Drug interactions
Amlodipine-hydrochlorothiazide-valsartan + Tolvaptan
Severity: Moderate
Amlodipine-hydrochlorothiazide-valsartan and Tolvaptan: moderate 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
Tolvaptan causes aquaresis and can lead to rapid sodium rise, dehydration, and hypovolemia, which together with thiazide diuresis and an ARB can cause hypotension and renal impairment. Potassium may rise with valsartan and tolvaptan but fall with hydrochlorothiazide, so changes are unpredictable.
What this interaction means in plain words
Amlodipine-hydrochlorothiazide-valsartan and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amlodipine-hydrochlorothiazide-valsartan belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive volume depletion and opposing effects on serum potassium.
What to do
Monitor serum sodium, potassium, creatinine and volume status closely, particularly at initiation. Consider reducing the diuretic dose if dehydration occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Amlodipine-hydrochlorothiazide-valsartan with Tolvaptan?
MediHelp rates the interaction as moderate. Amlodipine-hydrochlorothiazide-valsartan and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tolvaptan causes aquaresis and can lead to rapid sodium rise, dehydration, and hypovolemia, which together with thiazide diuresis and an ARB can cause hypotension and renal impairment. Potassium may rise with valsartan and tolvaptan but fall with hydrochlorothiazide, so changes are unpredictable.
How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum sodium, potassium, creatinine and volume status closely, particularly at initiation. Consider reducing the diuretic dose if dehydration occurs.
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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