Trandolapril and Furosemide Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Furosemide Injection
Trandolapril
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of severe hypotension and deterioration in renal function, including renal failure
Interaction Deep Dive
Concomitant administration of furosemide with angiotensin converting enzyme (ACE) inhibitors may lead to severe hypotension and deterioration in renal function, including renal failure. Monitor for changes in blood pressure and renal function and interrupt or reduce the dosage of furosemide and ACE inhibitors if needed21. Although the combination should increase natriuresis, paradoxically, ACE inhibitors may also reduce glomerular filtration, diuresis and natriuretic responses to diuretics leading to edema and fluid retention 57.
Why it happens (mechanism)
Potentiated antihypertensive effects
Literature reports
4 reports — tap to read
a) In one study, renal excretion and the diuretic effect of furosemide was not altered by captopril in hypertensive patients 3. However, more recent data demonstrate that conventional doses of captopril blunt the natriuretic and diuretic effects of furosemide in patients with mild to moderate congestive heart failure. Sodium excretion increased 623% while on furosemide; this dropped to 242% upon addition of captopril 4. A number of authors have reported weight gain, sodium retention, and peripheral edema in patients on diuretic therapy upon initiation of ACE inhibitors 567.
b) In a single-dose study, oral benazepril (10 mg) and oral furosemide (40 mg) were administered alone and in combination to 12 healthy volunteers. There were no significant effects on the pharmacokinetics of benazepril. The urinary excretion of total furosemide was reduced by 10% to 20% during combination administration. With single doses of each drug alone, blood pressure and pulse were not significantly affected. However, a decrease in erect blood pressure and an increase in pulse rate was observed with the combination. Maximal effects occurred four hours post administration (122 to 104 mm Hg and 87 to 107 beats per minute, respectively). Dizziness was experienced in the majority of subjects receiving the combination, and occurred in association with blood pressure reductions 8.
c) Concomitant captopril and furosemide therapy has been reported to result in a potentiation of the hypotensive effects of captopril. Blood pressure dropped abruptly from 290/150 mm Hg to 135/60 mm Hg within 10 minutes in one patient with high plasma renin activity who received 50 mg captopril and intravenous furosemide 9.
d) Severe postural hypotension has been reported when ACE inhibitors are added to loop diuretic therapy. First dose hypotension is commonly seen in patients with sodium depletion or hypovolemia due to diuretics or sodium restriction. This hypotensive response is usually transient 1011128.
Common questions
Can I take Trandolapril and Furosemide Injection together?
An increased risk of severe hypotension and deterioration in renal function, including renal failure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Trandolapril and Furosemide Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Trandolapril or Furosemide Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (12)
- Product Information: LASIX® ONYU subcutaneous injection, furosemide subcutaneous injection. SQ Innovation, Inc (per manufacturer), Burlington, MA, 2025. DailyMed
- Product Information: FUROSCIX(R) subcutaneous injection, furosemide subcutaneous injection. scPharmaceuticals Inc (per FDA), Burlington, MA, 2025. DailyMed
- Fujimura A, Shimokawa Y, & Ebihara A: Influence of captopril on urinary excretion of furosemide in hypertensive subjects. J Clin Pharmacol 1990; 30:538-542. PubMed
- McLay JS, McMurray JJ, Bridges AB, et al: Acute effects of captopril on the renal actions of furosemide in patients with chronic heart failure. Am Heart J 1993; 126:879-886. DOI
- Cleland JGF, Gillen G, & Dargie HJ: The effects of frusemide and angiotensin-converting enzyme inhibitors and their combination on cardiac and renal haemodynamics in heart failure. Eur Heart J 1988; 9:132-141. PubMed
- Odemuyiwa O, Gilmartin J, Kenny D, et al: Captopril and the diuretic requirements in moderate and severe chronic heart failure. Eur Heart J 1989; 10:586-590. PubMed
- Flapan AD, Davies E, Waugh C, et al: Acute administration of captopril lowers the natriuretic and diuretic response to a loop diuretic in patients with chronic cardiac failure. Eur Heart J 1991; 12:924-927. DOI
- De Lepeleire I, Van Hecken A, Verbesselt R, et al: Interaction between furosemide and the converting enzyme inhibitor benazepril in healthy volunteers. Eur J Clin Pharmacol 1988; 34:465-468. PubMed
- Case DB, Atlas SA, Laragh JH, et al: Clinical experience with blockade of the renin-angiotensin-aldosterone system by an oral converting-enzyme inhibitor (SQ 14,255, captopril) in hypertensive patients. Prog Cardiovasc Dis 1978; 21:195-206.
- Clementy J, Schwebig A, Mazaud C, et al: Comparative study of the efficacy and tolerance of Capozide and Moduretic administered in a single daily dose for the treatment of chronic moderate arterial hypertension. Postgrad Med J 1986; 62(suppl 1):132.
- Gluck Z, Beretta-Piccoli C, & Reubi FC: Long-term effects of captopril on renal function in hypertensive patients. Eur J Clin Pharmacol 1984; 26:315-323. PubMed
- Vlasses PH, Ferguson RK, & Chatterjee K: Captopril: clinical pharmacology and benefit-to-risk ratio in hypertension and congestive heart failure. Pharmacotherapy 1982; 2:1-17. DOI
Keep reading about Furosemide Injection
Keep reading about Trandolapril
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