Compare Enalapril vs. hydrochlorothiazide

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Vasotec
(enalapril)

Microzide
(hydrochlorothiazide )

Lowers blood pressure. Enalapril is a good blood pressure-lowering medicine that protects kidney function.Removes water from the body, which lowers blood pressure. Microzide (hydrochlorothiazide (HCTZ)) is a well-tolerated water pill that's often the first-choice treatment for mild high blood pressure.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.26Enalapril
Reviews for Enalapril
44%
of people (All ages) say Enalapril is worth it
40%
say it works well
21%
say it's a big hassle
Have you used Vasotec (enalapril)?
Worth itNot sureNot worth it
Reviews for hydrochlorothiazide
47%
-3% worse vs. Enalapril
31%
+9% better vs. Enalapril
16%
-5% worse vs. Enalapril
139 reviews
Have you used Microzide (hydrochlorothiazide )?
Worth itNot sureNot worth it
Side effects
Enalaprilhydrochlorothiazide
  • Hypotension 7%
  • Orthostatic Hypotension 2%
  • Asthenia 2%
  • Orthostatic Effects 2%
  • Syncope 2%
More Enalapril side effects »

The hydrochlorothiazide FDA package insert doesn’t have numbers about how common side effects are.

More about hydrochlorothiazide side effects »
How it works
Enalaprilhydrochlorothiazide
Enalapril is an angiotensin converting enzyme (ACE) inhibitor. It blocks a chemical that tightens blood vessels. This makes blood vessels relax, which lowers blood pressure and allows more blood and oxygen to get to your heart and other organs.Microzide (hydrochlorothiazide (HCTZ)) is a thiazide diuretic (water pill) that makes you urinate more. It works in the kidneys to remove extra water and certain electrolytes, while lowering blood pressure and reducing swelling.
Type of medication
Enalaprilhydrochlorothiazide
Prescription onlyPrescription only
Available as
Enalaprilhydrochlorothiazide
  • Pill
  • Liquid
  • Pill
Used for
Enalaprilhydrochlorothiazide
Risk factors for serious side effects
Enalaprilhydrochlorothiazide
  • Women of childbearing age
  • African descent
  • Current kidney problems
  • Medicine that increase potassium
  • Use of salt substitute
Detailed Vasotec (enalapril) risks & warnings »
  • Current electrolyte imbalance
  • Lower kidney function
  • Dehydration
  • History of sulfa allergies
  • History of gout
Detailed Microzide (hydrochlorothiazide ) risks & warnings »
Pregnancy

Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

Kidneys and liver
Enalaprilhydrochlorothiazide
  • Requires routine blood tests to check kidney function.
  • Protects kidney function, which is especially useful for people with diabetes or mild-to-moderate kidney disease.
  • Requires routine blood tests to check kidney function.
Upsides and benefits
Enalaprilhydrochlorothiazide
  • A first-choice blood pressure treatment for many people.
  • Lowers the risk of heart attack and stroke.
  • Protects kidney function, which is especially useful for people with diabetes or mild-to-moderate kidney disease.
  • Recommended for anyone with heart failure since it lowers the risk of death and further damage to your heart.
  • The only ACE inhibitor that doctors can give through an IV if that's needed.
  • Does a good job getting rid of extra fluids in your body by making you urinate more.
  • A first-choice blood pressure treatment. Works especially well for people of African descent.
  • Lowers the risk of heart attack and stroke.
  • Good option if you have high blood pressure and heart failure.
  • Most people have very few side effects from Microzide (hydrochlorothiazide (HCTZ)).
  • Can be good for patients with osteoporosis since it raises the body's level of calcium.
Downsides and risks
Enalaprilhydrochlorothiazide
  • Up to 1 in 10 people can get a dry cough with this medicine. It ranges from a mild tickle in the throat to a persistent hacking cough.
  • Compared to other ACE inhibitors, less flexible on when you take it. Enalapril needs to be taken multiple times a day on an empty stomach.
  • Requires a yearly blood test to see how the medicine is affecting your body.
  • Not safe to use if you're pregnant.
  • Makes you urinate more often.
  • Microzide (hydrochlorothiazide (HCTZ)) doesn't work well in people with severe kidney problems.
  • It can increase the risk of gout attacks in people with poor kidney function or a history of gout.
  • People with a sulfa allergy may be allergic to Microzide (hydrochlorothiazide (HCTZ)).
Tips from our pharmacists for people taking the medication
Enalaprilhydrochlorothiazide
  • Can cause dizziness in the first few days.
  • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
  • Tell your doctor about any dizziness, fatigue, cough, or throat irritation that doesn't go away.
  • Requires routine blood tests to check kidney function.
  • Don't take it if you're pregnant.
  • Microzide (hydrochlorothiazide (HCTZ)) starts working in about 2 hours.
  • It makes you urinate more often, so don't take it at bedtime.
  • Can cause dizziness in the first few days.
  • Check your blood pressure 1 week after starting this medicine, and tell your doctor if it hasn't improved.
  • Tell your doctor about any tiredness or muscle weakness that doesn't go away.
  • Requires routine blood tests to check kidney function.
Learn more
More about EnalaprilSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Vasotec (enalapril)?
Worth itNot sureNot worth it
More about hydrochlorothiazideSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Microzide (hydrochlorothiazide )?
Worth itNot sureNot worth it