Drug interactions
Hydrochlorothiazide-telmisartan + Perindopril
Severity: Major
Hydrochlorothiazide-telmisartan and Perindopril: 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
Combining an ACE inhibitor with an angiotensin receptor blocker produces dual renin-angiotensin system blockade. This raises the risk of symptomatic hypotension, hyperkalemia and acute kidney injury without a clear gain in cardiovascular outcomes.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Perindopril 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; Perindopril belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic suppression of the renin-angiotensin-aldosterone system, reducing glomerular filtration pressure and potassium excretion.
What to do
Avoid the combination in most patients and use a single RAAS blocker. If it is used, monitor blood pressure, serum potassium and creatinine 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 Perindopril
- Aliskiren + Perindopril Contraindicated
- Perindopril + Protein a column Contraindicated
- Perindopril + Sacubitril / valsartan Contraindicated
- Perindopril + Sacubitril-valsartan Contraindicated
- Amifostine + Perindopril Major
- Amiloride + Perindopril Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Perindopril?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan and Perindopril 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. Combining an ACE inhibitor with an angiotensin receptor blocker produces dual renin-angiotensin system blockade. This raises the risk of symptomatic hypotension, hyperkalemia and acute kidney injury without a clear gain in cardiovascular outcomes.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Perindopril?
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 the combination in most patients and use a single RAAS blocker. If it is used, monitor blood pressure, serum potassium and creatinine 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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