Valsartan and hydrochlorothiazide interactions

Valsartan and hydrochlorothiazide (Diovan HCT), an angiotensin II receptor blocker (ARB) has 235 documented interactions across the FDA labels and fact sheets we index: 32 major, 180 moderate, 22 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (32)

  • Acetazolamidecarbonic anhydrase inhibitorMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

  • AliskirenantihypertensiveMajor

    Do not coadminister aliskiren with Diovan HCT in patients with diabetes [see Drug Interactions (7)] . (Valsartan and hydrochlorothiazide label, Contraindications)

  • Amiloridepotassium-sparing diureticMajor

    Hyperkalemia occurs commonly (about 10%) when amiloride is used without a kaliuretic diuretic. (Amiloride label, Boxed warning)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerMajor

    Do not administer amlodipine and benazepril hydrochloride capsules within 36 hours of switching to or from a neprilysin inhibitor, e.g., sacubitril/valsartan [see Warnings and Precautions (5.1) ]. (Amlodipine and benazepril label, Contraindications)

  • BenazeprilACE inhibitorMajor

    Do not administer Lotensin within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor [see Warnings and Precautions (5.2) ]. (Benazepril label, Contraindications)

  • Bumetanideloop diureticMajor

    WARNING Bumetanide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. (Bumetanide label, Boxed warning)

  • CaptoprilACE inhibitorMajor

    Do not administer captopril tablets within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor (see PRECAUTIONS, Drug Interactions ). (Captopril label, Contraindications)

  • ClozapineantipsychoticMajor

    Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

  • CyclosporineimmunosuppressantMajor

    Potassium-Sparing Diuretics Cyclosporine should not be used with potassium-sparing diuretics because hyperkalemia can occur. (Cyclosporine label, Drug interactions)

  • DofetilideantiarrhythmicMajor

    The concomitant use of hydrochlorothiazide (alone or in combinations such as with triamterene) with dofetilide is contraindicated (see PRECAUTIONS, Drug-Drug Interactions ) because this has been shown to significantly increase dofetilide plasma concentrations and QT interval prolongation. (Dofetilide label, Contraindications)

  • Dorzolamidecarbonic anhydrase inhibitorMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

  • Dorzolamide and timololcarbonic anhydrase inhibitorMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

  • EnalaprilACE inhibitorMajor

    Do not administer enalapril maleate within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor [see Warnings and Precautions ( 5.2 )] . (Enalapril label, Contraindications)

  • Eplerenonealdosterone antagonistMajor

    …• serum creatinine > 2.0 mg/dL in males or >1.8 mg/dL in females, • creatinine clearance < 50 mL/min, or • concomitant administration of potassium supplements or potassium-sparing diuretics (e.g., amiloride, spironolactone, or triamterene) [see Warnings and Precautions (5.1) , Adverse Reactions (6.2) , Drug Interactions (7) , and Clinical Pharmacology (12.3)… (Eplerenone label, Contraindications)

  • Ethacrynic acidloop diureticMajor

    CONTRAINDICATIONS All diuretics, including ethacrynic acid, are contraindicated in anuria. (Ethacrynic acid label, Contraindications)

  • GentamicinaminoglycosideMajor

    The concurrent use of gentamicin with potent diuretics, such as ethacrynic acid or furosemide, should be avoided, since certain diuretics by themselves may cause ototoxicity. (Gentamicin label, Boxed warning)

  • Itraconazoleazole antifungalMajor

    Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

  • LisinoprilACE inhibitorMajor

    Do not administer Zestril within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor [ see Warnings and Precautions (5.2)] . (Lisinopril label, Contraindications)

  • Metolazonethiazide diureticMajor

    Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

  • MinoxidilvasodilatorMajor

    Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

  • NeomycinaminoglycosideMajor

    The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided, since certain diuretics by themselves may cause ototoxicity. (Neomycin label, Boxed warning)

