Drug interactions
Fosinopril-hydrochlorothiazide + Procainamide
Severity: Moderate
Fosinopril-hydrochlorothiazide and Procainamide: moderate 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
Procainamide and its active metabolite NAPA are renally eliminated partly by tubular secretion, and thiazide-induced volume contraction or reduced renal clearance may raise their levels. Higher exposure increases the risk of proarrhythmia and QT prolongation, and thiazide-induced hypokalemia adds to this risk.
What this interaction means in plain words
Fosinopril-hydrochlorothiazide and Procainamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Reduced renal clearance of procainamide/NAPA, possibly via competition for tubular secretion, plus electrolyte disturbance from the thiazide.
What to do
Monitor procainamide and NAPA concentrations, ECG and serum potassium and magnesium. Adjust the procainamide dose according to levels and renal function.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fosinopril-hydrochlorothiazide
- Aliskiren + Fosinopril-hydrochlorothiazide Contraindicated
- Dofetilide + Fosinopril-hydrochlorothiazide Contraindicated
- Fosinopril-hydrochlorothiazide + Protein a column Contraindicated
- Fosinopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aldesleukin + Fosinopril-hydrochlorothiazide Major
- Amifostine + Fosinopril-hydrochlorothiazide Major
Frequently asked questions
Can I take Fosinopril-hydrochlorothiazide with Procainamide?
MediHelp rates the interaction as moderate. Fosinopril-hydrochlorothiazide and Procainamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Procainamide and its active metabolite NAPA are renally eliminated partly by tubular secretion, and thiazide-induced volume contraction or reduced renal clearance may raise their levels. Higher exposure increases the risk of proarrhythmia and QT prolongation, and thiazide-induced hypokalemia adds to this risk.
How serious is the interaction between Fosinopril-hydrochlorothiazide and Procainamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor procainamide and NAPA concentrations, ECG and serum potassium and magnesium. Adjust the procainamide dose according to levels and renal function.
What other medicines interact with Fosinopril-hydrochlorothiazide?
MediHelp also lists interactions of Fosinopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Fosinopril-hydrochlorothiazide page.
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