Drug interactions
Hydrochlorothiazide-lisinopril + Procainamide
Severity: Moderate
Hydrochlorothiazide-lisinopril and Procainamide: moderate 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
Procainamide is partly cleared by renal tubular cationic secretion, and thiazide-induced electrolyte disturbances can enhance its proarrhythmic risk. Hypokalemia and hypomagnesemia from hydrochlorothiazide can promote QT prolongation and torsades with procainamide. Reduced renal clearance may also raise procainamide and NAPA levels.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Procainamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Possible competition for renal tubular secretion, plus diuretic-induced hypokalemia and hypomagnesemia that increase arrhythmia susceptibility.
What to do
Monitor ECG, procainamide and NAPA levels, and electrolytes. Correct potassium and magnesium deficits and adjust procainamide dose, especially with renal impairment.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Procainamide?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-lisinopril and Procainamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Procainamide is partly cleared by renal tubular cationic secretion, and thiazide-induced electrolyte disturbances can enhance its proarrhythmic risk. Hypokalemia and hypomagnesemia from hydrochlorothiazide can promote QT prolongation and torsades with procainamide. Reduced renal clearance may also raise procainamide and NAPA levels.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Procainamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG, procainamide and NAPA levels, and electrolytes. Correct potassium and magnesium deficits and adjust procainamide dose, especially with renal impairment.
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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