Drug interactions
Hydrochlorothiazide + Sotalol
Severity: Major
Hydrochlorothiazide and Sotalol: major 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
Hydrochlorothiazide-induced hypokalemia and hypomagnesemia markedly increase the risk of QT prolongation and torsades de pointes with sotalol. This is a clinically important interaction despite the slight potassium-raising tendency of beta-blockers.
What this interaction means in plain words
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 belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Thiazide-induced hypokalemia and hypomagnesemia add to the potassium channel blocking, QT-prolonging effect of sotalol.
What to do
Check and correct potassium and magnesium before and during sotalol therapy, keeping potassium in the normal range. Monitor ECG and QT interval, especially after dose changes.
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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Other interactions of Hydrochlorothiazide
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 Hydrochlorothiazide with Sotalol?
MediHelp rates the interaction as major. 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-induced hypokalemia and hypomagnesemia markedly increase the risk of QT prolongation and torsades de pointes with sotalol. This is a clinically important interaction despite the slight potassium-raising tendency of beta-blockers.
How serious is the interaction between 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: Check and correct potassium and magnesium before and during sotalol therapy, keeping potassium in the normal range. Monitor ECG and QT interval, especially after dose changes.
What other medicines interact with Hydrochlorothiazide?
MediHelp also lists interactions of Hydrochlorothiazide with, for example, Dofetilide, Amifostine, Amiodarone. The full list is on the Hydrochlorothiazide page.
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