Drug interactions
Eprosartan-hydrochlorothiazide + Metolazone
Severity: Major
Eprosartan-hydrochlorothiazide and Metolazone: major 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
Metolazone is often added to a thiazide for sequential nephron blockade, and the combination produces a markedly stronger diuresis. This can cause profound hypokalemia, hyponatremia, hypovolemia and reduced renal function.
What this interaction means in plain words
Eprosartan-hydrochlorothiazide and Metolazone 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.
Eprosartan-hydrochlorothiazide belongs to Cardiovascular; Metolazone belongs to Cardiovascular.
Why it happens
Additive inhibition of sodium reabsorption in the distal tubule, as both agents act on the same thiazide-sensitive transporter, with added effects on electrolyte and fluid loss.
What to do
Avoid concurrent use of two thiazide-type drugs unless deliberately prescribed for resistant edema. If used, monitor electrolytes, creatinine and volume status closely, starting within the first few days.
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 Eprosartan-hydrochlorothiazide and Metolazone, 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 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 Metolazone
Frequently asked questions
Can I take Eprosartan-hydrochlorothiazide with Metolazone?
MediHelp rates the interaction as major. Eprosartan-hydrochlorothiazide and Metolazone 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. Metolazone is often added to a thiazide for sequential nephron blockade, and the combination produces a markedly stronger diuresis. This can cause profound hypokalemia, hyponatremia, hypovolemia and reduced renal function.
How serious is the interaction between Eprosartan-hydrochlorothiazide and Metolazone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use of two thiazide-type drugs unless deliberately prescribed for resistant edema. If used, monitor electrolytes, creatinine and volume status closely, starting within the first few days.
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.
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.
