Drug interactions
Eplerenone + Eprosartan-hydrochlorothiazide
Severity: Major
Eplerenone and Eprosartan-hydrochlorothiazide: 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
Eplerenone is a potassium-sparing aldosterone antagonist and, combined with an angiotensin receptor blocker, markedly increases the risk of hyperkalemia. Risk is greatest with renal impairment, diabetes and older age. The thiazide partly counteracts potassium retention but does not remove the risk.
What this interaction means in plain words
Eplerenone and Eprosartan-hydrochlorothiazide 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.
Eplerenone belongs to Cardiovascular; Eprosartan-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
Additive reduction of aldosterone-mediated potassium excretion through receptor blockade of both angiotensin II and mineralocorticoid actions.
What to do
Check potassium and creatinine at baseline, within the first week and regularly afterwards. Reduce or stop eplerenone if potassium rises above the normal range, and avoid potassium supplements.
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 Eprosartan-hydrochlorothiazide
- Aliskiren + Eprosartan-hydrochlorothiazide Contraindicated
- Dofetilide + Eprosartan-hydrochlorothiazide Contraindicated
- Eprosartan-hydrochlorothiazide + Sparsentan Contraindicated
- Aceclofenac + Eprosartan-hydrochlorothiazide Major
- Aldesleukin + Eprosartan-hydrochlorothiazide Major
- Amifostine + Eprosartan-hydrochlorothiazide Major
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Eplerenone with Eprosartan-hydrochlorothiazide?
MediHelp rates the interaction as major. Eplerenone and Eprosartan-hydrochlorothiazide 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. Eplerenone is a potassium-sparing aldosterone antagonist and, combined with an angiotensin receptor blocker, markedly increases the risk of hyperkalemia. Risk is greatest with renal impairment, diabetes and older age. The thiazide partly counteracts potassium retention but does not remove the risk.
How serious is the interaction between Eplerenone and Eprosartan-hydrochlorothiazide?
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 creatinine at baseline, within the first week and regularly afterwards. Reduce or stop eplerenone if potassium rises above the normal range, and avoid potassium supplements.
What other medicines interact with Eprosartan-hydrochlorothiazide?
MediHelp also lists interactions of Eprosartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Eprosartan-hydrochlorothiazide page.
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