enalapril maleate and hydrochlorothiazide
Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about Enalapril/HCT Sandoz 20mg/6mg. It
does not contain all the available information. It does not take the place of talking
to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking
Enalapril/HCT Sandoz 20mg/6mg against the benefits it is expected to have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may need to read it again.
What Enalapril/HCT Sandoz 20mg/6mg is used for
The name of your medicine is Enalapril/HCT Sandoz 20mg/6mg. It contains the active
ingredients enalapril maleate and hydrochlorothiazide.
It is used to treat mild to moderate high blood pressure (hypertension).
Everyone has blood pressure. This pressure helps to circulate the blood all around
your body. Your blood pressure may be different at different times of the day, depending
on how busy or worried you are. You have hypertension (high blood pressure) when your
blood pressure stays higher than is needed, even when you are calm and relaxed.
There are usually no symptoms of hypertension. The only way of knowing that you have
hypertension is to have your blood pressure checked on a regular basis. If high blood
pressure is not treated it can lead to serious health problems. You may feel fine
and have no symptoms, but eventually hypertension can cause stroke, heart disease
and kidney failure. Enalapril/HCT Sandoz 20mg/6mg helps to lower your blood pressure.
Ask your doctor if you have any questions about why this medicine has been prescribed
Your doctor may have prescribed it for another reason.
How Enalapril/HCT Sandoz 20mg/6mg works
Enalapril/HCT Sandoz 20mg/6mg contains two active ingredients. One of these is enalapril
maleate. It belongs to a group of medicines called angiotensin converting enzyme (ACE)
inhibitors. It works by widening your blood vessels. This means that blood is able
to pass through them more easily and the heart doesn't have to pump as hard to move
blood around the body.
The other active ingredient is hydrochlorothiazide, which is a fluid tablet or diuretic.
It helps reduce the amount of fluid in the body by making your kidneys pass more water
Both of these active ingredients help to lower high blood pressure.
There is no evidence that Enalapril/HCT Sandoz 20mg/6mg is addictive.
Before you take Enalapril/HCT Sandoz 20mg/6mg
When you must not take it
Do not take this medicine if:
you are allergic to the active ingredients or any of the inactive ingredients mentioned
at the end of this leaflet under Product Description. Some of the symptoms of an allergic
reaction may include shortness of breath; wheezing or difficulty breathing; swelling
of the face, lips, tongue or other parts of the body; rash, itching or hives on the
you have an allergy to any sulfur medicines or sulfonamide antibiotics.
One of the active ingredients in this medicine, hydrochlorothiazide, is a sulfur-containing
medicine (a sulfonamide). Therefore, if you are allergic to sulfur medicines, such
as some antibiotics or some tablets used to treat diabetes, you are likely to be allergic
to Enalapril/HCT Sandoz 20mg/6mg. Check with your doctor or pharmacist if you are
not sure whether you are allergic to sulfur medicines.
you have taken any other 'ACE inhibitor' medicines for high blood pressure or heart
failure before, which caused your face, lips, tongue, throat, hands or feet to swell
up, or made it hard for you to breathe. If you have had an allergic reaction to an
ACE inhibitor before, you may be allergic to this medicine.
you have a history of swelling of the face, lips, tongue, throat, hands or feet, for
no apparent reason
you have renal artery stenosis, a disease of the kidney
you are not passing urine
you have diabetes and are taking a medicine called aliskiren to reduce blood pressure
you are pregnant or breastfeeding. Your baby may absorb this medicine in the womb
or from breast milk and therefore there is a possibility of harm to the baby.
it is past its expiry date or the packaging appears to have been tampered with.
If you are not sure whether you should start taking this medicine, talk to your doctor.
Do not give Enalapril/HCT Sandoz 20mg/6mg to a child.
Its safety in children has not been established.
Before you start to take it
Tell your doctor if:
you plan on becoming pregnant or will be breastfeeding while you are using this medicine.
It should not be used during pregnancy or while breastfeeding.
you have or have had any medical conditions, especially the following:
kidney disease, or if you are undergoing dialysis
passing less urine than is normal
cerebrovascular disease (e.g. stroke)
diseases known to affect the bone marrow or treatment with medicines which are known
to be associated with bone marrow depression
you are following a very low salt diet
you have received desensitisation for an allergy
you have an allergy to any other medicines, especially if they are in the same drug
class as enalapril maleate or hydrochlorothiazide
you have had an allergy to any other substances, including foods, preservatives or
you have recently suffered from excessive vomiting or diarrhoea
you suffer from low blood pressure (you may notice this as faintness or dizziness,
especially when standing)
surgery and anaesthesia (even at the dentist office) are scheduled, as there may be
a sudden fall in blood pressure associated with anaesthesia.
