Drug interactions
Amiloride + Captopril-hydrochlorothiazide
Severity: Major
Amiloride and Captopril-hydrochlorothiazide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amiloride is a potassium-sparing diuretic and captopril reduces aldosterone, so together they can cause significant hyperkalemia, especially in renal impairment or diabetes. The hydrochlorothiazide component partly offsets potassium retention but does not remove the risk. Additive blood pressure lowering may also occur.
What this interaction means in plain words
Amiloride and Captopril-hydrochlorothiazide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiloride belongs to Cardiovascular; Captopril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Additive potassium retention from ENaC blockade (amiloride) and reduced aldosterone secretion from ACE inhibition.
What to do
Check serum potassium and creatinine at baseline, within the first week or so, and periodically thereafter. Avoid potassium supplements and salt substitutes, and stop amiloride if hyperkalemia develops.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-hydrochlorothiazide Major
Other interactions of Amiloride
- Amiloride + Eplerenone Contraindicated
- Amiloride + Spironolactone Contraindicated
- Amiloride + Triamterene Contraindicated
- Aceclofenac + Amiloride Major
- Acemetacin + Amiloride Major
- Amiloride + Amlodipine-benazepril Major
Frequently asked questions
Can I take Amiloride with Captopril-hydrochlorothiazide?
MediHelp rates the interaction as major. Amiloride and Captopril-hydrochlorothiazide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Amiloride is a potassium-sparing diuretic and captopril reduces aldosterone, so together they can cause significant hyperkalemia, especially in renal impairment or diabetes. The hydrochlorothiazide component partly offsets potassium retention but does not remove the risk. Additive blood pressure lowering may also occur.
How serious is the interaction between Amiloride and Captopril-hydrochlorothiazide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and creatinine at baseline, within the first week or so, and periodically thereafter. Avoid potassium supplements and salt substitutes, and stop amiloride if hyperkalemia develops.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-hydrochlorothiazide page.
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