Drug interactions
Captopril-hydrochlorothiazide + Lithium
Severity: Major
Captopril-hydrochlorothiazide and Lithium: 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
Hydrochlorothiazide and captopril both reduce renal lithium clearance, raising serum lithium levels. Toxicity can develop, with tremor, confusion, ataxia, vomiting and, in severe cases, seizures or renal injury.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Lithium 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; Lithium belongs to Central Nervous System.
Why it happens
Thiazide-induced sodium depletion increases proximal tubular lithium reabsorption, and ACE inhibitors further reduce lithium excretion.
What to do
Avoid the combination if possible; if used, reduce the lithium dose and monitor serum lithium closely after initiation and dose changes. Educate patients on signs of toxicity and maintain hydration.
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 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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Lithium?
MediHelp rates the interaction as major. Captopril-hydrochlorothiazide and Lithium 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. Hydrochlorothiazide and captopril both reduce renal lithium clearance, raising serum lithium levels. Toxicity can develop, with tremor, confusion, ataxia, vomiting and, in severe cases, seizures or renal injury.
How serious is the interaction between Captopril-hydrochlorothiazide and Lithium?
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 if possible; if used, reduce the lithium dose and monitor serum lithium closely after initiation and dose changes. Educate patients on signs of toxicity and maintain hydration.
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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