If you have not told your doctor about any of the above, tell them before you start
taking Enalapril/HCT Sandoz 20mg/6mg tablets.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you get
without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and Enalapril/HCT Sandoz 20mg/6mg may interfere with each other. These
other fluid tablets (diuretics)
other medicines used to treat high blood pressure
lithium, used to treat severe mood swings and some types of depression
potassium tablets or potassium-containing salt substitutes
potassium-sparing agents (e.g. spironolactone, eplerenone, triamterene, amiloride)
steroid medicines such as cortisone, prednisone
insulin and tablets used to treat diabetes
barbiturates, used to treat epilepsy, such as phenobarbitone
strong pain killers such as codeine, morphine, dextropropoxyphene
non-steroidal anti-inflammatory drugs (NSAIDs or COX-2 inhibitors) used to treat inflammation,
arthritis medicines including gold therapy
insulin or oral antidiabetic medicines. You should be closely monitored for low blood
glucose levels, especially during the first month of treatment with Enalapril/HCT
mammalian target of rapamycin inhibitors (e.g. temsirolimus, sirolimus, everolimus)
cholestyramine and colestipol, used to treat high cholesterol
medicines used to relax muscles before or during surgery
medicines used in emergency situations, such as adrenaline
medicines used to change the heart rate
These medicines may be affected by Enalapril/HCT Sandoz 20mg/6mg, or may affect how
well it works. You may need to use different amounts of your medicine, or you may
need to take different medicines.
Your doctor and pharmacist have more information on medicines to be careful with or
avoid while taking this medicine.
How to take Enalapril/HCT Sandoz 20mg/6mg
Follow all directions given to you by your doctor or pharmacist carefully.
They may differ from the information contained in this leaflet.
If you do not understand the instructions, ask your doctor or pharmacist for help.
How much to take
Your doctor will tell you how many tablets you need to take each day. This depends
on your condition and whether you are taking other medicines.
For most patients, the usual dose is one tablet a day.
When to take Enalapril/HCT Sandoz 20mg/6mg
Take Enalapril/HCT Sandoz 20mg/6mg at about the same time each day.
This is best in the morning, for example, at breakfast time. Taking it at the same
time each day will have the best effect. It will also help you remember when to take
How to take it
Swallow the tablet whole with a full glass of water.
How long to take it
Enalapril/HCT Sandoz 20mg/6mg helps control your high blood pressure but does not
cure it. Therefore it must be taken every day. Continue taking this medicine for as
long as your doctor prescribes.
If you forget to take it
If it is less than six hours until your next dose, skip the dose you missed and take
your next dose when you are meant to. Otherwise, take it as soon as you remember,
and then go back to taking your tablet(s) as you would normally.
Do not take a double dose to make up for the dose you missed.
This may increase the chance of you getting an unwanted side effect.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist for
If you take too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13
11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you
think you or anyone else has taken too much Enalapril/HCT Sandoz 20mg/6mg. Do this
even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
If you take too many tablets, you will probably feel light-headed or dizzy, or you
may faint. You may also become very thirsty, confused, have a change in the amount
of urine passed or have a fast heart beat.
While you are taking Enalapril/HCT Sandoz 20mg/6mg
Things you must do
Always follow your doctor's instructions carefully.
Tell your doctor immediately if you become pregnant while taking this medicine.
If you are about to start taking a new medicine, tell your doctor and pharmacist that
you are taking Enalapril/HCT Sandoz 20mg/6mg.
Have your blood pressure checked when your doctor says, to make sure this medicine
If you feel any light-headedness or dizziness after you take your first dose of Enalapril/HCT
Sandoz 20mg/6mg or if your dose is increased, tell your doctor immediately.
If you feel light-headed, dizzy or faint, get up slowly when getting out of bed or
standing up. This may be because your blood pressure is falling suddenly. Standing
up slowly, especially when you get up from bed or chairs, will help your body get
used to the change in position and blood pressure. If this problem gets worse or continues,
talk to your doctor.
If you have excessive vomiting and/or diarrhoea while taking this medicine, or you
have any of the following symptoms, tell your doctor:
dry mouth, thirst
weakness, tiredness, drowsiness
muscle pains or cramps
fast heart beat
passing less urine than normal.
