Drug interactions
Hydrochlorothiazide-olmesartan + Lily of the valley
Severity: Major
Hydrochlorothiazide-olmesartan and Lily of the valley: 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
Lily of the valley contains cardiac glycosides, and hydrochlorothiazide-induced hypokalemia and hypomagnesemia increase susceptibility to glycoside-related arrhythmias. Herbal glycoside content is unstandardized and toxicity can be serious.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan and Lily of the valley 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
Thiazide-induced hypokalemia and hypomagnesemia sensitize the myocardium to cardiac glycoside toxicity.
What to do
Advise avoiding lily of the valley preparations. If exposure occurs, check potassium, magnesium and ECG and correct electrolyte disturbances.
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-olmesartan
- Aliskiren + Hydrochlorothiazide-olmesartan Contraindicated
- Dofetilide + Hydrochlorothiazide-olmesartan Contraindicated
- Hydrochlorothiazide-olmesartan + Sparsentan Contraindicated
- Acemetacin + Hydrochlorothiazide-olmesartan Major
- Amifostine + Hydrochlorothiazide-olmesartan Major
- Amiloride + Hydrochlorothiazide-olmesartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-olmesartan with Lily of the valley?
MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan and Lily of the valley 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. Lily of the valley contains cardiac glycosides, and hydrochlorothiazide-induced hypokalemia and hypomagnesemia increase susceptibility to glycoside-related arrhythmias. Herbal glycoside content is unstandardized and toxicity can be serious.
How serious is the interaction between Hydrochlorothiazide-olmesartan and Lily of the valley?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise avoiding lily of the valley preparations. If exposure occurs, check potassium, magnesium and ECG and correct electrolyte disturbances.
What other medicines interact with Hydrochlorothiazide-olmesartan?
MediHelp also lists interactions of Hydrochlorothiazide-olmesartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-olmesartan page.
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