Drug interactions
Hydrochlorothiazide-irbesartan + Lily of the valley
Severity: Major
Hydrochlorothiazide-irbesartan and Lily of the valley: 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
Lily of the valley contains cardiac glycosides with digoxin-like activity. Thiazide-induced hypokalemia and hypomagnesemia increase sensitivity to these glycosides and the risk of arrhythmias.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Lily of the valley 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.
Why it happens
Diuretic-induced potassium and magnesium depletion enhances myocardial sensitivity to cardiac glycosides.
What to do
Avoid the herbal product, which has a narrow therapeutic margin and is unstandardized. If exposure occurs, monitor potassium, magnesium and ECG.
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-irbesartan
- Aliskiren + Hydrochlorothiazide-irbesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-irbesartan Contraindicated
- Hydrochlorothiazide-irbesartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-irbesartan Major
- Amifostine + Hydrochlorothiazide-irbesartan Major
- Amiloride + Hydrochlorothiazide-irbesartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-irbesartan with Lily of the valley?
MediHelp rates the interaction as major. Hydrochlorothiazide-irbesartan and Lily of the valley 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. Lily of the valley contains cardiac glycosides with digoxin-like activity. Thiazide-induced hypokalemia and hypomagnesemia increase sensitivity to these glycosides and the risk of arrhythmias.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Lily of the valley?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the herbal product, which has a narrow therapeutic margin and is unstandardized. If exposure occurs, monitor potassium, magnesium and ECG.
What other medicines interact with Hydrochlorothiazide-irbesartan?
MediHelp also lists interactions of Hydrochlorothiazide-irbesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-irbesartan page.
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