Drug interactions
Hydrochlorothiazide-losartan + Tolvaptan
Severity: Moderate
Hydrochlorothiazide-losartan and Tolvaptan: 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
Tolvaptan is an aquaretic that causes substantial free-water loss, which with hydrochlorothiazide can add to volume depletion and hypotension. Losartan may cause potassium retention, and the net effect on potassium and renal function can be unpredictable.
What this interaction means in plain words
Hydrochlorothiazide-losartan and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Additive pharmacodynamic effects on fluid loss and electrolytes, with tolvaptan aquaresis, thiazide natriuresis and angiotensin receptor blockade.
What to do
Monitor serum sodium, potassium, creatinine, volume status and blood pressure closely, especially at initiation. Adjust diuretic doses if volume depletion develops.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-losartan and Tolvaptan, 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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-losartan with Tolvaptan?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-losartan and Tolvaptan 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. Tolvaptan is an aquaretic that causes substantial free-water loss, which with hydrochlorothiazide can add to volume depletion and hypotension. Losartan may cause potassium retention, and the net effect on potassium and renal function can be unpredictable.
How serious is the interaction between Hydrochlorothiazide-losartan and Tolvaptan?
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 serum sodium, potassium, creatinine, volume status and blood pressure closely, especially at initiation. Adjust diuretic doses if volume depletion develops.
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.
