Drug interactions
Hydrochlorothiazide-losartan + Insulin nph
Severity: Moderate
Hydrochlorothiazide-losartan and Insulin nph: 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
Angiotensin receptor blockers can improve insulin sensitivity and may increase the glucose-lowering effect of NPH insulin. Hypoglycemia may occur more often, especially after the ARB is started. Hydrochlorothiazide may raise glucose and partly offset this effect.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Insulin nph 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
ARBs may enhance insulin sensitivity, while thiazides can impair glucose tolerance, so the net effect on glycemic control is variable.
What to do
Monitor blood glucose more often when starting or stopping the combination and reduce the insulin dose if hypoglycemia occurs. Counsel the patient on the symptoms of hypoglycemia.
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-losartan
- Aliskiren + Hydrochlorothiazide-losartan Contraindicated
- Dofetilide + Hydrochlorothiazide-losartan Contraindicated
- Hydrochlorothiazide-losartan + Sparsentan Contraindicated
- Aceclofenac + Hydrochlorothiazide-losartan Major
- Aldesleukin + Hydrochlorothiazide-losartan Major
- Amifostine + Hydrochlorothiazide-losartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Insulin nph?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan and Insulin nph 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. Angiotensin receptor blockers can improve insulin sensitivity and may increase the glucose-lowering effect of NPH insulin. Hypoglycemia may occur more often, especially after the ARB is started. Hydrochlorothiazide may raise glucose and partly offset this effect.
How serious is the interaction between Hydrochlorothiazide-losartan and Insulin nph?
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 blood glucose more often when starting or stopping the combination and reduce the insulin dose if hypoglycemia occurs. Counsel the patient on the symptoms of hypoglycemia.
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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