  • PerindoprilACE inhibitorMajor

    Do not administer perindopril erbumine tablets within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor [see Warnings and Precautions (5.1) ]. (Perindopril label, Contraindications)

  • PotassiumVitamin and mineralMajor

    These medicines reduce potassium excretion; adding potassium supplements or salt substitutes can cause hyperkalemia, which affects heart rhythm. (NIH Office of Dietary Supplements, Potassium)

  • QuinaprilACE inhibitorMajor

    Do not administer quinapril tablets are within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor (see WARNINGS and PRECAUTIONS ). (Quinapril label, Contraindications)

  • RamiprilACE inhibitorMajor

    Do not administer ramipril within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor [see Warnings and Precautions (5.1) ] . (Ramipril label, Contraindications)

  • Silver sulfadiazinesulfonamideMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

  • Sodium bicarbonateantacidMajor

    Sodium bicarbonate injection is contraindicated in patients who are losing chloride by vomiting or from continuous gastrointestinal suction and in patients receiving diuretics known to produce a hypochloremic alkalosis. (Sodium bicarbonate label, Contraindications)

  • Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

  • SulfasalazinesulfonamideMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

  • TadalafilPDE5 inhibitorMajor

    …coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

  • TrandolaprilACE inhibitorMajor

    Do not administer trandolapril tablets within 36 hours of switching to or from sacubitril/valsartan, a neprilysin inhibitor (see WARNINGS ). (Trandolapril label, Contraindications)

  • ZonisamideanticonvulsantMajor

    Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs. (Valsartan and hydrochlorothiazide label, Contraindications)

Moderate interactions (180)

  • AcarboseantidiabeticModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Albuterolbeta-adrenergic agonistModerate

    Diuretics: Use with caution. (Albuterol label, Drug interactions)

  • Alfuzosinalpha blockerModerate

    Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

  • Allopurinolxanthine oxidase inhibitorModerate

    Hypersensitivity reactions to allopurinol tablets may be increased in patients with decreased kidney function receiving thiazide diuretics and allopurinol tablets concurrently. (Allopurinol label, Warnings and precautions)

  • AmiodaroneantiarrhythmicModerate

    Give special attention to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or in patients receiving concomitant diuretics and laxatives. (Amiodarone label, Warnings and precautions)

  • Amoxicillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Amoxicillin and clavulanatepenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Ampicillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • AripiprazoleantipsychoticModerate

    Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

  • ArmodafinilCNS stimulantModerate

    There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)

  • AsenapineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

  • AspirinNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Aspirin and dipyridamoleantiplatelet agentModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Atenololbeta blockerModerate

    Because of its relative beta 1 selectivity, however, TENORMIN may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Atenolol label, Warnings)

  • Atomoxetinenorepinephrine reuptake inhibitorModerate

    Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

  • AvanafilPDE5 inhibitorModerate

    • Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)

  • Azilsartanangiotensin II receptor blocker (ARB)Moderate

    Hypotension in Volume- or Salt-Depleted Patients In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment with azilsartan medoxomil. (Azilsartan label, Warnings and precautions)

  • Bisoprololbeta blockerModerate

    Because of its relative beta 1 -selectivity, however, BISOPROLOL FUMARATE may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol label, Warnings)

  • Bisoprolol and hydrochlorothiazidebeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • BrexpiprazoleantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

  • Brimonidinealpha-adrenergic agonistModerate

    Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

  • Budesonide and formoterolcorticosteroidModerate

    Diuretics: Use with caution. (Budesonide and formoterol label, Drug interactions)

  • BuprenorphineopioidModerate

    Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine label, Drug interactions)

  • Buprenorphine and naloxoneopioidModerate

    Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Buprenorphine and naloxone label, Drug interactions)

  • Calcitriolvitamin D analogModerate

    Thiazides Thiazides are known to induce hypercalcemia by the reduction of calcium excretion in urine. (Calcitriol label, Drug interactions)

  • CanagliflozinSGLT2 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Candesartanangiotensin II receptor blocker (ARB)Moderate

