Drug interactions
Canagliflozin + Hydrochlorothiazide-valsartan
Severity: Moderate
Canagliflozin and Hydrochlorothiazide-valsartan: 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 adds to the diuretic and antihypertensive effects of hydrochlorothiazide and valsartan. This can lead to volume depletion, hypotension and acute kidney injury, especially in older patients or those with renal impairment. Potassium changes are small.
What this interaction means in plain words
Canagliflozin and Hydrochlorothiazide-valsartan 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-valsartan belongs to Cardiovascular.
Why it happens
Additive volume depletion from SGLT2 inhibitor-induced osmotic diuresis and thiazide natriuresis with RAS blockade.
What to do
Assess volume status before starting canagliflozin and consider reducing 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Canagliflozin and Hydrochlorothiazide-valsartan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Hydrochlorothiazide-valsartan
- Aliskiren + Hydrochlorothiazide-valsartan Contraindicated
- Dofetilide + Hydrochlorothiazide-valsartan Contraindicated
- Hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-valsartan Major
- Amifostine + Hydrochlorothiazide-valsartan Major
- Amiloride + Hydrochlorothiazide-valsartan Major
Other interactions of Canagliflozin
Frequently asked questions
Can I take Canagliflozin with Hydrochlorothiazide-valsartan?
MediHelp rates the interaction as moderate. Canagliflozin and Hydrochlorothiazide-valsartan 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 adds to the diuretic and antihypertensive effects of hydrochlorothiazide and valsartan. This can lead to volume depletion, hypotension and acute kidney injury, especially in older patients or those with renal impairment. Potassium changes are small.
How serious is the interaction between Canagliflozin and Hydrochlorothiazide-valsartan?
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 reducing the diuretic dose. Monitor blood pressure, creatinine and electrolytes.
What other medicines interact with Hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-valsartan page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
