Drug interactions
Hydrochlorothiazide-telmisartan + Metolazone
Severity: Major
Hydrochlorothiazide-telmisartan and Metolazone: 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
Metolazone added to a thiazide produces profound sequential nephron blockade with marked diuresis. This can cause severe hypokalemia, hyponatremia, volume depletion and hypotension, and telmisartan adds to the risk of renal dysfunction.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Metolazone 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; Metolazone belongs to Cardiovascular.
Why it happens
Duplicate thiazide-type inhibition of sodium chloride reabsorption causes additive electrolyte loss and volume depletion.
What to do
Avoid combining two thiazide-type diuretics unless intentionally prescribed for resistant edema. If used, monitor sodium, potassium, creatinine and volume status closely.
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 Metolazone
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Metolazone?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan and Metolazone 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. Metolazone added to a thiazide produces profound sequential nephron blockade with marked diuresis. This can cause severe hypokalemia, hyponatremia, volume depletion and hypotension, and telmisartan adds to the risk of renal dysfunction.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Metolazone?
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 combining two thiazide-type diuretics unless intentionally prescribed for resistant edema. If used, monitor sodium, potassium, creatinine and volume status closely.
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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