Prilenap H 10 mg/25 mg tablets (enalapril, hydrochlorothiazide) – for high blood pressure

Prilenap H is a combination medicine for treating high blood pressure. It contains enalapril maleate, an ACE inhibitor that widens the blood vessels, and hydrochlorothiazide, a diuretic (“water tablet”) that increases the amount of urine. Taking both substances together may enhance their effect compared with taking the individual medicines.

Each tablet contains 10 mg enalapril maleate and 25 mg hydrochlorothiazide.

What is Prilenap H used for and how should it be taken correctly?

Basic information about the medicine

What is Prilenap H used for?

According to the summary of product characteristics, Prilenap H is intended for the treatment of mild to moderate hypertension in patients whose blood pressure is adequately controlled with enalapril maleate and hydrochlorothiazide given concurrently at the doses contained in this medicine.

Enalapril widens the blood vessels and hydrochlorothiazide increases urine output – this lowers blood pressure.

How is Prilenap H used and dosed?

Take the medicine exactly as prescribed by your doctor. According to the leaflet:

• the recommended dose is one tablet once daily;
• your doctor may increase the dose to two tablets once daily (taken at the same time);
• the medicine is taken by mouth, with or after a meal, with water; it can also be taken independently of food;
• the score line is only to help break the tablet for easier swallowing, not to divide it into equal doses;
• do not take more or less medicine than prescribed.

Special patient groups

• Children and adolescents: use is not recommended (safety and efficacy have not been established).
• Kidney impairment: thiazide diuretics are not effective at a creatinine clearance of 30 mL/min or less; the medicine must not be taken in severe kidney impairment.
• Older patients: efficacy and tolerability are similar to those in younger patients.
• Severe liver impairment: the medicine must not be taken.

Contraindications – when the medicine must not be used

• allergy to enalapril maleate, hydrochlorothiazide, sulfonamides or the excipients;
• swelling of the face, lips, tongue and/or throat with difficulty swallowing or breathing after previous use of an ACE inhibitor, as well as hereditary or idiopathic angioedema;
• inability to pass urine;
• diabetes or impaired kidney function with concomitant use of aliskiren;
• pregnancy beyond three months;
• narrowing of the arteries supplying the kidneys (renal artery stenosis);
• severe kidney or liver impairment;
• current or recent use of sacubitril/valsartan.

Precautions and warnings

• breathing or lung problems after previous use of hydrochlorothiazide – seek help immediately in case of severe shortness of breath;
• kidney disease, recent kidney transplant, haemodialysis, use of diuretics;
• blood disorders or liver disease; a low-salt diet, recent vomiting or diarrhoea;
• aortic stenosis, hypertrophic cardiomyopathy or left ventricular outflow obstruction;
• collagen vascular disease, immunosuppressive therapy, allopurinol or procainamide – report any infection (fever, chills) to your doctor immediately;
• diabetes – check your blood sugar regularly, especially in the first month of treatment;
• potassium supplements or potassium-containing salt substitutes, heparin, co-trimoxazole, lithium;
• previous skin cancer or a new skin lesion during treatment;
• mTOR inhibitors (sirolimus, everolimus, temsirolimus), sacubitril, racecadotril, vildagliptin – higher risk of angioedema;
• sartans (valsartan, telmisartan, irbesartan) or aliskiren;
• sudden decrease in visual acuity or eye pain (possible choroidal effusion or increased eye pressure);
• surgery or anaesthesia (including at the dentist), LDL apheresis, desensitisation to wasp or bee venom – tell the doctor you take this medicine;
• the medicine may give a positive result in a doping test.

Interactions with other medicines, food and drink

Tell your doctor or pharmacist about all medicines you take, especially:

• angiotensin II receptor blockers (sartans) and aliskiren;
• potassium-sparing diuretics (spironolactone, eplerenone, triamterene, amiloride), potassium supplements, potassium-containing salt substitutes, heparin, trimethoprim/co-trimoxazole;
• other diuretics (furosemide, bumetanide) and other blood pressure lowering medicines (nitroglycerin, nitrates, vasodilators);
• lithium – must not be taken with this medicine;
• barbiturates, tricyclic antidepressants (e.g. amitriptyline), antipsychotics, morphine and anaesthetics;
• colestyramine, colestipol, antacids, carbenoxolone, excessive use of laxatives;
• NSAIDs (e.g. diflunisal, diclofenac) and gold preparations;
• ephedrine (in some cough and cold medicines), noradrenaline and adrenaline;
• ACTH, corticosteroids, allopurinol, ciclosporin, medicines for cancer;
• procainamide, amiodarone, sotalol, digitalis;
• insulin and other medicines for diabetes;
• mTOR inhibitors, sacubitril/valsartan, racecadotril, vildagliptin.

