Captopril and Valsartan and hydrochlorothiazide interaction

Captopril and Valsartan and hydrochlorothiazide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Captopril label · effective 2026-02-06

Major

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

Contraindicationsnames Valsartan and hydrochlorothiazideView label on DailyMed
Moderate

Hypotension Excessive hypotension was rarely seen in hypertensive patients but is a possible consequence of captopril use in salt/volume depleted persons (such as those treated vigorously with diuretics), patients with heart failure or those patients undergoing renal dialysis.

Warningsby drug classView label on DailyMed
Moderate

Patients should be followed closely for the first two weeks of treatment and whenever the dose of captopril and/or diuretic is increased.

Warningsby drug classView label on DailyMed
Moderate

In patients with heart failure, reducing the dose of diuretic, if feasible, may minimize the fall in blood pressure.

Warningsby drug classView label on DailyMed
Moderate

Drug Interactions 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.

Drug interactionsby drug classView label on DailyMed

From the Valsartan and hydrochlorothiazide (Diovan HCT) label · effective 2026-02-13

Moderate

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.

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.