Drug interactions
Hydrochlorothiazide-lisinopril + Tolvaptan
Severity: Moderate
Hydrochlorothiazide-lisinopril and Tolvaptan: 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
Tolvaptan causes aquaresis and, combined with a thiazide diuretic, can increase the risk of volume depletion, hypotension and rapid shifts in sodium. Tolvaptan may also raise serum potassium, while hydrochlorothiazide lowers it, so electrolyte effects are unpredictable. Rapid sodium correction is a serious risk, particularly with diuretic co-therapy.
What this interaction means in plain words
Hydrochlorothiazide-lisinopril and Tolvaptan 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.
Hydrochlorothiazide-lisinopril belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive diuretic and volume-depleting effects of V2-receptor antagonism and thiazide natriuresis, with opposing effects on potassium.
What to do
Monitor serum sodium, potassium, volume status and blood pressure closely, especially at initiation. Adjust or hold diuretic doses if dehydration or overly rapid sodium rise occurs.
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
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-lisinopril with Tolvaptan?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-lisinopril and Tolvaptan 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. Tolvaptan causes aquaresis and, combined with a thiazide diuretic, can increase the risk of volume depletion, hypotension and rapid shifts in sodium. Tolvaptan may also raise serum potassium, while hydrochlorothiazide lowers it, so electrolyte effects are unpredictable. Rapid sodium correction is a serious risk, particularly with diuretic co-therapy.
How serious is the interaction between Hydrochlorothiazide-lisinopril and Tolvaptan?
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 serum sodium, potassium, volume status and blood pressure closely, especially at initiation. Adjust or hold diuretic doses if dehydration or overly rapid sodium rise occurs.
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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