Drug interactions
Hydrochlorothiazide-losartan + Irbesartan
Severity: Major
Hydrochlorothiazide-losartan and Irbesartan: 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
Combining two angiotensin receptor blockers gives no added clinical benefit and raises the risk of hypotension, hyperkalemia and renal impairment. Dual renin-angiotensin system blockade has been associated with more adverse renal events.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Irbesartan 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; Irbesartan belongs to Cardiovascular.
Why it happens
Duplicate blockade of the AT1 receptor produces additive pharmacodynamic effects on blood pressure, aldosterone-mediated potassium retention and glomerular filtration.
What to do
Avoid using two ARBs together and keep a single agent. If it cannot be avoided, monitor potassium, creatinine and blood pressure 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?
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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
Other interactions of Irbesartan
- Aliskiren + Irbesartan Contraindicated
- Irbesartan + Sparsentan Contraindicated
- Amifostine + Irbesartan Major
- Amiloride + Irbesartan Major
- Amlodipine-benazepril + Irbesartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Irbesartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Irbesartan?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Irbesartan 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. Combining two angiotensin receptor blockers gives no added clinical benefit and raises the risk of hypotension, hyperkalemia and renal impairment. Dual renin-angiotensin system blockade has been associated with more adverse renal events.
How serious is the interaction between Hydrochlorothiazide-losartan and Irbesartan?
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 ARBs together and keep a single agent. If it cannot be avoided, monitor potassium, creatinine and blood pressure 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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