    Symptomatic hypotension is most likely to occur in patients who have been volume and/or salt depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. (Candesartan label, Warnings and precautions)

  • CarbamazepineanticonvulsantModerate

    Elderly patients and patients treated with diuretics are at greater risk of developing hyponatremia. (Carbamazepine label, Warnings and precautions)

  • Carbidopa and levodopadopaminergic drugModerate

    Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

  • CariprazineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

  • Carvedilolbeta blockerModerate

    If such symptoms occur, diuretics should be increased and the carvedilol dose should not be advanced until clinical stability resumes [see Dosage and Administration (2) ] . (Carvedilol label, Warnings and precautions)

  • CelecoxibNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • ChlorpromazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Chlorpromazine label, Precautions)

  • Chlorthalidonethiazide diureticModerate

    Effect of chlorthalidone on other drugs Chlorthalidone may add to or potentiate the action of other antihypertensive drugs. (Chlorthalidone label, Drug interactions)

  • Cholestyraminebile acid sequestrantModerate

    Ion Exchange Resins: Staggering the dosage of hydrochlorothiazide and ion exchange resins (e.g., cholestyramine, colestipol) such that hydrochlorothiazide is administered at least 4 hours before or 4 to 6 hours after the administration of resins would potentially minimize the interaction [see Clinical Pharmacology (12.3)] . (Valsartan and hydrochlorothiazide label, Drug interactions)

  • CitalopramSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume depleted may be at greater risk for developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Citalopram label, Warnings and precautions)

  • CodeineopioidModerate

    Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Codeine label, Drug interactions)

  • Cyclobenzaprinemuscle relaxantModerate

    …concomitant use of TONMYA with: MAO inhibitors may be life-threatening [see Contraindications (4) ] , Alcohol, barbiturates, and other CNS depressants may increase the risk of adverse reactions associated with these drugs, Tramadol may increase the seizure risk, Guanethidine or other similar acting drugs may block the antihypertensive action of these drugs. (Cyclobenzaprine label, Drug interactions)

  • Dalfampridinepotassium supplementModerate

    …Serum Potassium: Concomitant use of valsartan with other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • DapagliflozinSGLT2 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • DesmopressinModerate

    …Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)

  • DesvenlafaxineSNRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk [see Use in Specific Populations (8.5) and Clinical Pharmacology (12.3) ] . (Desvenlafaxine label, Warnings and precautions)

  • Dexlansoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Dexlansoprazole label, Warnings and precautions)

  • DexmethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

  • DiclofenacNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Dicloxacillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Digoxindigitalis glycosideModerate

    Serum potassium levels should be carefully monitored when digoxin is given to patients at high risk of hypokalemia ( e.g. , those receiving diuretics, corticosteroids, or other drugs that commonly lead to potassium loss; those with gastrointestinal losses through diarrhea, vomiting, or nasogastric suction; or those with potassium-losing endocrinopathies or nephropathies). (Digoxin label, Warnings and precautions)

  • Drospirenone and ethinyl estradioloral contraceptiveModerate

    Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Drospirenone and ethinyl estradiol label, Warnings and precautions)

  • DulaglutideGLP-1 receptor agonistModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • DuloxetineSNRIModerate

    The risk of BP decreases may be greater in patients taking concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors [see Warnings and Precautions ( 5.12 ) and Drug Interactions ( 7.1 )] and in patients taking CYMBALTA at doses above 60 mg daily. (Duloxetine label, Warnings and precautions)

  • EmpagliflozinSGLT2 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Empagliflozin and metforminSGLT2 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • EnoxaparinanticoagulantModerate

    …other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart failure patients to increases in serum creatinine. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • EpinephrinesympathomimeticModerate

