Drug interactions
Hydrochlorothiazide-lisinopril + Sacubitril / valsartan
Severity: Contraindicated
Hydrochlorothiazide-lisinopril and Sacubitril / valsartan: contraindicated 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 lisinopril with sacubitril/valsartan is contraindicated because of angioedema risk. Dual RAAS blockade also increases hypotension, hyperkalemia and renal dysfunction. Hydrochlorothiazide adds volume depletion and further hypotension risk.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
ACE inhibition plus neprilysin inhibition raises bradykinin levels, causing angioedema, and dual RAAS blockade compounds hypotension and hyperkalemia.
What to do
Do not use together. Allow a 36-hour washout after stopping the ACE inhibitor before starting sacubitril/valsartan, and vice versa.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Hydrochlorothiazide-lisinopril
- Dofetilide + Hydrochlorothiazide-lisinopril Contraindicated
- Amifostine + Hydrochlorothiazide-lisinopril Major
- Amiloride + Hydrochlorothiazide-lisinopril Major
- Benazepril + Hydrochlorothiazide-lisinopril Major
- Bendroflumethiazide + Hydrochlorothiazide-lisinopril Major
- Candesartan + Hydrochlorothiazide-lisinopril Major
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Sacubitril / valsartan?
MediHelp rates the interaction as contraindicated. Hydrochlorothiazide-lisinopril and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining lisinopril with sacubitril/valsartan is contraindicated because of angioedema risk. Dual RAAS blockade also increases hypotension, hyperkalemia and renal dysfunction. Hydrochlorothiazide adds volume depletion and further hypotension risk.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Sacubitril / valsartan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together. Allow a 36-hour washout after stopping the ACE inhibitor before starting sacubitril/valsartan, and vice versa.
What other medicines interact with Hydrochlorothiazide-lisinopril?
MediHelp also lists interactions of Hydrochlorothiazide-lisinopril with, for example, Dofetilide, Amifostine, Amiloride. The full list is on the Hydrochlorothiazide-lisinopril page.
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