Drug interactions
Captopril-hydrochlorothiazide + Midodrine
Severity: Moderate
Captopril-hydrochlorothiazide and Midodrine: 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
Midodrine raises blood pressure and is used to treat orthostatic hypotension, so it pharmacologically opposes the effects of captopril and hydrochlorothiazide. Combining them may reduce antihypertensive control or the benefit of midodrine. The proposed renal tubular competition is of minor importance.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism between the alpha-1 agonist vasopressor and the antihypertensive agents.
What to do
Monitor supine and standing blood pressure and reassess the need for each drug, aiming for the lowest effective antihypertensive dose.
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 Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Midodrine?
MediHelp rates the interaction as moderate. Captopril-hydrochlorothiazide and Midodrine 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. Midodrine raises blood pressure and is used to treat orthostatic hypotension, so it pharmacologically opposes the effects of captopril and hydrochlorothiazide. Combining them may reduce antihypertensive control or the benefit of midodrine. The proposed renal tubular competition is of minor importance.
How serious is the interaction between Captopril-hydrochlorothiazide and Midodrine?
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 supine and standing blood pressure and reassess the need for each drug, aiming for the lowest effective antihypertensive dose.
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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