    …Precautions (5.6) and Adverse Reactions (6) ]. β-blockers, such as propranolol Cyclopropane or halogenated hydrocarbon anesthetics, such as halothane Antihistamines Thyroid hormones Diuretics Cardiac glycosides, such as digitalis glycosides Quinidine Drugs potentiating hypokalemic effects of epinephrine • Potassium depleting diuretics • Corticosteroids • Theophylline… (Epinephrine label, Drug interactions)

  • Epoetin alfaModerate

    Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)

  • EscitalopramSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Escitalopram label, Warnings and precautions)

  • Esmololbeta blockerModerate

    Antihypertensive agents clonidine, guanfacine, or moxonidine: Beta blockers also increase the risk of clonidine-, guanfacine-, or moxonidine-withdrawal rebound hypertension. (Esmolol label, Drug interactions)

  • Esomeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Esomeprazole label, Warnings and precautions)

  • EtodolacNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • ExenatideGLP-1 receptor agonistModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • FentanylopioidModerate

    …treatment with Class 1 and Class III antiarrhythmics, 4) treatment with monoamine oxidase inhibitors (MAOI's), 5) concomitant treatment with other drug products known to prolong the QT interval and 6) electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs (e.g., diuretics) that may cause electrolyte imbalance. (Fentanyl label, Warnings and precautions)

  • Fluconazoleazole antifungalModerate

    Hydrochlorothiazide In a pharmacokinetic interaction study, coadministration of multiple-dose hydrochlorothiazide to healthy volunteers receiving fluconazole increased plasma concentrations of fluconazole by 40%. (Fluconazole label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Amphotericin B or potassium-depleting diuretics (benzothiadiazines and related drugs, ethacrynic acid and furosemide)—enhanced hypokalemia. (Fludrocortisone label, Drug interactions)

  • FluoxetineSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Fluoxetine label, Warnings and precautions)

  • Fluticasone and salmeterolcorticosteroidModerate

    Diuretics: Use with caution. (Fluticasone and salmeterol label, Drug interactions)

  • FluvoxamineSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)

  • Formoterolbeta-adrenergic agonistModerate

    • Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. (Formoterol label, Drug interactions)

  • FosinoprilACE inhibitorModerate

    Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Furosemideloop diureticModerate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • GemfibrozilfibrateModerate

    OATP1B1 substrates – Gemfibrozil is an inhibitor of organic anion-transporter polyprotein (OATP) 1B1 and may increase exposure of drugs that are substrates of OATP1B1 (e.g., atrasentan, atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, SN-38 [active metabolite of irinotecan], rosuvastatin, pitavastatin, pravastatin, rifampin, valsartan, olmesartan). (Gemfibrozil label, Warnings)

  • GlimepiridesulfonylureaModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • GlipizidesulfonylureaModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • GlyburidesulfonylureaModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Glyburide and metforminsulfonylureaModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • HaloperidolantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are at risk for hypotension (e.g., geriatric patients, patients with dehydration, hypovolemia, and concomitantly treated with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Haloperidol label, Warnings and precautions)

  • HeparinanticoagulantModerate

    …other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart failure patients to increases in serum creatinine. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Hydrocodone and acetaminophenopioidModerate

    Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Hydrocodone and acetaminophen label, Drug interactions)

  • HydromorphoneopioidModerate

    Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Hydromorphone label, Drug interactions)

  • IbuprofenNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • IloperidoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)

  • Indapamidethiazide diureticModerate

    Drug Interactions Other Antihypertensives: Indapamide may add to or potentiate the action of other antihypertensive drugs. (Indapamide label, Drug interactions)

  • IndomethacinNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Insulin aspartinsulinModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Insulin degludecinsulinModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Insulin detemirinsulinModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Insulin glargineinsulinModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Insulin lisproinsulinModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Insulin regular (human)insulinModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Irbesartanangiotensin II receptor blocker (ARB)Moderate

    Hypotension in Volume or Salt-Depleted Patients In patients with an activated renin-angiotensin system, such as volume or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initialization of treatment with AVAPRO. (Irbesartan label, Warnings and precautions)

