Metoprolol and hydrochlorothiazide and Torsemide interaction

Metoprolol and hydrochlorothiazide and Torsemide: 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 Metoprolol and hydrochlorothiazide (METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE) label · effective 2025-01-22

Moderate

If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of metoprolol.

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Moderate

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects of diuretics.

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Moderate

Lithium : Diuretics reduce the renal clearance of lithium and increase the risk of lithium toxicity.

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Moderate

Non-Steroidal Anti-Inflammatory Drugs : NSAIDs can reduce the diuretic, natriuretic, and antihypertensive effects of thiazide diuretics.

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Minor

Because of its relative beta 1 cardio-selectivity, however, metoprolol tartrate may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment.

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From the Torsemide label · effective 2026-07-21

Moderate

Ototoxicity Tinnitus and hearing loss (usually reversible) have been observed with loop diuretics, including torsemide.

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Moderate

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic, and antihypertensive effects; risk of renal impairment.

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Moderate

Organic Anion Drugs: May decrease diuretic activity of torsemide.

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Moderate

The antihypertensive and diuretic effects of torsemide can be reduced by NSAIDs.

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Moderate

Monitor diuretic effect and blood pressure when used in combination with CYP2C9 inhibitor or inducer.

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.