Drug interactions
Captopril + Tolvaptan
Severity: Moderate
Captopril 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 has been associated with increases in serum potassium, and ACE inhibitors also retain potassium. Together they may cause hyperkalemia.
What this interaction means in plain words
Captopril 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.
Captopril belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
ACE inhibition reduces aldosterone-mediated potassium excretion while tolvaptan may raise serum potassium, giving additive hyperkalemia risk.
What to do
Check serum potassium before and within the first weeks of combined therapy, and periodically afterwards. Avoid potassium supplements and potassium-sparing agents unless hypokalemia is documented.
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 Captopril
- Aliskiren + Captopril Contraindicated
- Captopril + Sacubitril / valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Amifostine + Captopril Major
- Amiloride + Captopril Major
- Amlodipine-hydrochlorothiazide-valsartan + Captopril 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 Captopril with Tolvaptan?
MediHelp rates the interaction as moderate. Captopril 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 has been associated with increases in serum potassium, and ACE inhibitors also retain potassium. Together they may cause hyperkalemia.
How serious is the interaction between Captopril 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: Check serum potassium before and within the first weeks of combined therapy, and periodically afterwards. Avoid potassium supplements and potassium-sparing agents unless hypokalemia is documented.
What other medicines interact with Captopril?
MediHelp also lists interactions of Captopril with, for example, Aliskiren, Sacubitril / valsartan, Sacubitril-valsartan. The full list is on the Captopril page.
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