Drug interactions
Fosinopril-hydrochlorothiazide + Sacubitril / valsartan
Severity: Contraindicated
Fosinopril-hydrochlorothiazide and Sacubitril / valsartan: contraindicated 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
Concurrent ACE inhibition and neprilysin inhibition substantially increases the risk of angioedema, which may involve the airway. Additive RAS blockade also raises hypotension and hyperkalemia risk.
What this interaction means in plain words
Fosinopril-hydrochlorothiazide and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Combined ACE and neprilysin inhibition reduces bradykinin degradation, causing excess bradykinin and angioedema.
What to do
Never coadminister; leave at least 36 hours between stopping fosinopril and starting sacubitril/valsartan, or the reverse.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Fosinopril-hydrochlorothiazide
- Aliskiren + Fosinopril-hydrochlorothiazide Contraindicated
- Dofetilide + Fosinopril-hydrochlorothiazide Contraindicated
- Fosinopril-hydrochlorothiazide + Protein a column Contraindicated
- Aldesleukin + Fosinopril-hydrochlorothiazide Major
- Amifostine + Fosinopril-hydrochlorothiazide Major
- Amiloride + Fosinopril-hydrochlorothiazide Major
Frequently asked questions
Can I take Fosinopril-hydrochlorothiazide with Sacubitril / valsartan?
MediHelp rates the interaction as contraindicated. Fosinopril-hydrochlorothiazide and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Concurrent ACE inhibition and neprilysin inhibition substantially increases the risk of angioedema, which may involve the airway. Additive RAS blockade also raises hypotension and hyperkalemia risk.
How serious is the interaction between Fosinopril-hydrochlorothiazide and Sacubitril / valsartan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Never coadminister; leave at least 36 hours between stopping fosinopril and starting sacubitril/valsartan, or the reverse.
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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