Drug interactions
Candesartan + Hydrochlorothiazide-losartan
Severity: Major
Candesartan and Hydrochlorothiazide-losartan: 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
Adding a second angiotensin receptor blocker to losartan gives dual RAAS blockade, which increases the risks of hyperkalemia, hypotension and renal impairment without added outcome benefit. The hydrochlorothiazide component offsets potassium only partly.
What this interaction means in plain words
Candesartan and Hydrochlorothiazide-losartan 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.
Candesartan belongs to Cardiovascular; Hydrochlorothiazide-losartan belongs to Cardiovascular.
Why it happens
Duplicate angiotensin II type 1 receptor blockade producing additive hemodynamic and potassium-retaining effects.
What to do
Avoid using two ARBs together; use a single ARB at an optimized dose. If unavoidable, monitor potassium and creatinine closely.
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 Hydrochlorothiazide-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan Major
Other interactions of Candesartan
- Aliskiren + Candesartan Contraindicated
- Candesartan + Sparsentan Contraindicated
- Amifostine + Candesartan Major
- Amiloride + Candesartan Major
- Amlodipine-benazepril + Candesartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Candesartan Major
Frequently asked questions
Can I take Candesartan with Hydrochlorothiazide-losartan?
MediHelp rates the interaction as major. Candesartan and Hydrochlorothiazide-losartan 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. Adding a second angiotensin receptor blocker to losartan gives dual RAAS blockade, which increases the risks of hyperkalemia, hypotension and renal impairment without added outcome benefit. The hydrochlorothiazide component offsets potassium only partly.
How serious is the interaction between Candesartan and Hydrochlorothiazide-losartan?
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 using two ARBs together; use a single ARB at an optimized dose. If unavoidable, monitor potassium and creatinine closely.
What other medicines interact with Hydrochlorothiazide-losartan?
MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan page.
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