Inhibace Plus (Cilazapril, Hydrochlorothiazide)

Inhibace Plus, containing an ACE inhibitor and a thiazide diuretic, is used in the management of hypertension.

• Essential hypertension: lowers systolic and diastolic blood pressure to target levels.
• Stage 1 hypertension: helps achieve blood pressure control when monotherapy is insufficient.
• Stage 2 hypertension: provides additional pressure reduction in patients requiring combination therapy.

• Cilazapril inhibits the angiotensin‑converting enzyme, decreasing formation of angiotensin II and leading to vasodilation and reduced aldosterone secretion. Hydrochlorothiazide blocks Na⁺/Cl⁻ reabsorption in the distal convoluted tubule, increasing urinary sodium and water excretion, which lowers blood volume. The combined actions result in synergistic reduction of arterial pressure.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Dizziness or light‑headedness, especially after standing.
• Headache: mild to moderate intensity.
• Increased urination: due to diuretic effect.
• Electrolyte disturbances: mild changes in potassium or sodium levels.
• Fatigue: general feeling of tiredness.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe dehydration: excessive fluid loss leading to low blood pressure.
• Hyperkalemia: elevated potassium that may affect heart rhythm.
• Acute renal impairment: sudden decline in kidney function.
• Severe hypotension: dangerously low blood pressure.
• Blood dyscrasias: rare blood cell abnormalities such as agranulocytosis.

Before initiating therapy, clinicians should evaluate patient history and monitor relevant parameters.

• Blood pressure monitoring: ensure adequate control and avoid excessive lowering.
• Renal function assessment: check serum creatinine and eGFR periodically.
• Electrolyte surveillance: monitor potassium and sodium levels, especially with concomitant drugs.
• Pregnancy safety: avoid use in pregnancy due to known fetal risk (Category D).
• Elderly patients: start at lower doses and watch for orthostatic hypotension.
• Store at ambient temperature: keep in the original packaging, protect from moisture and direct sunlight.

Inhibace Plus may interact with several medicines; careful review is essential.

Major Interactions (Avoid)

• Aliskiren: combined use can cause severe hypotension and renal dysfunction.
• Potassium‑sparing diuretics or supplements: increase risk of hyperkalemia.
• Lithium: may raise lithium concentrations, leading to toxicity.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may reduce antihypertensive effect and impair renal function.
• Other antihypertensives (beta‑blockers, calcium channel blockers): may cause additive blood pressure lowering.
• Diuretics causing electrolyte loss: monitor sodium and potassium levels closely.