Drug interactions
Captopril + Hydrochlorothiazide-losartan
Severity: Major
Captopril 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
Combining an ACE inhibitor with an angiotensin receptor blocker gives dual renin-angiotensin blockade. This increases the risk of hypotension, hyperkalemia and acute kidney injury without clear added benefit in most patients.
What this interaction means in plain words
Captopril 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.
Captopril belongs to Cardiovascular; Hydrochlorothiazide-losartan belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic blockade of the renin-angiotensin-aldosterone system at two sites.
What to do
Avoid the combination in general, particularly in diabetic nephropathy or renal impairment. If used, monitor potassium, creatinine and blood pressure 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 Captopril
- Aliskiren + Captopril Contraindicated
- Captopril + Sacubitril / valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Amifostine + Captopril Major
- Amiloride + Captopril Major
- Amlodipine-hydrochlorothiazide-valsartan + Captopril Major
Frequently asked questions
Can I take Captopril with Hydrochlorothiazide-losartan?
MediHelp rates the interaction as major. Captopril 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. Combining an ACE inhibitor with an angiotensin receptor blocker gives dual renin-angiotensin blockade. This increases the risk of hypotension, hyperkalemia and acute kidney injury without clear added benefit in most patients.
How serious is the interaction between Captopril 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 the combination in general, particularly in diabetic nephropathy or renal impairment. If used, monitor potassium, creatinine and blood pressure 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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