Drug interactions
Hydrochlorothiazide-lisinopril + Lithium
Severity: Major
Hydrochlorothiazide-lisinopril and Lithium: 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
Thiazide diuretics and ACE inhibitors both reduce renal lithium clearance, so serum lithium concentrations can rise substantially. This may lead to lithium toxicity with tremor, confusion, ataxia, and arrhythmias.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Lithium 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-lisinopril belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Thiazide-induced sodium depletion and ACE inhibitor effects increase proximal tubular lithium reabsorption and decrease its renal excretion.
What to do
Avoid the combination where possible; if used, reduce the lithium dose and check serum lithium levels within the first week and after any dose change. Counsel the patient on symptoms of toxicity and dehydration.
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-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Hydrochlorothiazide-lisinopril + Sacubitril / valsartan Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril Major
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Lithium?
MediHelp rates the interaction as major. Hydrochlorothiazide-lisinopril and Lithium 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. Thiazide diuretics and ACE inhibitors both reduce renal lithium clearance, so serum lithium concentrations can rise substantially. This may lead to lithium toxicity with tremor, confusion, ataxia, and arrhythmias.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Lithium?
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 combination where possible; if used, reduce the lithium dose and check serum lithium levels within the first week and after any dose change. Counsel the patient on symptoms of toxicity and dehydration.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Sacubitril / valsartan, Amifostine. The full list is on the Hydrochlorothiazide-lisinopril page.
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