Drug interactions
Hydrochlorothiazide-losartan + Midodrine
Severity: Moderate
Hydrochlorothiazide-losartan and Midodrine: 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
Midodrine's active metabolite is secreted by renal tubular transport, so thiazides may slightly raise its levels. More relevant, midodrine raises blood pressure and opposes the antihypertensive intent of this combination.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Midodrine 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-losartan belongs to Cardiovascular; Midodrine belongs to Miscellaneous.
Why it happens
Pharmacodynamic opposition (alpha-1 vasoconstriction versus blood pressure lowering) plus possible minor tubular competition.
What to do
Monitor supine and standing blood pressure, and reassess the need for each agent in patients with orthostatic hypotension.
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
Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Midodrine?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan and Midodrine 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. Midodrine's active metabolite is secreted by renal tubular transport, so thiazides may slightly raise its levels. More relevant, midodrine raises blood pressure and opposes the antihypertensive intent of this combination.
How serious is the interaction between Hydrochlorothiazide-losartan and Midodrine?
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 supine and standing blood pressure, and reassess the need for each agent in patients with orthostatic hypotension.
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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