Drug interactions
Captopril-hydrochlorothiazide + Eplerenone
Severity: Major
Captopril-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
Eplerenone and ACE inhibitors both reduce potassium excretion, so combined use increases the risk of serious hyperkalemia, especially with renal impairment or diabetes. The thiazide partially counters this effect.
What this interaction means in plain words
Captopril-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.
Captopril-hydrochlorothiazide belongs to Cardiovascular; Eplerenone belongs to Cardiovascular.
Why it happens
Additive potassium retention from aldosterone receptor blockade and ACE inhibition.
What to do
Check serum potassium and renal function before starting, within the first week, and periodically; 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 Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-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 Captopril-hydrochlorothiazide with Eplerenone?
MediHelp rates the interaction as major. Captopril-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. Eplerenone and ACE inhibitors both reduce potassium excretion, so combined use increases the risk of serious hyperkalemia, especially with renal impairment or diabetes. The thiazide partially counters this effect.
How serious is the interaction between Captopril-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: Check serum potassium and renal function before starting, within the first week, and periodically; reduce or stop eplerenone if potassium rises above the safe range.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-hydrochlorothiazide page.
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