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)
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)
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)
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)
Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)
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)
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)
These medicines reduce potassium excretion; adding potassium supplements or salt substitutes can cause hyperkalemia, which affects heart rhythm. (NIH Office of Dietary Supplements, Potassium)
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)
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)
…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)
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)
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)
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)
Check Valsartan and hydrochlorothiazide against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot 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.