Drug interactions
Hydrochlorothiazide-olmesartan + Lithium
Severity: Major
Hydrochlorothiazide-olmesartan and Lithium: 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 diuretics and angiotensin receptor blockers both reduce renal lithium clearance, and together they can raise serum lithium into the toxic range. Toxicity may present with tremor, confusion, ataxia and, in severe cases, seizures or renal injury.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan and Lithium 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-olmesartan belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Thiazide-induced sodium depletion and RAS blockade increase proximal tubular reabsorption of lithium, reducing its renal clearance.
What to do
Avoid the combination where possible; if used, reduce the lithium dose and monitor serum lithium within the first week and after any dose change. Watch for signs of toxicity and maintain hydration.
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-olmesartan and Lithium, 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-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
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Hydrochlorothiazide-olmesartan with Lithium?
MediHelp rates the interaction as major. Hydrochlorothiazide-olmesartan and Lithium 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 diuretics and angiotensin receptor blockers both reduce renal lithium clearance, and together they can raise serum lithium into the toxic range. Toxicity may present with tremor, confusion, ataxia and, in severe cases, seizures or renal injury.
How serious is the interaction between Hydrochlorothiazide-olmesartan and Lithium?
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 the combination where possible; if used, reduce the lithium dose and monitor serum lithium within the first week and after any dose change. Watch for signs of toxicity and maintain hydration.
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.
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.