Alcohol with this medicine may cause an excessive fall in blood pressure (dizziness, light-headedness, fainting) – keep alcohol intake to a minimum.

Pregnancy and breastfeeding

• Pregnancy: use is not recommended during pregnancy, and the medicine must not be taken after the third month. Your doctor will probably advise you to stop the medicine before you become pregnant or as soon as you know you are pregnant and will prescribe another medicine.
• Breastfeeding: use is not recommended in breastfeeding women.

Driving and using machines

• Blurred vision, dizziness, drowsiness and confusion have been reported. If this happens to you, do not drive or use tools and machines.

Possible side effects

• Stop the medicine immediately and seek emergency help: allergic reaction (itching, shortness of breath, wheezing, swelling of the hands, mouth, throat, face or eyelids); severe skin reaction with fever, blisters and peeling; severe liver damage or hepatitis (yellow skin).
• Stop the medicine and contact your doctor: severe light-headedness or dizziness, especially at the start of treatment, when the dose is increased or when standing up.
• Very common: blurred vision, cough, nausea, weakness.
• Common: low blood pressure, headache, depression, fainting, chest pain, heart rhythm changes, angina pectoris, fast heartbeat, difficulty breathing, diarrhoea, abdominal pain, taste changes, fluid retention, tiredness, raised or lowered potassium, raised creatinine, cholesterol, triglycerides and uric acid, muscle cramps.
• Uncommon: anaemia, low blood sugar, confusion, drowsiness, insomnia, nervousness, tingling or numbness, palpitations, runny nose, sore throat, pancreatitis, vomiting, constipation, dry mouth, gout, stomach ulcer, sweating, itching, hives, hair loss, impotence, ringing in the ears, low sodium and magnesium, impaired kidney function, joint pain.
• Rare and very rare: blood count changes, Raynaud’s syndrome, eosinophilic pneumonia, mouth ulcers, gallbladder problems, serious rashes, breast enlargement in men, muscle weakness, intestinal angioedema, acute respiratory distress syndrome.
• Frequency not known: sensitivity to sunlight, skin and lip cancer (non-melanoma skin cancer), decreased vision or eye pain due to increased eye pressure.

Overdose, missed dose and stopping treatment

• Overdose: contact a doctor immediately. The most common signs are a fall in blood pressure and stupor; dizziness, palpitations and fast heartbeat, anxiety, cough, kidney failure and rapid breathing are also possible.
• Missed dose: skip it and take the next dose at the usual time. Do not take a double dose.
• Stopping treatment: do not stop the medicine without your doctor’s advice – blood pressure may rise again and affect the heart and kidneys.

Related information

For regular blood pressure measurement at home, see also the category Blood pressure monitors – products in this category do not replace the medicine prescribed to you.

Composition, pack and manufacturer

• active substances: enalapril maleate 10 mg and hydrochlorothiazide 25 mg per tablet;
• excipients: lactose monohydrate; heavy magnesium carbonate; gelatin; crospovidone; magnesium stearate (the medicine contains lactose);
• round, slightly biconvex, white to almost white tablets with a score line on one side;
• pack: 20 tablets (2 blisters of 10) or 30 tablets (3 blisters of 10);
• marketing authorisation holder and manufacturer: Hemofarm a.d. Vršac, Beogradski put bb, Vršac, Serbia.

Storage

• store in the original package to protect from moisture;
• shelf life: 3 years;
• keep out of the sight and reach of children; return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

What is the difference between Prilenap H and Prilenap HL?

Both medicines contain 10 mg enalapril maleate, but Prilenap H contains 25 mg and Prilenap HL 12.5 mg hydrochlorothiazide. Your doctor decides which strength you take based on the doses that suit you.

Can I split a Prilenap H tablet in half?

The score line is only to help break the tablet for easier swallowing, not to divide it into equal doses. Do not change the dose without agreement with your doctor.

What if I forget to take a tablet?

Skip the missed dose and take the next one at the usual time. Do not take a double dose.

Can I drink alcohol while taking Prilenap H?

The leaflet advises keeping alcohol to a minimum, as together with the medicine it may cause an excessive fall in blood pressure with dizziness, light-headedness or fainting.

Sources

• ALIMS – Patient information leaflet Prilenap H (20 tablets) (PIL)
• ALIMS – Summary of product characteristics Prilenap H (20 tablets) (SmPC)
• ALIMS – Patient information leaflet Prilenap H (30 tablets) (PIL)

Sources checked on: 25 October 2026.