Drug interactions
Hydrochlorothiazide-losartan + Sacubitril / valsartan
Severity: Major
Hydrochlorothiazide-losartan and Sacubitril / valsartan: 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 losartan with valsartan, as in sacubitril/valsartan, is dual angiotensin receptor blockade and increases risk of hypotension, hyperkalemia and renal impairment without added benefit. Hydrochlorothiazide adds further hypotension and volume depletion.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Sacubitril / valsartan 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
Duplicate angiotensin II receptor blockade with additive hypotensive and potassium-retaining effects.
What to do
Avoid using losartan with sacubitril/valsartan; stop losartan when switching and monitor blood pressure, potassium and creatinine if the thiazide is continued.
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 Sacubitril / valsartan?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Sacubitril / valsartan 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 losartan with valsartan, as in sacubitril/valsartan, is dual angiotensin receptor blockade and increases risk of hypotension, hyperkalemia and renal impairment without added benefit. Hydrochlorothiazide adds further hypotension and volume depletion.
How serious is the interaction between Hydrochlorothiazide-losartan and Sacubitril / valsartan?
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 losartan with sacubitril/valsartan; stop losartan when switching and monitor blood pressure, potassium and creatinine if the thiazide is continued.
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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