Enalapril and Lithium Interaction
Drug interaction information between Enalapril and Lithium.
Enalapril and Lithium have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Enalapril and Lithium. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Enalapril can cause your body to lose sodium, which makes it harder for your kidneys to get rid of lithium. This can cause lithium to build up to toxic levels in your blood.
What To Do
Your doctor should check your lithium blood levels often to prevent them from getting too high.
FDA Label Information
Lithium Lithium toxicity has been reported in patients receiving lithium concomitantly with drugs which cause elimination of sodium, including ACE inhibitors. A few cases of lithium toxicity have been reported in patients receiving concomitant enalapril maleate and lithium and were reversible upon discontinuation of both drugs. It is recommended that serum lithium levels be monitored frequently if enalapril is administered concomitantly with lithium.
Enalapril Also Interacts With
- Aliskiren major
- Spironolactone minor
- Hydralazine minor
- Prazosin minor
- Methyldopa minor
Lithium Also Interacts With
- Amlodipine/Benazepril major
- Risperidone major
- Amiloride moderate
- Amiodarone moderate
- Amlodipine/Valsartan moderate
Frequently Asked Questions
Can I take Enalapril and Lithium together?
This is a minor interaction. Your doctor should check your lithium blood levels often to prevent them from getting too high.
How serious is the interaction between Enalapril and Lithium?
This interaction is classified as "minor" severity by the FDA. Minor interactions are unlikely to cause significant problems but should still be mentioned to your healthcare provider.
Why do Enalapril and Lithium interact?
Enalapril can cause your body to lose sodium, which makes it harder for your kidneys to get rid of lithium. This can cause lithium to build up to toxic levels in your blood.
Understanding the Enalapril and Lithium Interaction
FDA-approved prescribing information for these two drugs flags their combination as a minor-severity interaction. Enalapril belongs to the ACE Inhibitor class and Lithium belongs to the Mood Stabilizer class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Enalapril can cause your body to lose sodium, which makes it harder for your kidneys to get rid of lithium. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Enalapril has 16 total documented interactions on file in this dataset, and Lithium has 90. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should check your lithium blood levels often to prevent them from getting too high. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Enalapril or Lithium based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.