  • Ketoconazoleazole antifungalModerate

    Diuretics eplerenone The potential increase in plasma concentrations of eplerenone when coadministered with ketoconazole tablets may increase the risk of hyperkalemia and hypotension. (Ketoconazole label, Drug interactions)

  • KetorolacNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Lansoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Lansoprazole label, Warnings and precautions)

  • Levalbuterolbeta-adrenergic agonistModerate

    Diuretics The ECG changes or hypokalemia that may result from the administration of non-potassium-sparing diuretics (such as loop and thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Levalbuterol label, Drug interactions)

  • LevomilnacipranSNRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

  • LevorphanolopioidModerate

    Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Levorphanol label, Drug interactions)

  • LinagliptinDPP-4 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • LinezolidantibioticModerate

    Monitor serum sodium levels regularly in the elderly, in patients taking diuretics, and in other patients at risk of hyponatremia and/or SIADH while taking Linezolid injection. (Linezolid label, Warnings and precautions)

  • LiraglutideGLP-1 receptor agonistModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Lisinopril and hydrochlorothiazideACE inhibitorModerate

    Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Lithiumserotonergic drugModerate

    Lithium Interaction Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of valsartan or thiazide diuretics. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Losartanangiotensin II receptor blocker (ARB)Moderate

    Hypotension in Volume- or Salt-Depleted Patients In patients with an activated renin-angiotensin system, such as volume- or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of treatment with COZAAR. (Losartan label, Warnings and precautions)

  • LumateperoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

  • LurasidoneantipsychoticModerate

    Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

  • MeloxicamNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • MeperidineopioidModerate

    Examples: Cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Meperidine label, Drug interactions)

  • MetforminbiguanideModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • MethadoneopioidModerate

    Closely monitor patients with risk factors for development of prolonged QT interval (e.g., cardiac hypertrophy, concomitant diuretic use, hypokalemia, hypomagnesemia), a history of cardiac conduction abnormalities, and those taking medications affecting cardiac conduction. (Methadone label, Warnings and precautions)

  • MethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

  • Metoprololbeta blockerModerate

    If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)

  • MirtazapineantidepressantModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia [see Use in Specific Populations (8.5) ] . (Mirtazapine label, Warnings and precautions)

  • ModafinilCNS stimulantModerate

    However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)

  • MoexiprilACE inhibitorModerate

    Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • MorphineopioidModerate

    Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Morphine label, Drug interactions)

  • NabumetoneNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Nadololbeta blockerModerate

    Although beta-blockers should be avoided in overt congestive heart failure, if necessary, they can be used with caution in patients with a history of failure who are well-compensated, usually with digitalis and diuretics. (Nadolol label, Warnings)

  • NalbuphineopioidModerate

    Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Nalbuphine label, Drug interactions)

  • NaproxenNSAIDModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • NiacinModerate

    Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)

  • NitroglycerinnitrateModerate

    Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

  • OlanzapineantipsychoticModerate

    …of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

  • OliceridineopioidModerate

    Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oliceridine label, Drug interactions)

  • Olmesartanangiotensin II receptor blocker (ARB)Moderate

    Hypotension in Volume- or Salt-Depleted Patients In patients with an activated renin-angiotensin-aldosterone system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may be anticipated after initiation of treatment with Benicar. (Olmesartan label, Warnings and precautions)

  • Omeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (Omeprazole label, Warnings and precautions)

  • OxycodoneopioidModerate

    Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxycodone label, Drug interactions)

  • Oxycodone and acetaminophenopioidModerate

    Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxycodone and acetaminophen label, Drug interactions)

  • OxymorphoneopioidModerate

    Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Oxymorphone label, Drug interactions)

  • PaliperidoneantipsychoticModerate

    Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

  • Pantoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Pantoprazole label, Warnings and precautions)

  • ParoxetineSSRIModerate

    Geriatric patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Paroxetine label, Warnings and precautions)

