Drug interactions
Amlodipine-hydrochlorothiazide-valsartan + Eplerenone
Severity: Major
Amlodipine-hydrochlorothiazide-valsartan and Eplerenone: major interaction.
Last updated Sources: US FDA label
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
Valsartan and eplerenone both reduce potassium excretion, and combining them increases the risk of clinically significant hyperkalemia. The risk is greater in renal impairment, diabetes, older age or with potassium supplements. The thiazide component lowers potassium and may partly offset this effect.
What this interaction means in plain words
Amlodipine-hydrochlorothiazide-valsartan and Eplerenone 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.
Amlodipine-hydrochlorothiazide-valsartan belongs to Cardiovascular; Eplerenone belongs to Cardiovascular.
Why it happens
Angiotensin receptor blockade lowers aldosterone, and eplerenone blocks the mineralocorticoid receptor, so both reduce renal potassium excretion.
What to do
Measure serum potassium and renal function at baseline, within the first week or so after starting or changing doses, and regularly thereafter. Avoid additional potassium supplements and reduce or stop eplerenone if potassium rises significantly.
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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References
Other interactions of Amlodipine-hydrochlorothiazide-valsartan
- Aliskiren + Amlodipine-hydrochlorothiazide-valsartan Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Dofetilide Contraindicated
- Amlodipine-hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aceclofenac + Amlodipine-hydrochlorothiazide-valsartan Major
- Aldesleukin + Amlodipine-hydrochlorothiazide-valsartan Major
- Amifostine + Amlodipine-hydrochlorothiazide-valsartan Major
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Amlodipine-hydrochlorothiazide-valsartan with Eplerenone?
MediHelp rates the interaction as major. Amlodipine-hydrochlorothiazide-valsartan and Eplerenone 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. Valsartan and eplerenone both reduce potassium excretion, and combining them increases the risk of clinically significant hyperkalemia. The risk is greater in renal impairment, diabetes, older age or with potassium supplements. The thiazide component lowers potassium and may partly offset this effect.
How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Eplerenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure serum potassium and renal function at baseline, within the first week or so after starting or changing doses, and regularly thereafter. Avoid additional potassium supplements and reduce or stop eplerenone if potassium rises significantly.
What other medicines interact with Amlodipine-hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.
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