Drug & supplement interaction

Squill + Enalapril Maleate, Hydrochlorothiazide

Enalapril Maleate, Hydrochlorothiazide brand name: Vaseretic.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Squill has a moderate interaction with Enalapril Maleate, Hydrochlorothiazide. Squill contains cardiac glycosides. Theoretically, concomitant use with potassium-depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Squill and Enalapril Maleate, Hydrochlorothiazide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DIURETIC DRUGS

Why this applies to Enalapril Maleate, Hydrochlorothiazide

Enalapril Maleate, Hydrochlorothiazide falls under DIURETIC DRUGS — the group Squill interacts with.

Squill contains cardiac glycosides. Theoretically, concomitant use with potassium-depleting diuretics can increase the risk of cardiac glycoside toxicity due to potassium depletion. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know about your Vaseretic: it contains hydrochlorothiazide, a "water pill" that makes your body flush out extra fluid and salt. The catch is that this same process can drag potassium out along with it, leaving your potassium levels on the low side. Squill, meanwhile, carries natural compounds called cardiac glycosides that act on the heart much like the drug digoxin.

When potassium runs low, the heart becomes more sensitive to those squill compounds, and that theoretically raises the odds of toxic effects on your heart rhythm, like an irregular or skipped heartbeat. This concern is based on pharmacology rather than strong real-world studies, but squill itself can be quite toxic. I'd encourage you to talk with your doctor or pharmacist before combining the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Squill Also Interacts With Other Medications

Squill has 1 major, 154 moderate known drug interactions in our database — the Enalapril Maleate, Hydrochlorothiazide one above is one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 154 No known interaction 2,675 (incl. Enalapril Maleate, Hydrochlorothiazide)
Taking anything else?

Check Another of Your Medications Against Squill

Covers the 2,830 medications we’ve checked against Squill. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Enalapril Maleate, Hydrochlorothiazide

This page covers Squill only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enalapril Maleate, Hydrochlorothiazide page lists 238 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 11 major · 200 moderate · 27 minor.

From our pharmacist’s overview on the Enalapril Maleate, Hydrochlorothiazide page

“If you take Vaseretic (enalapril with hydrochlorothiazide) for blood pressure, check this list carefully before adding any supplement; 11 of the 238 entries are rated major. Most run one of two ways: herbs that also drop blood pressure and can take it too low, or ones that raise it and fight the medicine.”

Reviewed by 2 · Jul 18, 2026

Open the Enalapril Maleate, Hydrochlorothiazide interaction page

One more smart check

Taking Squill as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Squill, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Squill. Your product may carry other ingredients that interact with Enalapril Maleate, Hydrochlorothiazide too, on top of Squill — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Squill and Enalapril Maleate, Hydrochlorothiazide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Squill
Top half

#618 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Enalapril Maleate, Hydrochlorothiazide
Top 25%

#565 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Squill

What is Squill?

Squill
  • Cough and chest congestion
  • Fluid retention (diuretic)
  • Heart conditions (traditional 'cardiac tonic')
  • Hair loss (topical use)
  • Rodenticide (red squill, non-medicinal)

Squill is a bulb plant that contains potent cardiac glycosides, which can affect the heart much like the drug digoxin. While it has a long history of use as a cough remedy and heart tonic, it can be dangerously toxic and there is little solid evidence for its modern use, so we do not recommend taking it without close medical supervision.

Read the full Squill monograph & all interactions
Medication

About Enalapril and Hydrochlorothiazide

What Is Enalapril and Hydrochlorothiazide Used For?

Brand name: Vaseretic

Enalapril and hydrochlorothiazide tablets — sold under brand names including Vaseretic and Enalapril maleate and hydrochlorothiazide — are used to treat high blood pressure (hypertension). This combination is not meant as the first treatment tried; it's generally used when a single blood pressure medicine hasn't done the job on its own.

Because this is a fixed-dose combination, your doctor will typically adjust each medicine separately first, then switch you to the combination tablet once the right doses are found.

See full Enalapril and Hydrochlorothiazide drug information
Keep checking

Other Drugs & Squill

Browse every other medication we’ve checked against Squill — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
154Moderate
0Minor
2,674No known interaction
1 Major 154 Moderate 2,674 No interaction
Major

1 interaction

Moderate

154 interactions

Showing 60 of 154 moderate interactions — see all 154 on the Squill page.

No interaction 2,674 drugs checked — show the list

We also checked Squill against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,674 medications checked with no known interaction — see the full Squill list.

See the full Squill interactions page
See every supplement checked against Enalapril Maleate, Hydrochlorothiazide, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Squill monograph › Uses, safety, and every drug interaction in one place Enalapril Maleate, Hydrochlorothiazide supplement interactions › Every supplement checked against Enalapril Maleate, Hydrochlorothiazide, ranked by severity Enalapril and Hydrochlorothiazide drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Squill and Enalapril Maleate, Hydrochlorothiazide Together: Common Questions

Can you take Squill with Enalapril Maleate, Hydrochlorothiazide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Squill and Enalapril Maleate, Hydrochlorothiazide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Enalapril Maleate, Hydrochlorothiazide and Squill?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.