Moderate
Dexamethasone × Enalapril
Glucocorticoids×Angiotensin-converting enzyme inhibitors (ACEi)
Mechanism
Dexamethasone has minimal mineralocorticoid activity but, at high doses and prolonged use, blunts the ACE inhibitor's antihypertensive effect. The effect is weaker than with prednisolone.
Symptoms
Possible rise in blood pressure with long-term therapy. Weakness, fatigue, paraesthesias, arrhythmia. Symptoms develop at potassium above 5.5 mmol/L; life-threatening above 6.5 mmol/L.
Management
For short dexamethasone courses, no specific adjustment needed. For long-term therapy, check BP every 1–2 weeks. If BP rises, intensify antihypertensive therapy (increase enalapril or add a thiazide). Potassium and creatinine monthly.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.