Drug interactions
Hydrochlorothiazide-irbesartan + Sotalol
Severity: Major
Hydrochlorothiazide-irbesartan 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 can cause hypokalemia and hypomagnesemia, which increase the risk of QT prolongation and torsades de pointes with sotalol. Irbesartan and sotalol also add to blood pressure lowering and bradycardia.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan 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-irbesartan belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Diuretic-induced electrolyte depletion augments sotalol's class III QT prolongation, with additive antihypertensive and negative chronotropic effects.
What to do
Maintain potassium and magnesium in the normal range and monitor them regularly. Monitor ECG for QTc and heart rate, and adjust the sotalol dose to renal function.
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
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-irbesartan with Sotalol?
MediHelp rates the interaction as major. Hydrochlorothiazide-irbesartan 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 increase the risk of QT prolongation and torsades de pointes with sotalol. Irbesartan and sotalol also add to blood pressure lowering and bradycardia.
How serious is the interaction between Hydrochlorothiazide-irbesartan 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: Maintain potassium and magnesium in the normal range and monitor them regularly. Monitor ECG for QTc and heart rate, and adjust the sotalol dose to renal function.
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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