Drug interactions
Canagliflozin + Hydrochlorothiazide-olmesartan
Severity: Moderate
Canagliflozin and Hydrochlorothiazide-olmesartan: 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 volume reduction, which adds to the effects of a thiazide and an ARB. This can cause hypotension and acute kidney injury, particularly in older or volume-depleted patients.
What this interaction means in plain words
Canagliflozin and Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular.
Why it happens
Additive diuretic and hemodynamic effects from SGLT2 inhibition, thiazide diuresis and ARB-mediated efferent arteriolar dilation.
What to do
Assess volume status and renal function before and after starting canagliflozin. Consider reducing the diuretic dose if volume depletion is a concern.
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-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan Major
Other interactions of Canagliflozin
Frequently asked questions
Can I take Canagliflozin with Hydrochlorothiazide-olmesartan?
MediHelp rates the interaction as moderate. Canagliflozin and Hydrochlorothiazide-olmesartan 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 volume reduction, which adds to the effects of a thiazide and an ARB. This can cause hypotension and acute kidney injury, particularly in older or volume-depleted patients.
How serious is the interaction between Canagliflozin and Hydrochlorothiazide-olmesartan?
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 and renal function before and after starting canagliflozin. Consider reducing the diuretic dose if volume depletion is a concern.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan page.
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