Drug interactions
Empagliflozin + Hydrochlorothiazide-irbesartan
Severity: Moderate
Empagliflozin and Hydrochlorothiazide-irbesartan: 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
Empagliflozin causes osmotic diuresis and mild natriuresis, which adds to the diuretic effect of hydrochlorothiazide and an ARB. This can lead to volume depletion, hypotension and acute kidney function decline, particularly in elderly patients.
What this interaction means in plain words
Empagliflozin and Hydrochlorothiazide-irbesartan 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.
Empagliflozin belongs to Endocrine; Hydrochlorothiazide-irbesartan belongs to Cardiovascular.
Why it happens
Additive natriuresis and volume depletion from SGLT2 inhibition, thiazide action and RAAS blockade.
What to do
Assess volume status and renal function before and after starting empagliflozin, and consider reducing the diuretic dose if the patient is volume-depleted. Counsel on hydration and sick-day rules.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Empagliflozin and Hydrochlorothiazide-irbesartan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Hydrochlorothiazide-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan Major
Other interactions of Empagliflozin
- Amiloride + Empagliflozin Moderate
- Amlodipine-hydrochlorothiazide-valsartan + Empagliflozin Moderate
- Amlodipine-olmesartan-hydrochlorothiazide + Empagliflozin Moderate
- Atenolol-chlorthalidone + Empagliflozin Moderate
- Azilsartan-chlorthalidone + Empagliflozin Moderate
- Bendroflumethiazide + Empagliflozin Moderate
Frequently asked questions
Can I take Empagliflozin with Hydrochlorothiazide-irbesartan?
MediHelp rates the interaction as moderate. Empagliflozin and Hydrochlorothiazide-irbesartan 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. Empagliflozin causes osmotic diuresis and mild natriuresis, which adds to the diuretic effect of hydrochlorothiazide and an ARB. This can lead to volume depletion, hypotension and acute kidney function decline, particularly in elderly patients.
How serious is the interaction between Empagliflozin and Hydrochlorothiazide-irbesartan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess volume status and renal function before and after starting empagliflozin, and consider reducing the diuretic dose if the patient is volume-depleted. Counsel on hydration and sick-day rules.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
