Drug interactions
Azilsartan + Captopril-hydrochlorothiazide
Severity: Major
Azilsartan and Captopril-hydrochlorothiazide: 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
Combining an ACE inhibitor with an angiotensin receptor blocker produces dual renin-angiotensin system blockade. This raises the risk of hypotension, hyperkalemia and acute kidney injury without clear added benefit in most patients.
What this interaction means in plain words
Azilsartan 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.
Azilsartan belongs to Cardiovascular; Captopril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic inhibition of the renin-angiotensin-aldosterone system at two points reduces glomerular filtration pressure and aldosterone-mediated potassium excretion.
What to do
Avoid the combination and use a single renin-angiotensin agent. If unavoidable, monitor blood pressure, serum potassium and creatinine closely.
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 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 Azilsartan
- Aliskiren + Azilsartan Contraindicated
- Azilsartan + Sparsentan Contraindicated
- Amifostine + Azilsartan Major
- Amlodipine-benazepril + Azilsartan Major
- Amlodipine-perindopril + Azilsartan Major
- Azilsartan + Benazepril Major
Frequently asked questions
Can I take Azilsartan with Captopril-hydrochlorothiazide?
MediHelp rates the interaction as major. Azilsartan 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. Combining an ACE inhibitor with an angiotensin receptor blocker produces dual renin-angiotensin system blockade. This raises the risk of hypotension, hyperkalemia and acute kidney injury without clear added benefit in most patients.
How serious is the interaction between Azilsartan 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: Avoid the combination and use a single renin-angiotensin agent. If unavoidable, monitor blood pressure, serum potassium and creatinine closely.
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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