Drug interactions
Captopril-hydrochlorothiazide + Furosemide
Severity: Moderate
Captopril-hydrochlorothiazide and Furosemide: 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
Adding furosemide to an ACE inhibitor and thiazide regimen can cause marked volume depletion, first-dose hypotension and a decline in renal function. The risk is highest in sodium-depleted or elderly patients and those with renal artery stenosis or heart failure.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Furosemide 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-hydrochlorothiazide belongs to Cardiovascular; Furosemide belongs to Cardiovascular.
Why it happens
Additive diuresis and natriuresis activate the renin-angiotensin system, and ACE inhibition removes efferent arteriolar compensation, causing hypotension and reduced glomerular filtration.
What to do
Monitor blood pressure, serum creatinine and electrolytes after starting or adjusting doses. Consider reducing the diuretic dose or temporarily holding it before starting or increasing the ACE inhibitor.
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-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 Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide Major
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Furosemide?
MediHelp rates the interaction as moderate. Captopril-hydrochlorothiazide and Furosemide 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. Adding furosemide to an ACE inhibitor and thiazide regimen can cause marked volume depletion, first-dose hypotension and a decline in renal function. The risk is highest in sodium-depleted or elderly patients and those with renal artery stenosis or heart failure.
How serious is the interaction between Captopril-hydrochlorothiazide and Furosemide?
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 blood pressure, serum creatinine and electrolytes after starting or adjusting doses. Consider reducing the diuretic dose or temporarily holding it before starting or increasing the ACE inhibitor.
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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