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Drug interactions

Hydrochlorothiazide-losartan + Indapamide

Severity: Major

Hydrochlorothiazide-losartan and Indapamide: 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

Indapamide is a thiazide-like diuretic and duplicates the action of hydrochlorothiazide. The combination increases the risk of hypokalemia, hyponatremia, volume depletion and renal impairment.

What this interaction means in plain words

Hydrochlorothiazide-losartan and Indapamide 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-losartan belongs to Cardiovascular; Indapamide belongs to Cardiovascular.

Evidence level: Moderate

Why it happens

Duplicate thiazide-type diuretic action at the distal tubule giving additive natriuresis and potassium loss.

What to do

Avoid using two thiazide-type diuretics together; choose one agent. If the combination is unavoidable, monitor sodium, potassium and renal function closely.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Hydrochlorothiazide-losartan with Indapamide?

MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Indapamide 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. Indapamide is a thiazide-like diuretic and duplicates the action of hydrochlorothiazide. The combination increases the risk of hypokalemia, hyponatremia, volume depletion and renal impairment.

How serious is the interaction between Hydrochlorothiazide-losartan and Indapamide?

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 using two thiazide-type diuretics together; choose one agent. If the combination is unavoidable, monitor sodium, potassium and renal function closely.

What other medicines interact with Hydrochlorothiazide-losartan?

MediHelp also lists interactions of Hydrochlorothiazide-losartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-losartan page.

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