Drug interactions
Eprosartan-hydrochlorothiazide + Sotalol
Severity: Major
Eprosartan-hydrochlorothiazide and Sotalol: major interaction.
Last updated Sources: UK SmPC
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
Hydrochlorothiazide may cause hypokalemia and hypomagnesemia, which markedly increase the risk of QT prolongation and torsades de pointes with sotalol. Additive hypotension and bradycardia may also occur with the combination.
What this interaction means in plain words
Eprosartan-hydrochlorothiazide and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Diuretic-induced hypokalemia and hypomagnesemia potentiate the QT-prolonging class III action of sotalol, with additive beta-blocking and antihypertensive effects.
What to do
Correct and monitor potassium and magnesium, and obtain baseline and follow-up ECGs for QT interval. Adjust the sotalol dose according to renal function and QT response.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Eprosartan-hydrochlorothiazide with Sotalol?
MediHelp rates the interaction as major. Eprosartan-hydrochlorothiazide and Sotalol 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. Hydrochlorothiazide may cause hypokalemia and hypomagnesemia, which markedly increase the risk of QT prolongation and torsades de pointes with sotalol. Additive hypotension and bradycardia may also occur with the combination.
How serious is the interaction between Eprosartan-hydrochlorothiazide and Sotalol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Correct and monitor potassium and magnesium, and obtain baseline and follow-up ECGs for QT interval. Adjust the sotalol dose according to renal function and QT response.
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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