Drug interactions
Hydrochlorothiazide-irbesartan + Squill
Severity: Major
Hydrochlorothiazide-irbesartan and Squill: 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 lower serum potassium and magnesium, and hypokalemia increases sensitivity to cardiac glycosides. Squill has digitalis-like cardioactive glycosides, so arrhythmia and glycoside toxicity become more likely.
What this interaction means in plain words
Hydrochlorothiazide-irbesartan and Squill 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
Thiazide-induced potassium and magnesium depletion sensitizes the myocardium to the cardiac glycoside effects of squill.
What to do
Avoid squill where possible; if unavoidable, monitor serum potassium and magnesium and correct deficits promptly. Monitor ECG for arrhythmias.
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 Squill?
MediHelp rates the interaction as major. Hydrochlorothiazide-irbesartan and Squill 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 lower serum potassium and magnesium, and hypokalemia increases sensitivity to cardiac glycosides. Squill has digitalis-like cardioactive glycosides, so arrhythmia and glycoside toxicity become more likely.
How serious is the interaction between Hydrochlorothiazide-irbesartan and Squill?
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 squill where possible; if unavoidable, monitor serum potassium and magnesium and correct deficits promptly. Monitor ECG for arrhythmias.
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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