  • Penicillin Gpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Penicillin Vpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Pentazocine and naloxoneopioidModerate

    Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Pentazocine and naloxone label, Drug interactions)

  • PentoxifyllinemethylxanthineModerate

    Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

  • PhenelzineMAO inhibitorModerate

    …hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)

  • Phentermine and topiramateCNS stimulantModerate

    Concomitant administration of hydrochlorothiazide alone with topiramate alone has been shown to increase the C max and AUC of topiramate by 27% and 29%, respectively. (Phentermine and topiramate label, Drug interactions)

  • Pindololbeta blockerModerate

    Although beta-blockers should be avoided in overt congestive heart failure, if necessary, pindolol tablets can be used with caution in patients with a history of failure who are well-compensated, usually with digitalis and diuretics. (Pindolol label, Warnings)

  • PioglitazonethiazolidinedioneModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Potassium chloridepotassium supplementModerate

    …Serum Potassium: Concomitant use of valsartan with other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Prazosinalpha blockerModerate

    Syncopal episodes have usually occurred within 30 to 90 minutes of the initial dose of the drug; occasionally, they have been reported in association with rapid dosage increases or the introduction of another antihypertensive drug into the regimen of a patient taking high doses of prazosin hydrochloride capsules. (Prazosin label, Warnings)

  • ProchlorperazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Prochlorperazine label, Precautions)

  • QuetiapineantipsychoticModerate

    Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

  • Rabeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Rabeprazole label, Warnings and precautions)

  • RepaglinidemeglitinideModerate

    …Serum Potassium: Concomitant use of valsartan with other agents that block the renin-angiotensin system, potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, salt substitutes containing potassium or other drugs that may increase potassium levels (e.g., heparin) may lead to increases in serum potassium and in heart… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • RiociguatvasodilatorModerate

    Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

  • RisperidoneantipsychoticModerate

    Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

  • Sacubitril and valsartanangiotensin II receptor blocker (ARB)Moderate

    Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. (Sacubitril and valsartan label, Warnings and precautions)

  • Salmeterolbeta-adrenergic agonistModerate

    Diuretics: Use with caution. (Salmeterol label, Drug interactions)

  • SemaglutideGLP-1 receptor agonistModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • SertralineSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Sertraline label, Warnings and precautions)

  • SildenafilPDE5 inhibitorModerate

    Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)

  • SitagliptinDPP-4 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Sitagliptin and metforminDPP-4 inhibitorModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • Sotalolbeta blockerModerate

    Special attention should be given to electrolyte and acid-base balance in patients experiencing severe or prolonged diarrhea or patients receiving concomitant diuretic drugs. (Sotalol label, Warnings and precautions)

  • Spironolactonealdosterone antagonistModerate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistModerate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Sumatriptan and naproxentriptanModerate

    Non-Steroidal Anti-Inflammatory Agents (NSAIDs), Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including valsartan,… (Valsartan and hydrochlorothiazide label, Drug interactions)

  • TacrolimusimmunosuppressantModerate

    • Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)

  • TapentadolopioidModerate

    …use of skeletal muscle relaxants and opioids, consider prescribing naloxone for the emergency treatment of opioid overdose [see Dosage and Administration (2.2) , Warnings and Precautions (5.2 , 5.3) ] Examples: cyclobenzaprine, metaxalone Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Tapentadol label, Drug interactions)

  • Telmisartanangiotensin II receptor blocker (ARB)Moderate

    Hypotension In patients with an activated renin-angiotensin system, such as volume- or salt-depleted patients (e.g., those being treated with high doses of diuretics), symptomatic hypotension may occur after initiation of therapy with telmisartan tablets. (Telmisartan label, Warnings and precautions)

  • Terazosinalpha blockerModerate

    Risk of Hypotension with Concomitant Use of Other Antihypertensive Agents and Phospodiesterase Type 5 Inhibitors (PDE5-I): Concomitant administration of TEZRULY with antihypertensives or phosphodiesterase-5 (PDE-5) inhibitors can result in additive blood pressure lowering effects and symptomatic hypotension (5.3). (Terazosin label, Warnings and precautions)

