Drug interactions
Hydrochlorothiazide-losartan + Sotalol
Severity: Major
Hydrochlorothiazide-losartan and Sotalol: 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
Thiazide-induced hypokalemia and hypomagnesemia significantly increase the risk of QT prolongation and torsades de pointes with sotalol. Additive blood pressure lowering and bradycardia can also occur with losartan.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Thiazide-related electrolyte depletion potentiates sotalol's class III QT-prolonging effect, with additive hemodynamic effects.
What to do
Monitor and keep serum potassium and magnesium within normal range, and check QTc at initiation and with dose changes. Consider an alternative to the thiazide if electrolytes cannot be maintained.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-losartan and Sotalol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Sotalol?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Sotalol 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. Thiazide-induced hypokalemia and hypomagnesemia significantly increase the risk of QT prolongation and torsades de pointes with sotalol. Additive blood pressure lowering and bradycardia can also occur with losartan.
How serious is the interaction between Hydrochlorothiazide-losartan and Sotalol?
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 and keep serum potassium and magnesium within normal range, and check QTc at initiation and with dose changes. Consider an alternative to the thiazide if electrolytes cannot be maintained.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
