Drug interactions
Amlodipine-hydrochlorothiazide-valsartan + Lithium
Severity: Major
Amlodipine-hydrochlorothiazide-valsartan and Lithium: 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
Both valsartan and hydrochlorothiazide can reduce renal lithium clearance, raising serum lithium and risking toxicity such as tremor, ataxia, confusion and arrhythmias. The thiazide effect is particularly well documented and the risk is greater with volume depletion.
What this interaction means in plain words
Amlodipine-hydrochlorothiazide-valsartan and Lithium 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; Lithium belongs to Central Nervous System.
Why it happens
Reduced renal lithium excretion due to increased proximal tubular sodium and lithium reabsorption from thiazide-induced volume contraction and angiotensin receptor blockade.
What to do
Avoid if possible; otherwise check lithium level within the first week after starting and after dose changes and reduce the lithium dose as needed. Educate the patient about toxicity symptoms and maintain hydration.
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 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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Amlodipine-hydrochlorothiazide-valsartan with Lithium?
MediHelp rates the interaction as major. Amlodipine-hydrochlorothiazide-valsartan and Lithium 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. Both valsartan and hydrochlorothiazide can reduce renal lithium clearance, raising serum lithium and risking toxicity such as tremor, ataxia, confusion and arrhythmias. The thiazide effect is particularly well documented and the risk is greater with volume depletion.
How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Lithium?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise check lithium level within the first week after starting and after dose changes and reduce the lithium dose as needed. Educate the patient about toxicity symptoms and maintain hydration.
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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