A fixed combination of 2 drugs in one pill.
Sold as Vaseretic.
A combination is graded by its riskiest ingredient: each part of the score is the lowest of the ingredients' scores. This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.
Each ingredient has its own full page with the FDA label, side-effect reports, recalls, evidence, and payments. Open them for the detail behind this grade.
Score breakdown (76/100)
Safety ×35%
C
Evidence ×25%
D
Regulatory ×15%
B
Money & lawsuits ×15%
A
Options ×10%
A
Safety: 70
Graded by its riskiest ingredient, enalapril (70)
Carries an FDA boxed warning, the strongest warning the FDA issues (-30)
2,303 FDA reports naming it as the suspect drug per million Medicare fills, 0.8x the median drug on this site
Death share in reports is near or below the FAERS average (1.1x)
Evidence: 55
Graded by its riskiest ingredient, enalapril (55)
817 randomized trials and 7 systematic reviews/meta-analyses indexed in PubMed
On the WHO Model List of Essential Medicines (shown for context; no score effect)
No Cochrane review found (-5)
Only 34% of completed registered trials posted results (-15)
Regulatory history: 85
Graded by its riskiest ingredient, hydrochlorothiazide (85)
Recalls since 2016: 1 Class I, 0 Class II, 0 Class III across 32 generic makers (-15)
Money & lawsuits: 100
Graded by its riskiest ingredient, enalapril (100)
Pharma paid doctors $0 tied to this drug last year: negligible
Not named in any pending federal MDL
Options: 100
Graded by its riskiest ingredient, enalapril (100)
Generic versions approved (23 applications)
13 same-class alternatives exist
Money and lawsuits
In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this combination's brands across 0 transactions.
No pending federal MDL names this combination or its brands.
The ingredients' own payments and lawsuits are on their pages and already count toward this grade.
Who takes it and what it costs
19,211Medicare Part D patients (2024)
61,690prescriptions filled
$24average cost per fill
$1Mtotal Medicare spend
Product
Fills
$/fill
Enalapril-Hydrochlorothiazide
61,579
$23
Vaseretic
111
$689
Questions to ask your prescriber
This is a fixed combination of enalapril and hydrochlorothiazide. Why both together, instead of only the one I need?
This drug carries a boxed warning. Which specific risk does it cover, and does it apply to me?
The most-reported problems in FDA's adverse event data are acute kidney injury, diarrhoea, dyspnoea. How would we recognize and handle those?
Why this one over benazepril, captopril, cilazapril? What would make you pick one of those instead?
What result are we expecting, by when, and what is the plan if it does not happen?
If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)
The most-reported problems in FDA's adverse event data are fatigue, nausea, diarrhoea. How would we recognize and handle those?
Why this one over bendroflumethiazide, chlorothiazide, cyclopenthiazide? What would make you pick one of those instead?