Drug interactions
Captopril-hydrochlorothiazide + Isosorbide mononitrate
Severity: Moderate
Captopril-hydrochlorothiazide and Isosorbide mononitrate: 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
Nitrates combined with an ACE inhibitor and thiazide produce additive blood pressure lowering. Patients may experience dizziness, orthostatic hypotension or syncope, especially at initiation or dose increases.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Isosorbide mononitrate 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; Isosorbide mononitrate belongs to Cardiovascular.
Why it happens
Additive vasodilation and reduced preload through nitrate venodilation, ACE inhibition and diuresis.
What to do
Monitor blood pressure and orthostatic symptoms when starting or titrating. Start with low doses and advise patients to rise slowly.
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 Isosorbide mononitrate
- Avanafil + Isosorbide mononitrate Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Sildenafil Contraindicated
- Isosorbide mononitrate + Tadalafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Ergotamine + Isosorbide mononitrate Major
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Isosorbide mononitrate?
MediHelp rates the interaction as moderate. Captopril-hydrochlorothiazide and Isosorbide mononitrate 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. Nitrates combined with an ACE inhibitor and thiazide produce additive blood pressure lowering. Patients may experience dizziness, orthostatic hypotension or syncope, especially at initiation or dose increases.
How serious is the interaction between Captopril-hydrochlorothiazide and Isosorbide mononitrate?
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 and orthostatic symptoms when starting or titrating. Start with low doses and advise patients to rise slowly.
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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