Drug interactions
Hydrochlorothiazide-telmisartan + Levalbuterol
Severity: Moderate
Hydrochlorothiazide-telmisartan and Levalbuterol: 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
Levalbuterol can lower serum potassium through intracellular shift, and hydrochlorothiazide causes renal potassium loss. Together they may produce clinically relevant hypokalemia, which can provoke arrhythmias, mainly at higher beta-agonist doses.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Levalbuterol 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.
Why it happens
Additive hypokalemia from beta-2 stimulated cellular potassium uptake plus thiazide-induced urinary potassium loss.
What to do
Monitor serum potassium in patients using frequent or high-dose levalbuterol, and correct hypokalemia. Note that telmisartan partly offsets potassium loss.
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-telmisartan
- Aliskiren + Hydrochlorothiazide-telmisartan Contraindicated
- Dofetilide + Hydrochlorothiazide-telmisartan Contraindicated
- Hydrochlorothiazide-telmisartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-telmisartan Major
- Amifostine + Hydrochlorothiazide-telmisartan Major
- Amiloride + Hydrochlorothiazide-telmisartan Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Levalbuterol?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Levalbuterol 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. Levalbuterol can lower serum potassium through intracellular shift, and hydrochlorothiazide causes renal potassium loss. Together they may produce clinically relevant hypokalemia, which can provoke arrhythmias, mainly at higher beta-agonist doses.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Levalbuterol?
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 potassium in patients using frequent or high-dose levalbuterol, and correct hypokalemia. Note that telmisartan partly offsets potassium loss.
What other medicines interact with Hydrochlorothiazide-telmisartan?
MediHelp also lists interactions of Hydrochlorothiazide-telmisartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-telmisartan page.
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