Drug interactions
Azilsartan-chlorthalidone + Bretylium
Severity: Major
Azilsartan-chlorthalidone and Bretylium: 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
Bretylium frequently causes hypotension by blocking norepinephrine release from sympathetic nerve terminals. Combined with an ARB and a thiazide-like diuretic, hypotension may be more severe and prolonged.
What this interaction means in plain words
Azilsartan-chlorthalidone and Bretylium 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.
Why it happens
Additive hypotension from adrenergic neuron blockade plus renin-angiotensin blockade and diuresis.
What to do
Monitor blood pressure closely and consider holding or reducing antihypertensives while bretylium is given. Correct volume depletion and be ready to give fluids if hypotension occurs.
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 Azilsartan-chlorthalidone
Frequently asked questions
Can I take Azilsartan-chlorthalidone with Bretylium?
MediHelp rates the interaction as major. Azilsartan-chlorthalidone and Bretylium 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. Bretylium frequently causes hypotension by blocking norepinephrine release from sympathetic nerve terminals. Combined with an ARB and a thiazide-like diuretic, hypotension may be more severe and prolonged.
How serious is the interaction between Azilsartan-chlorthalidone and Bretylium?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure closely and consider holding or reducing antihypertensives while bretylium is given. Correct volume depletion and be ready to give fluids if hypotension occurs.
What other medicines interact with Azilsartan-chlorthalidone?
MediHelp also lists interactions of Azilsartan-chlorthalidone with, for example, Aliskiren, Sparsentan, Aceclofenac. The full list is on the Azilsartan-chlorthalidone page.
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