Drug interactions
Amlodipine-olmesartan-hydrochlorothiazide + Lithium
Severity: Major
Amlodipine-olmesartan-hydrochlorothiazide and Lithium: 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
Both olmesartan and hydrochlorothiazide reduce renal lithium clearance, which can raise serum lithium into the toxic range. Toxicity may present with tremor, confusion, ataxia, vomiting and, in severe cases, seizures or renal injury.
What this interaction means in plain words
Amlodipine-olmesartan-hydrochlorothiazide 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-olmesartan-hydrochlorothiazide belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Angiotensin receptor blockade and thiazide-induced sodium depletion increase proximal tubular lithium reabsorption and reduce lithium clearance.
What to do
Avoid if possible. If used, measure serum lithium before starting and frequently in the first weeks, and reduce the lithium dose as needed.
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-olmesartan-hydrochlorothiazide
- Aliskiren + Amlodipine-olmesartan-hydrochlorothiazide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Aldesleukin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Amifostine + Amlodipine-olmesartan-hydrochlorothiazide 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-olmesartan-hydrochlorothiazide with Lithium?
MediHelp rates the interaction as major. Amlodipine-olmesartan-hydrochlorothiazide 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 olmesartan and hydrochlorothiazide reduce renal lithium clearance, which can raise serum lithium into the toxic range. Toxicity may present with tremor, confusion, ataxia, vomiting and, in severe cases, seizures or renal injury.
How serious is the interaction between Amlodipine-olmesartan-hydrochlorothiazide 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. If used, measure serum lithium before starting and frequently in the first weeks, and reduce the lithium dose as needed.
What other medicines interact with Amlodipine-olmesartan-hydrochlorothiazide?
MediHelp also lists interactions of Amlodipine-olmesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-olmesartan-hydrochlorothiazide page.
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