  • Terbutalinebeta-adrenergic agonistModerate

    Diuretics The ECG changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. (Terbutaline label, Precautions)

  • TestosteroneandrogenModerate

    In patients with hypertension on antihypertensive therapy, KYZATREX® increased the mean systolic/diastolic BP by 3.4/0.7 mm Hg from baseline after 4 months of treatment and 3.1/1.0 mm Hg from baseline after 6 months of treatment. [see Adverse Reactions (6.1) ]. (Testosterone label, Warnings and precautions)

  • TirzepatideGLP-1 receptor agonistModerate

    Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)

  • TobramycinaminoglycosideModerate

    Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)

  • TopiramateanticonvulsantModerate

    Hydrochlorothiazide (HCTZ) Topiramate C max and AUC increased when HCTZ was added to immediate-release topiramate. (Topiramate label, Drug interactions)

  • Torsemideloop diureticModerate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • TramadolopioidModerate

    Diuretics Clinical Impact: Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. (Tramadol label, Drug interactions)

  • TrazodoneantidepressantModerate

    Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

  • Triamterenepotassium-sparing diureticModerate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan and hydrochlorothiazide label, Warnings and precautions)

  • Umeclidinium and vilanterolanticholinergicModerate

    Diuretics: Use with caution. (Umeclidinium and vilanterol label, Drug interactions)

  • Valsartanangiotensin II receptor blocker (ARB)Moderate

    In patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur. (Valsartan label, Warnings and precautions)

  • VardenafilPDE5 inhibitorModerate

    Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)

  • VenlafaxineSNRIModerate

    Also, patients taking diuretics or who are otherwise volume-depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Venlafaxine label, Warnings and precautions)

  • Verapamilcalcium channel blockerModerate

    Control patients with milder ventricular dysfunction, if possible, with optimum doses of digitalis and/or diuretics before verapamil treatment is started [see Drug Interactions ( 7.5 )] . (Verapamil label, Warnings and precautions)

  • VilazodoneSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs [see Use in Specific Populations ( 8.5 )] . (Vilazodone label, Warnings and precautions)

  • Vitamin DVitamin and mineralModerate

    Thiazide diuretics reduce calcium excretion; combined with vitamin D and calcium supplements this can lead to hypercalcemia, especially in older adults. (NIH Office of Dietary Supplements, Vitamin D)

  • VortioxetineantidepressantModerate

    Also, patients taking diuretics or who are otherwise volume-depleted can be at greater risk. (Vortioxetine label, Warnings and precautions)

  • ZiprasidoneantipsychoticModerate

    Hypokalemia may result from diuretic therapy, diarrhea, and other causes. (Ziprasidone label, Warnings and precautions)

Minor mentions (22)

  • AmbrisentanMinor

    Patients required intervention with a diuretic, fluid management, or, in some cases, hospitalization for decompensating heart failure. (Ambrisentan label, Warnings and precautions)

  • BosentanCYP3A4 inducerMinor

    Patients required intervention with a diuretic, fluid management, or hospitalization for decompensating heart failure. (Bosentan label, Warnings and precautions)

  • ButorphanolopioidMinor

    In such cases, butorphanol should be discontinued and the hypertension treated with antihypertensive drugs. (Butorphanol label, Warnings)

  • CalciumVitamin and mineralMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • DronedaroneantiarrhythmicMinor

    Hypokalemia and Hypomagnesemia with Potassium-Depleting Diuretics Hypokalemia or hypomagnesemia may occur with concomitant administration of potassium-depleting diuretics. (Dronedarone label, Warnings and precautions)

  • Febuxostatxanthine oxidase inhibitorMinor

    In Vivo Drug Interaction Studies Based on drug interaction studies in healthy patients, ULORIC does not have clinically significant interactions with colchicine, naproxen, indomethacin, hydrochlorothiazide, warfarin or desipramine [see Clinical Pharmacology (12.3) ]. (Febuxostat label, Drug interactions)