You may be dehydrated because you are losing too much water. This may also drop your
blood pressure too much. Make sure you drink enough water during exercise and hot
weather when you are taking this medicine, especially if you sweat a lot. If you do
not drink enough water while taking it, you may faint or feel light-headed or sick.
This is because your blood pressure is dropping suddenly. If you continue to feel
unwell, tell your doctor.
If you plan to have surgery (even at the dentist) that needs a general anaesthetic,
tell your doctor or dentist that you are taking Enalapril/HCT Sandoz 20mg/6mg. Your
blood pressure may drop suddenly.
Go to your doctor regularly for a check-up. Your doctor may occasionally do a blood
test to check your potassium level in the blood and to see how your kidneys are working.
Things you must not do
Do not stop taking this medicine without your doctor's permission.
Do not use it to treat any other complaints unless your doctor says so.
Do not give this medication to anyone else, even if their symptoms seem similar to
Things to be careful of
Be careful driving or operating machinery until you know how this medicine affects
you. It may cause dizziness or light-headedness in some people, especially after the
first dose. If you drink alcohol, dizziness or light-headedness may be worse.
Tell your doctor or pharmacist as soon as possible if you do not feel well while taking
Enalapril/HCT Sandoz 20mg/6mg.
All medicines can have side effects. Sometimes they are serious, most of the time
they are not. You may need medical attention if you get some of the side effects.
Do not be alarmed by this list of possible side effects. You may not experience any
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
light-headedness or dizziness because blood pressure is too low
tiredness or weakness
feeling sick (nausea), vomiting, loss of appetite
diarrhoea, constipation, stomach upset, pains or cramps
transient blurred vision or yellow vision.
These are the more common side effects of Enalapril/HCT Sandoz 20mg/6mg. Mostly, these
are mild and short-lived.
Tell your doctor immediately if you notice any of the following:
changes in the way your heart beats, for example, if you notice it beating faster
severe dizziness, spinning sensation
skin rash, itchiness or other skin problems
signs of worrying or frequent infections such as fever, severe chills, sore throat
or mouth ulcers
signs of anaemia such as tiredness, headache, being short of breath when exercising,
passing less urine than is normal for you
yellowing of the skin and/or eyes, also called jaundice
numbness or tingling in the hands or feet
signs of dehydration such as nausea, vomiting, muscle cramps, headaches, drowsiness
and tiredness. If untreated, mental confusion and fits may develop. Your doctor may
need to monitor your blood sodium levels.
feelings of deep sadness and unworthiness (depression)
difficulty sleeping (insomnia) or unusual dreams
hallucinations (seeing or hearing things that are not there).
These may be serious side effects of Enalapril/HCT Sandoz 20mg/6mg. You may need urgent
medical attention. Serious side effects are rare.
If any of the following happen, stop taking this medicine and tell your doctor immediately,
or go to Accident and Emergency at your nearest hospital:
swelling of the face, lips, mouth, throat or tongue which may cause difficulty in
swallowing or breathing
swelling of the hands, feet, or ankles
pinkish, itchy swelling on the skin, also called hives or nettle rash
chest pain, angina
wheeziness due to chest tightness, shortness of breath
collapse, numbness or weakness of arms and legs.
These are very serious side effects. You may need urgent medical attention or hospitalisation.
All of these side effects are very rare.
Tell your doctor or pharmacist if you notice anything else that is making you feel
Other side effects not listed above may also occur in some people.
After taking Enalapril/HCT Sandoz 20mg/6mg
Keep your medicine in the original container.
If you take it out of its original container it may not keep well.
Keep your medicine in a cool dry place where the temperature stays below 25°C. Protect
Do not store Enalapril/HCT Sandoz 20mg/6mg tablets or any other medicine in the bathroom
or near a sink. Do not leave it on a window sill or in the car.
Heat and dampness can destroy some medicines.
Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place
to store medicines.
If your doctor tells you to stop taking this medicine or the expiry date has passed,
ask your pharmacist what to do with any medicine that is left over.
What it looks like
Enalapril/HCT Sandoz 20mg/6mg tablets are white, oval, biconvex tablets with a snap
tab on one side, scored and marked "EN20" on the other side. This medicine is available
in blister packs of 30 tablets.
Each Enalapril/HCT Sandoz 20mg/6mg tablet contains 20mg enalapril maleate and 6mg
Sandoz Pty Ltd
ABN 60 075 449 553
54 Waterloo Road
Macquarie Park, NSW 2113
Tel: 1800 634 500
This leaflet was revised in July 2017.
Australian Register Number:
Enalapril/HCT Sandoz 20mg/6mg tablets: AUST R 126490