Drug interactions
Hydrochlorothiazide-olmesartan + Tolvaptan
Severity: Moderate
Hydrochlorothiazide-olmesartan 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 causes aquaresis and may increase serum sodium rapidly, with possible volume depletion when combined with a thiazide. Potassium may rise with the ARB, and dehydration increases the risk of hypotension and renal impairment.
What this interaction means in plain words
Hydrochlorothiazide-olmesartan 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-olmesartan belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive fluid and electrolyte shifts from vasopressin antagonism, thiazide diuresis and ARB effects on potassium and renal hemodynamics.
What to do
Monitor serum sodium, potassium, creatinine, volume status and blood pressure closely, especially during initiation. Ensure adequate fluid intake.
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-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 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-olmesartan with Tolvaptan?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-olmesartan 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 causes aquaresis and may increase serum sodium rapidly, with possible volume depletion when combined with a thiazide. Potassium may rise with the ARB, and dehydration increases the risk of hypotension and renal impairment.
How serious is the interaction between Hydrochlorothiazide-olmesartan 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 during initiation. Ensure adequate fluid intake.
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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