Drug interactions
Candesartan-hydrochlorothiazide + Tolvaptan
Severity: Moderate
Candesartan-hydrochlorothiazide and Tolvaptan: 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
Tolvaptan is an aquaretic and combined with a thiazide diuretic may increase the risk of volume depletion, dehydration and hypotension. Rapid shifts in sodium and renal function can occur, and candesartan may add to renal hemodynamic effects.
What this interaction means in plain words
Candesartan-hydrochlorothiazide and Tolvaptan 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.
Candesartan-hydrochlorothiazide belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive fluid loss from vasopressin V2 antagonism and thiazide diuresis, with RAAS blockade reducing compensation.
What to do
Monitor volume status, blood pressure, serum sodium, potassium and creatinine. Reduce diuretic doses if volume depletion develops.
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 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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Candesartan-hydrochlorothiazide with Tolvaptan?
MediHelp rates the interaction as moderate. Candesartan-hydrochlorothiazide and Tolvaptan 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. Tolvaptan is an aquaretic and combined with a thiazide diuretic may increase the risk of volume depletion, dehydration and hypotension. Rapid shifts in sodium and renal function can occur, and candesartan may add to renal hemodynamic effects.
How serious is the interaction between Candesartan-hydrochlorothiazide and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor volume status, blood pressure, serum sodium, potassium and creatinine. Reduce diuretic doses if volume depletion develops.
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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