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Drug interactions

Captopril-hydrochlorothiazide + Sotalol

Severity: Major

Captopril-hydrochlorothiazide and Sotalol: major interaction.

Last updated Sources: UK SmPC

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 can cause hypokalemia and hypomagnesemia, which increase the risk of QT prolongation and torsades de pointes with sotalol. This is a clinically important arrhythmia risk.

What this interaction means in plain words

Captopril-hydrochlorothiazide and Sotalol 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; Sotalol belongs to Cardiovascular.

Evidence level: High

Why it happens

Diuretic-induced electrolyte depletion potentiates sotalol's QT-prolonging effect.

What to do

Check potassium and magnesium before and during therapy and correct deficits. Monitor the ECG QT interval and renal function, and adjust sotalol dose as needed.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Captopril-hydrochlorothiazide with Sotalol?

MediHelp rates the interaction as major. Captopril-hydrochlorothiazide and Sotalol 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 can cause hypokalemia and hypomagnesemia, which increase the risk of QT prolongation and torsades de pointes with sotalol. This is a clinically important arrhythmia risk.

How serious is the interaction between Captopril-hydrochlorothiazide and Sotalol?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check potassium and magnesium before and during therapy and correct deficits. Monitor the ECG QT interval and renal function, and adjust sotalol dose as needed.

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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