Drug interactions
Fosinopril-hydrochlorothiazide + Sotalol
Severity: Major
Fosinopril-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 can cause hypokalemia and hypomagnesemia, which raise the risk of QT prolongation and torsades de pointes with sotalol. Sotalol is also renally cleared, so reduced renal function from diuretic and ACE inhibitor use may increase exposure.
What this interaction means in plain words
Fosinopril-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.
Fosinopril-hydrochlorothiazide belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Thiazide-induced electrolyte depletion potentiates sotalol's class III QT prolongation, with possible reduced sotalol clearance.
What to do
Monitor and correct potassium and magnesium, and monitor ECG QT interval and renal function. Adjust the sotalol dose if renal function declines.
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 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
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 Fosinopril-hydrochlorothiazide with Sotalol?
MediHelp rates the interaction as major. Fosinopril-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 can cause hypokalemia and hypomagnesemia, which raise the risk of QT prolongation and torsades de pointes with sotalol. Sotalol is also renally cleared, so reduced renal function from diuretic and ACE inhibitor use may increase exposure.
How serious is the interaction between Fosinopril-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: Monitor and correct potassium and magnesium, and monitor ECG QT interval and renal function. Adjust the sotalol dose if renal function declines.
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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