Drug interactions
Eprosartan-hydrochlorothiazide + Trimethoprim
Severity: Major
Eprosartan-hydrochlorothiazide and Trimethoprim: 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
Trimethoprim blocks epithelial sodium channels in the distal nephron and reduces potassium excretion, and an ARB further limits aldosterone-mediated potassium loss. Hyperkalemia can be severe, especially in older patients, those with renal impairment or on high trimethoprim doses. The hydrochlorothiazide component only partly offsets this.
What this interaction means in plain words
Eprosartan-hydrochlorothiazide and Trimethoprim 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; Trimethoprim belongs to Anti Bacterial.
Why it happens
Additive reduction of renal potassium excretion through ENaC blockade by trimethoprim and angiotensin receptor blockade.
What to do
Check serum potassium and creatinine within several days of starting trimethoprim and avoid the combination in renal impairment; choose an alternative antibiotic when possible.
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 Trimethoprim
Frequently asked questions
Can I take Eprosartan-hydrochlorothiazide with Trimethoprim?
MediHelp rates the interaction as major. Eprosartan-hydrochlorothiazide and Trimethoprim 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. Trimethoprim blocks epithelial sodium channels in the distal nephron and reduces potassium excretion, and an ARB further limits aldosterone-mediated potassium loss. Hyperkalemia can be severe, especially in older patients, those with renal impairment or on high trimethoprim doses. The hydrochlorothiazide component only partly offsets this.
How serious is the interaction between Eprosartan-hydrochlorothiazide and Trimethoprim?
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 creatinine within several days of starting trimethoprim and avoid the combination in renal impairment; choose an alternative antibiotic when possible.
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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