Drug interactions
Captopril-hydrochlorothiazide + Tolvaptan
Severity: Moderate
Captopril-hydrochlorothiazide and Tolvaptan: 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
Tolvaptan can raise serum potassium, and when it is combined with an ACE inhibitor the hyperkalemia risk may increase. The thiazide component lowers potassium and may partly offset this, but the net effect is unpredictable. Tolvaptan also causes aquaresis, which adds to volume depletion and hypotension with diuretics.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Additive effects on potassium handling (ACE inhibitor reduces aldosterone, tolvaptan raises potassium, thiazide wastes potassium) and additive volume depletion.
What to do
Monitor serum potassium, sodium and renal function after starting or changing doses. Watch for volume depletion and hypotension.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Tolvaptan?
MediHelp rates the interaction as moderate. Captopril-hydrochlorothiazide and Tolvaptan 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. Tolvaptan can raise serum potassium, and when it is combined with an ACE inhibitor the hyperkalemia risk may increase. The thiazide component lowers potassium and may partly offset this, but the net effect is unpredictable. Tolvaptan also causes aquaresis, which adds to volume depletion and hypotension with diuretics.
How serious is the interaction between Captopril-hydrochlorothiazide and Tolvaptan?
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 serum potassium, sodium and renal function after starting or changing doses. Watch for volume depletion and hypotension.
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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