Drug interactions
Hydrochlorothiazide-losartan + Telmisartan
Severity: Major
Hydrochlorothiazide-losartan and Telmisartan: 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 telmisartan gives dual angiotensin receptor blockade, which increases the risk of hypotension, hyperkalemia and renal impairment without added cardiovascular benefit. The combination is generally discouraged.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Telmisartan 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; Telmisartan belongs to Cardiovascular.
Why it happens
Additive blockade of angiotensin II type 1 receptors, reducing aldosterone-mediated potassium excretion and glomerular filtration.
What to do
Avoid using two ARBs together; use a single agent titrated to dose. If coadministered, 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 Telmisartan
- Aliskiren + Telmisartan Contraindicated
- Sparsentan + Telmisartan Contraindicated
- Amifostine + Telmisartan Major
- Amiloride + Telmisartan Major
- Amlodipine-benazepril + Telmisartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Telmisartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Telmisartan?
MediHelp rates the interaction as major. Hydrochlorothiazide-losartan and Telmisartan 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 telmisartan gives dual angiotensin receptor blockade, which increases the risk of hypotension, hyperkalemia and renal impairment without added cardiovascular benefit. The combination is generally discouraged.
How serious is the interaction between Hydrochlorothiazide-losartan and Telmisartan?
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; use a single agent titrated to dose. If coadministered, 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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