Losartan and Quinapril and hydrochlorothiazide interaction

Losartan and Quinapril and hydrochlorothiazide: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Losartan (COZAAR) label · effective 2026-01-20

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.

Warnings and precautionsby drug classView label on DailyMed
Moderate

NSAIDs: Increased risk of renal impairment and reduced diuretic, natriuretic, and antihypertensive effects.

Drug interactionsby drug classView label on DailyMed
Moderate

Non-Steroidal Anti-Inflammatory Drugs (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 losartan)…

Drug interactionsby drug classView label on DailyMed
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, syncope, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy.

Drug interactionsby drug classView label on DailyMed
Minor

Renal Function Deterioration Changes in renal function including acute renal failure can be caused by drugs that inhibit the renin-angiotensin system and by diuretics.

Warnings and precautionsby drug classView label on DailyMed

From the Quinapril and hydrochlorothiazide label · effective 2023-12-11

Moderate

The thiazide component of quinapril and hydrochlorothiazide tablets may potentiate the action of other antihypertensive drugs, especially ganglionic or peripheral adrenergic- blocking drugs.

Warningsby drug classView label on DailyMed
Minor

Quinapril and hydrochlorothiazide tablets should be used cautiously in patients receiving concomitant therapy with other antihypertensives.

Warningsby drug classView label on DailyMed
Minor

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents.

Warningsby 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.