Drug interactions
Candesartan-hydrochlorothiazide + Sacubitril / valsartan
Severity: Major
Candesartan-hydrochlorothiazide and Sacubitril / valsartan: 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
Combining candesartan with sacubitril/valsartan gives dual angiotensin receptor blockade, increasing hypotension, hyperkalemia and renal dysfunction without added benefit. Valsartan is already present in the combination product.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Sacubitril / valsartan 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.
Why it happens
Duplicate angiotensin II type 1 receptor blockade with additive effects on blood pressure, aldosterone and renal hemodynamics.
What to do
Avoid concurrent use; stop candesartan when sacubitril/valsartan is started and monitor blood pressure, potassium and creatinine.
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
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Sacubitril / valsartan?
MediHelp rates the interaction as major. Candesartan-hydrochlorothiazide and Sacubitril / valsartan 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. Combining candesartan with sacubitril/valsartan gives dual angiotensin receptor blockade, increasing hypotension, hyperkalemia and renal dysfunction without added benefit. Valsartan is already present in the combination product.
How serious is the interaction between Candesartan-hydrochlorothiazide and Sacubitril / valsartan?
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 concurrent use; stop candesartan when sacubitril/valsartan is started and monitor blood pressure, potassium and creatinine.
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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