Drug interactions
Canagliflozin + Hydrochlorothiazide-irbesartan
Severity: Moderate
Canagliflozin and Hydrochlorothiazide-irbesartan: 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
Canagliflozin causes osmotic diuresis and mild natriuresis, which with hydrochlorothiazide and irbesartan can lead to volume depletion, hypotension and acute kidney injury. Risk is greater in older patients and those with renal impairment.
What this interaction means in plain words
Canagliflozin and Hydrochlorothiazide-irbesartan 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.
Canagliflozin belongs to Endocrine; Hydrochlorothiazide-irbesartan belongs to Cardiovascular.
Why it happens
Additive diuretic and blood pressure lowering effects, with RAS blockade reducing renal compensation for volume loss.
What to do
Assess volume status before starting canagliflozin and consider lowering the diuretic dose. Monitor blood pressure, creatinine and electrolytes.
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 Hydrochlorothiazide-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan Major
Other interactions of Canagliflozin
Frequently asked questions
Can I take Canagliflozin with Hydrochlorothiazide-irbesartan?
MediHelp rates the interaction as moderate. Canagliflozin and Hydrochlorothiazide-irbesartan 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. Canagliflozin causes osmotic diuresis and mild natriuresis, which with hydrochlorothiazide and irbesartan can lead to volume depletion, hypotension and acute kidney injury. Risk is greater in older patients and those with renal impairment.
How serious is the interaction between Canagliflozin and Hydrochlorothiazide-irbesartan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess volume status before starting canagliflozin and consider lowering the diuretic dose. Monitor blood pressure, creatinine and electrolytes.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
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