Drug interactions
Eplerenone + Hydrochlorothiazide-irbesartan
Severity: Major
Eplerenone and Hydrochlorothiazide-irbesartan: 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 and irbesartan both reduce potassium excretion, so combining them raises the risk of significant hyperkalemia, particularly with renal impairment or diabetes. The hydrochlorothiazide component partly offsets this but does not remove the risk.
What this interaction means in plain words
Eplerenone and Hydrochlorothiazide-irbesartan 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; Hydrochlorothiazide-irbesartan belongs to Cardiovascular.
Why it happens
Additive suppression of aldosterone effects through mineralocorticoid receptor antagonism and angiotensin receptor blockade.
What to do
Check serum potassium and renal function before starting, within the first week and regularly afterward, and avoid potassium supplements and other potassium-raising drugs. Reduce or stop eplerenone if potassium rises above the accepted limit.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Eplerenone 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.
References
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 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 Hydrochlorothiazide-irbesartan?
MediHelp rates the interaction as major. Eplerenone and Hydrochlorothiazide-irbesartan 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 and irbesartan both reduce potassium excretion, so combining them raises the risk of significant hyperkalemia, particularly with renal impairment or diabetes. The hydrochlorothiazide component partly offsets this but does not remove the risk.
How serious is the interaction between Eplerenone and Hydrochlorothiazide-irbesartan?
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 serum potassium and renal function before starting, within the first week and regularly afterward, and avoid potassium supplements and other potassium-raising drugs. Reduce or stop eplerenone if potassium rises above the accepted limit.
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.