  • Finasteride5-alpha reductase inhibitorMinor

    …clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives… (Finasteride label, Drug interactions)

  • FlecainideantiarrhythmicMinor

    Flecainide acetate has been used in a large number of patients receiving diuretics without apparent interaction. (Flecainide label, Drug interactions)

  • HydralazinevasodilatorMinor

    When other potent parenteral antihypertensive drugs, such as diazoxide, are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure. (Hydralazine label, Drug interactions)

  • ImatinibCYP3A4 inhibitorMinor

    Weigh patients regularly and manage unexpected rapid weight gain by drug interruption and diuretics. (Imatinib label, Warnings and precautions)

  • Isradipinedihydropyridine calcium channel blockerMinor

    Hydrochlorothiazide: A study in normal healthy volunteers has shown that concomitant administration of isradipine and hydrochlorothiazide does not result in altered pharmacokinetics of either drug. (Isradipine label, Drug interactions)

  • MacitentanMinor

    Postmarketing cases of edema and fluid retention occurring within weeks of starting OPSUMIT, some requiring intervention with a diuretic or hospitalization for decompensated heart failure, have been reported [see Adverse Reactions (6.2) ] . (Macitentan label, Warnings and precautions)

  • MagnesiumVitamin and mineralMinor

    Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

  • MethyldopaantihypertensiveMinor

    Drug Interactions When methyldopa is used with other antihypertensive drugs, potentiation of antihypertensive effect may occur. (Methyldopa label, Drug interactions)

  • MethylprednisolonecorticosteroidMinor

    Amphotericin B injection and potassium-depleting agents : When corticosteroids are administered concomitantly with potassium-depleting agents (e.g., amphotericin B, diuretics), patients should be observed closely for development of hypokalemia. (Methylprednisolone label, Drug interactions)

  • Nisoldipinedihydropyridine calcium channel blockerMinor

    The blood pressure effect of SULAR tended to be greater in patients on atenolol than in patients on no other antihypertensive therapy. (Nisoldipine label, Drug interactions)

  • Nortriptylinetricyclic antidepressantMinor

    The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

  • PrednisolonecorticosteroidMinor

    Potassium-depleting agents (e.g., diuretics, Amphotericin B): When corticosteroids are administered concomitantly with potassium-depleting agents, patients should be observed closely for development of hypokalemia. (Prednisolone label, Drug interactions)

  • PrednisonecorticosteroidMinor

    Potassium-Depleting Agents (e.g., Diuretics, Amphotericin B) When corticosteroids are administered concomitantly with potassium-depleting agents, patients should be observed closely for development of hypokalemia. (Prednisone label, Drug interactions)

  • TerbinafineantifungalMinor

    There is no information available from adequate drug-drug interaction studies with the following classes of drugs: oral contraceptives, hormone replacement therapies, hypoglycemics, phenytoins, thiazide diuretics, and calcium channel blockers. (Terbinafine label, Drug interactions)

  • TriamcinolonecorticosteroidMinor

    Amphotericin B injection and potassium-depleting agents: When corticosteroids are administered concomitantly with potassium-depleting agents ( i.e., amphotericin B, diuretics), patients should be observed closely for development of hypokalemia. (Triamcinolone label, Drug interactions)

  • ZincVitamin and mineralMinor

    Thiazide diuretics increase zinc loss in urine with long-term use. (NIH Office of Dietary Supplements, Zinc)

No significant interaction reported (1)

  • Ropiniroledopamine agonistNo interaction

    Commonly Administered Drugs: Population analysis showed that commonly administered drugs (e.g., selegiline, amantadine, tricyclic antidepressants, benzodiazepines, ibuprofen, thiazides, antihistamines, anticholinergics) did not affect the clearance of ropinirole. (Ropinirole label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.