Drug interactions
Azilsartan-chlorthalidone + Lithium
Severity: Major
Azilsartan-chlorthalidone 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 the thiazide-like diuretic and the angiotensin receptor blocker can raise serum lithium concentrations. This may lead to lithium toxicity with tremor, confusion, ataxia and arrhythmias.
What this interaction means in plain words
Azilsartan-chlorthalidone 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.
Azilsartan-chlorthalidone belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Sodium depletion from chlorthalidone and reduced aldosterone/renal hemodynamic effects of azilsartan increase proximal tubular lithium reabsorption and reduce its renal clearance.
What to do
Avoid if possible; otherwise check lithium levels before and within the first week after starting, then regularly, and reduce lithium dose as needed. Counsel patients on toxicity symptoms and maintaining 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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References
Other interactions of Azilsartan-chlorthalidone
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 Azilsartan-chlorthalidone with Lithium?
MediHelp rates the interaction as major. Azilsartan-chlorthalidone 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 the thiazide-like diuretic and the angiotensin receptor blocker can raise serum lithium concentrations. This may lead to lithium toxicity with tremor, confusion, ataxia and arrhythmias.
How serious is the interaction between Azilsartan-chlorthalidone 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 levels before and within the first week after starting, then regularly, and reduce lithium dose as needed. Counsel patients on toxicity symptoms and maintaining hydration.
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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