can be taken with or without food. Food may decrease the absorption rate of Losartan but not its overall bioavailability. Take at the same time each day, preferably in the morning. Do not skip doses. If a dose is missed, take it as soon as remembered unless it's almost time for the next dose. Do not double the dose.
Provides dual blockade of the Renin-Angiotensin-Aldosterone System (RAAS). Enalapril inhibits Angiotensin Converting Enzyme (ACE), reducing conversion of Angiotensin I to the potent vasoconstrictor Angiotensin II and decreasing breakdown of bradykinin. Losartan competitively and selectively blocks the AT1 receptor, through which Angiotensin II exerts its effects (vasoconstriction, aldosterone release, sodium/water retention, sympathetic activation, vascular/cardiac remodeling). This dual blockade aims for more complete RAAS suppression.
Pregnancy: CONTRANDICATED in second and third trimesters (FDA Category D). Can cause fetal injury and death: oligohydramnios, fetal renal failure, skull hypoplasia, contractures, pulmonary hypoplasia. Discontinue as soon as pregnancy is detected. Avoid in women planning pregnancy.
Driving: May cause dizziness, lightheadedness, or fatigue, especially during initiation or dose escalation. Patients should not drive or operate machinery until they know how the medication affects them.
| Potassium supplements / Potassium-sparing diuretics (Spironolactone, Eplerenone, Amiloride) | Markedly increased risk of severe hyperkalemia. | Major |
| NSAIDs (e.g., Ibuprofen, Diclofenac, Naproxen) | Increased risk of renal impairment, reduced antihypertensive efficacy, hyperkalemia. | Major |
| Lithium | Increased serum lithium levels and toxicity risk due to reduced renal clearance. | Major |
| Diuretics (especially loop and thiazide, initially) | Potentiated first-dose hypotension and risk of volume depletion. | Moderate |
| Aliskiren | Increased risk of hyperkalemia, hypotension, and renal impairment, especially in diabetes/CKD. Contraindicated in such patients. | Major |
| Other Antihypertensives | Additive hypotensive effect. | Moderate |
| Antidiabetics (Insulin, Sulfonylureas) | Enhanced hypoglycemic effect; monitor blood glucose. | Moderate |
| CYP2C9 Inhibitors (e.g., Fluconazole, Amiodarone) | May increase Losartan levels. | Moderate |
Same composition (Enalapril (5mg) + Losartan (25mg)), different brands: