Ramipril and Triamterene and hydrochlorothiazide interaction

Ramipril and Triamterene 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 Ramipril label · effective 2025-07-10

Moderate

Experience with another ACE inhibitor suggests that these increases would be reversible upon discontinuation of ramipril and/or diuretic therapy.

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Moderate

Some hypertensive patients with no apparent pre-existing renal vascular disease have developed increases in blood urea nitrogen and serum creatinine, usually minor and transient, especially when ramipril has been given concomitantly with a diuretic.

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Moderate

Dosage reduction of ramipril and/or discontinuation of the diuretic may be required.

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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.

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Moderate

Heart Failure Post-Myocardial Infarction In patients with heart failure post-myocardial infarction who are currently being treated with a diuretic, symptomatic hypotension occasionally can occur following the initial dose of ramipril.

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From the Triamterene and hydrochlorothiazide label · effective 2026-07-16

Moderate

Drug Interactions Angiotensin-Converting Enzyme Inhibitors Potassium-sparing agents should be used with caution in conjunction with angiotensin-converting enzyme (ACE) inhibitors due to an increased risk of hyperkalemia.

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Moderate

Thiazides may add to or potentiate the action of other antihypertensive drugs.

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Minor

See INDICATIONS AND USAGE for concomitant use with other antihypertensive drugs.

Drug interactionsby drug classView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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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.