Drug interactions
Hydrochlorothiazide-telmisartan + Midodrine
Severity: Minor
Hydrochlorothiazide-telmisartan and Midodrine: minor 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
Midodrine's active metabolite is secreted by renal tubules, so a competitive effect with thiazides is theoretically possible. Midodrine raises blood pressure and directly opposes the antihypertensive effect of the combination product. The pharmacokinetic effect is likely minor.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Midodrine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Hydrochlorothiazide-telmisartan belongs to Cardiovascular; Midodrine belongs to Miscellaneous.
Why it happens
Theoretical competition for renal tubular secretion, plus pharmacodynamic opposition of vasopressor and antihypertensive effects.
What to do
Monitor blood pressure, including supine readings, and adjust the doses of each drug to the clinical goal. Avoid supine hypertension.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Midodrine?
MediHelp rates the interaction as minor. Hydrochlorothiazide-telmisartan and Midodrine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Midodrine's active metabolite is secreted by renal tubules, so a competitive effect with thiazides is theoretically possible. Midodrine raises blood pressure and directly opposes the antihypertensive effect of the combination product. The pharmacokinetic effect is likely minor.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Midodrine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, including supine readings, and adjust the doses of each drug to the clinical goal. Avoid supine hypertension.
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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