Drug interactions
Hydrochlorothiazide-losartan + Potassium citrate / citric acid
Severity: Major
Hydrochlorothiazide-losartan and Potassium citrate / citric acid: 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
Losartan reduces aldosterone-mediated potassium excretion, and potassium citrate adds a potassium load. This can cause hyperkalemia, especially in renal impairment, diabetes or older patients; hydrochlorothiazide partly counteracts the effect.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Potassium citrate / citric acid 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.
Why it happens
Additive increase in serum potassium through angiotensin II receptor blockade and potassium supplementation.
What to do
Monitor serum potassium and renal function regularly, and avoid the combination in patients with renal impairment or baseline hyperkalemia. Adjust or stop potassium therapy if levels rise.
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
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Potassium citrate / citric acid?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Potassium citrate / citric acid 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. Losartan reduces aldosterone-mediated potassium excretion, and potassium citrate adds a potassium load. This can cause hyperkalemia, especially in renal impairment, diabetes or older patients; hydrochlorothiazide partly counteracts the effect.
How serious is the interaction between Hydrochlorothiazide-losartan and Potassium citrate / citric acid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and renal function regularly, and avoid the combination in patients with renal impairment or baseline hyperkalemia. Adjust or stop potassium therapy if levels rise.
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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