Drug interactions
Hydrochlorothiazide-irbesartan + Sacubitril / valsartan
Severity: Major
Hydrochlorothiazide-irbesartan and Sacubitril / valsartan: 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
Combining two angiotensin receptor blockers provides dual RAAS blockade with no added benefit and increases the risk of hypotension, hyperkalemia and renal impairment. The hydrochlorothiazide component does not make this combination appropriate.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Sacubitril / valsartan 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
Duplicate angiotensin II type 1 receptor blockade produces additive hypotension, reduced aldosterone and decreased renal potassium excretion.
What to do
Avoid using irbesartan together with sacubitril/valsartan; replace the irbesartan-containing product with an alternative antihypertensive if needed. If unavoidable, monitor blood pressure, potassium and creatinine closely.
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 Sacubitril / valsartan?
MediHelp rates the interaction as major. Hydrochlorothiazide-irbesartan and Sacubitril / valsartan 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. Combining two angiotensin receptor blockers provides dual RAAS blockade with no added benefit and increases the risk of hypotension, hyperkalemia and renal impairment. The hydrochlorothiazide component does not make this combination appropriate.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Sacubitril / valsartan?
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 using irbesartan together with sacubitril/valsartan; replace the irbesartan-containing product with an alternative antihypertensive if needed. If unavoidable, monitor blood pressure, potassium and creatinine closely.
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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