Drug interactions
Eplerenone + Hydrochlorothiazide-olmesartan
Severity: Major
Eplerenone and Hydrochlorothiazide-olmesartan: 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
Both olmesartan and eplerenone reduce aldosterone-mediated potassium excretion, so combined use can cause clinically significant hyperkalemia. The thiazide component offsets this only partly. Risk is greatest in renal impairment, diabetes and older patients.
What this interaction means in plain words
Eplerenone and Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular.
Why it happens
Additive inhibition of the renin-angiotensin-aldosterone system reduces renal potassium excretion.
What to do
Check potassium and renal function before starting, within the first week and regularly thereafter. Reduce or stop eplerenone if potassium rises above the acceptable range.
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-olmesartan, 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-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan 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-olmesartan?
MediHelp rates the interaction as major. Eplerenone and Hydrochlorothiazide-olmesartan 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. Both olmesartan and eplerenone reduce aldosterone-mediated potassium excretion, so combined use can cause clinically significant hyperkalemia. The thiazide component offsets this only partly. Risk is greatest in renal impairment, diabetes and older patients.
How serious is the interaction between Eplerenone and Hydrochlorothiazide-olmesartan?
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 renal function before starting, within the first week and regularly thereafter. Reduce or stop eplerenone if potassium rises above the acceptable range.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan 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.
