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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.

Evidence level: Moderate

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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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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