Inhibace Plus (Cilazapril, Hydrochlorothiazide)

• Inhibace Plus is indicated for the management of hypertension, a condition characterized by elevated arterial pressure.
• Hypertension: lowers systolic and diastolic blood pressure, reducing the risk of cardiovascular events.

• Cilazapril blocks the angiotensin‑converting enzyme, decreasing formation of angiotensin II and subsequent vasoconstriction and aldosterone release. Hydrochlorothiazide inhibits Na⁺/Cl⁻ reabsorption in the distal convoluted tubule, increasing urinary excretion of sodium and water, which reduces plasma volume and peripheral resistance, together producing an antihypertensive effect.

Inhibace Plus may cause a range of adverse reactions.

Common Side Effects

• Dizziness or light‑headedness
• Headache
• Persistent dry cough
• Increased urination or nocturia
• Electrolyte disturbances (e.g., low potassium)
• Fatigue

Serious or Rare Side Effects

• Angioedema (swelling of face, lips, tongue)
• Severe dehydration or hypotension
• Acute kidney injury or worsening renal function
• Severe electrolyte abnormalities (hyperkalemia, hyponatremia)
• Blood dyscrasias (e.g., agranulocytosis)
• Hepatic dysfunction or jaundice

• Before initiating therapy, clinicians should consider several safety measures.
• Monitor blood pressure regularly: ensure therapeutic control and detect hypotension.
• Assess renal function: baseline and periodic creatinine/eGFR measurements.
• Check serum electrolytes: especially potassium and sodium levels.
• Avoid use in pregnancy: drug is classified as Category D.
• Counsel patients on orthostatic dizziness: advise rising slowly from sitting or lying positions.
• Store at ambient temperature: keep in the original pack, protect from moisture.

Inhibace Plus can interact with several medicines; awareness of interaction severity guides management.

Major Interactions (Avoid)

• Aliskiren in diabetic patients: increased risk of renal impairment.
• Concurrent ACE inhibitor with ARB: heightened risk of hyperkalemia and renal dysfunction.
• Potassium‑sparing diuretics (e.g., spironolactone): may cause dangerous hyperkalemia.
• NSAIDs (e.g., ibuprofen): can reduce antihypertensive efficacy and impair renal function.
• Lithium: risk of lithium toxicity due to reduced clearance.

Moderate Interactions (Monitor Closely)

• Other thiazide diuretics or antihypertensives: may enhance blood‑pressure lowering effect.
• CYP450 inhibitors (e.g., ritonavir): may increase cilazapril levels.
• Antacids containing aluminum or magnesium: may decrease absorption of cilazapril.
• Beta‑blockers: may mask tachycardia from hypotension.
• Diuretics with glucose‑lowering agents: monitor blood glucose as hypoglycemia risk may rise.