Drug interactions
Hydrochlorothiazide-losartan + Tizanidine
Severity: Moderate
Hydrochlorothiazide-losartan and Tizanidine: 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
Tizanidine is a centrally acting alpha-2 agonist that lowers blood pressure. Combined with losartan and hydrochlorothiazide it can produce additive hypotension, with dizziness or syncope, especially after the first doses or dose increases.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Tizanidine 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; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic blood pressure lowering through central sympatholytic action plus angiotensin receptor blockade and diuresis.
What to do
Monitor blood pressure and orthostatic symptoms when starting or titrating tizanidine. Reduce the tizanidine or antihypertensive dose if symptomatic hypotension occurs.
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 Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Tizanidine?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan and Tizanidine 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. Tizanidine is a centrally acting alpha-2 agonist that lowers blood pressure. Combined with losartan and hydrochlorothiazide it can produce additive hypotension, with dizziness or syncope, especially after the first doses or dose increases.
How serious is the interaction between Hydrochlorothiazide-losartan and Tizanidine?
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 blood pressure and orthostatic symptoms when starting or titrating tizanidine. Reduce the tizanidine or antihypertensive dose if symptomatic hypotension occurs.
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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