Drug interactions
Cyclosporine + Hydrochlorothiazide-telmisartan
Severity: Major
Cyclosporine and Hydrochlorothiazide-telmisartan: 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
Cyclosporine causes potassium retention and renal vasoconstriction, so with telmisartan there is a risk of hyperkalemia and renal impairment. Thiazide-related hyponatremia and hyperuricemia can also be compounded.
What this interaction means in plain words
Cyclosporine and Hydrochlorothiazide-telmisartan 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.
Why it happens
Additive hyperkalemic and renal effects, plus cyclosporine inhibition of OATP-mediated hepatic uptake of telmisartan.
What to do
Monitor serum potassium, sodium, creatinine and uric acid closely, and check cyclosporine levels. Reduce the telmisartan dose or change therapy if hyperkalemia or renal decline develops.
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 Hydrochlorothiazide-telmisartan
- Aliskiren + Hydrochlorothiazide-telmisartan Contraindicated
- Dofetilide + Hydrochlorothiazide-telmisartan Contraindicated
- Hydrochlorothiazide-telmisartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-telmisartan Major
- Amifostine + Hydrochlorothiazide-telmisartan Major
- Amiloride + Hydrochlorothiazide-telmisartan Major
Frequently asked questions
Can I take Cyclosporine with Hydrochlorothiazide-telmisartan?
MediHelp rates the interaction as major. Cyclosporine and Hydrochlorothiazide-telmisartan 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. Cyclosporine causes potassium retention and renal vasoconstriction, so with telmisartan there is a risk of hyperkalemia and renal impairment. Thiazide-related hyponatremia and hyperuricemia can also be compounded.
How serious is the interaction between Cyclosporine and Hydrochlorothiazide-telmisartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium, sodium, creatinine and uric acid closely, and check cyclosporine levels. Reduce the telmisartan dose or change therapy if hyperkalemia or renal decline develops.
What other medicines interact with Hydrochlorothiazide-telmisartan?
MediHelp also lists interactions of Hydrochlorothiazide-telmisartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-telmisartan page.
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