Drug interactions
Hydrochlorothiazide-telmisartan + Lithium
Severity: Major
Hydrochlorothiazide-telmisartan 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
Both thiazide diuretics and angiotensin receptor blockers reduce renal lithium clearance, so serum lithium can rise to toxic levels. Toxicity may present as tremor, confusion, ataxia, and in severe cases seizures or renal injury.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan 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-telmisartan belongs to Cardiovascular; Lithium belongs to Central Nervous System.
Why it happens
Thiazide-induced sodium depletion increases proximal lithium reabsorption, and angiotensin receptor blockade further reduces renal lithium excretion.
What to do
Avoid if possible; if combined, reduce the lithium dose and monitor serum lithium within the first week and after any dose change. Watch for signs of toxicity and monitor renal function and sodium.
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-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
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-telmisartan with Lithium?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan 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. Both thiazide diuretics and angiotensin receptor blockers reduce renal lithium clearance, so serum lithium can rise to toxic levels. Toxicity may present as tremor, confusion, ataxia, and in severe cases seizures or renal injury.
How serious is the interaction between Hydrochlorothiazide-telmisartan 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 if possible; if combined, reduce the lithium dose and monitor serum lithium within the first week and after any dose change. Watch for signs of toxicity and monitor renal function and sodium.
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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