Drug interactions
Hydrochlorothiazide-telmisartan + Mycophenolate
Severity: Moderate
Hydrochlorothiazide-telmisartan and Mycophenolate: 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
Telmisartan may lower mycophenolic acid exposure by increasing its glucuronidation, which could reduce immunosuppressive efficacy. Hydrochlorothiazide may compete for renal tubular secretion of mycophenolic acid metabolites, with uncertain clinical effect.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Mycophenolate 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
Telmisartan upregulates UGT1A9 via PPAR-gamma, increasing mycophenolic acid clearance, while thiazide competes for renal anionic secretion.
What to do
Monitor for signs of reduced immunosuppression and consider mycophenolic acid exposure monitoring when telmisartan is started or stopped. Consider another antihypertensive if exposure is inadequate.
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 Mycophenolate?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Mycophenolate 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. Telmisartan may lower mycophenolic acid exposure by increasing its glucuronidation, which could reduce immunosuppressive efficacy. Hydrochlorothiazide may compete for renal tubular secretion of mycophenolic acid metabolites, with uncertain clinical effect.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Mycophenolate?
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 for signs of reduced immunosuppression and consider mycophenolic acid exposure monitoring when telmisartan is started or stopped. Consider another antihypertensive if exposure is inadequate.
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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