Inhibace Plus (Cilazapril, Hydrochlorothiazide)

• Inhibace Plus, a combination ACE inhibitor and thiazide diuretic, is used to manage hypertension.
• Hypertension: reduces systolic and diastolic blood pressure to target levels.
• Essential hypertension: assists in achieving long‑term blood pressure control.
• Hypertensive patients with fluid retention: promotes diuresis to decrease blood volume.

• Cilazapril blocks the angiotensin‑converting enzyme, preventing formation of angiotensin II and thereby reducing vasoconstriction and aldosterone‑mediated sodium retention. Hydrochlorothiazide inhibits NaCl reabsorption in the distal convoluted tubule, increasing urinary excretion of sodium and water, which lowers circulating blood volume and contributes to blood pressure reduction.

Inhibace Plus may cause a range of adverse reactions.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Dizziness or light‑headedness, especially after standing.
• Increased urination or mild electrolyte changes.
• Headache.
• Fatigue.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe dehydration or electrolyte imbalance (e.g., hyponatremia, hypokalemia).
• Acute kidney injury or worsening renal function.
• Hyperkalemia when combined with potassium‑sparing agents.
• Significant hypotension leading to syncope.
• Blood dyscrasias such as agranulocytosis.

• Before initiating therapy, consider the following precautions.
• Monitor blood pressure: ensure adequate control without excessive drop.
• Assess renal function: check serum creatinine and eGFR periodically.
• Check electrolytes: especially sodium and potassium levels.
• Avoid use in pregnancy: category D, potential fetal harm.
• Use with caution in diabetes: may affect glucose control.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Inhibace Plus can interact with several medicines.

Major Interactions (Avoid)

• Aliskiren: combined use increases risk of renal impairment and hyperkalemia.
• Lithium: may raise lithium levels, risking toxicity.
• Potassium‑sparing diuretics or supplements: can cause dangerous hyperkalemia.
• NSAIDs: may blunt antihypertensive effect and impair renal function.
• Other ACE inhibitors or ARBs: increase risk of angioedema and renal dysfunction.

Moderate Interactions (Monitor Closely)

• Loop diuretics: may exacerbate electrolyte disturbances.
• Antihypertensive agents: additive blood pressure lowering may require dose adjustment.
• Antidiabetic drugs: blood glucose may improve, necessitating monitoring.
• Corticosteroids: may increase sodium retention counteracting diuretic effect.
• Antimicrobials such as trimethoprim‑sulfamethoxazole: can raise potassium levels.