Drug interactions
Captopril-hydrochlorothiazide + Procainamide
Severity: Moderate
Captopril-hydrochlorothiazide and Procainamide: 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
Procainamide and its active metabolite are cleared in part by renal tubular secretion. Thiazides may reduce this clearance, raising levels and increasing risks of proarrhythmia or lupus-like effects. Thiazide-induced hypokalemia may also increase arrhythmia risk.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Procainamide 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.
Why it happens
Competition for renal tubular cationic secretion reduces procainamide clearance, and hypokalemia adds to proarrhythmic potential.
What to do
Monitor procainamide and NAPA levels, ECG and serum potassium. Adjust the procainamide dose accordingly.
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
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Procainamide?
MediHelp rates the interaction as moderate. Captopril-hydrochlorothiazide and Procainamide 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. Procainamide and its active metabolite are cleared in part by renal tubular secretion. Thiazides may reduce this clearance, raising levels and increasing risks of proarrhythmia or lupus-like effects. Thiazide-induced hypokalemia may also increase arrhythmia risk.
How serious is the interaction between Captopril-hydrochlorothiazide and Procainamide?
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 procainamide and NAPA levels, ECG and serum potassium. Adjust the procainamide dose accordingly.
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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