Drug interactions
Candesartan-hydrochlorothiazide + Eplerenone
Severity: Major
Candesartan-hydrochlorothiazide and Eplerenone: major 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
Both candesartan and eplerenone reduce potassium excretion, so using them together raises the risk of significant hyperkalemia. The risk is greatest in patients with renal impairment, diabetes or older age, though the thiazide component partly offsets it.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Eplerenone 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-hydrochlorothiazide belongs to Cardiovascular; Eplerenone belongs to Cardiovascular.
Why it happens
Additive potassium retention through angiotensin II receptor blockade and aldosterone receptor antagonism.
What to do
Measure serum potassium and creatinine at baseline, within the first week, and periodically thereafter. Reduce or stop eplerenone if potassium rises above the safe range.
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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Other interactions of Candesartan-hydrochlorothiazide
- Aliskiren + Candesartan-hydrochlorothiazide Contraindicated
- Candesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Candesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Candesartan-hydrochlorothiazide Major
- Amifostine + Candesartan-hydrochlorothiazide Major
- Amiloride + Candesartan-hydrochlorothiazide Major
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Eplerenone?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide and Eplerenone 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. Both candesartan and eplerenone reduce potassium excretion, so using them together raises the risk of significant hyperkalemia. The risk is greatest in patients with renal impairment, diabetes or older age, though the thiazide component partly offsets it.
How serious is the interaction between Candesartan-hydrochlorothiazide and Eplerenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure serum potassium and creatinine at baseline, within the first week, and periodically thereafter. Reduce or stop eplerenone if potassium rises above the safe range.
What other medicines interact with Candesartan-hydrochlorothiazide?
MediHelp also lists interactions of Candesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Candesartan-hydrochlorothiazide page.
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