Drug interactions
Hydrochlorothiazide-telmisartan + Pirbuterol
Severity: Moderate
Hydrochlorothiazide-telmisartan and Pirbuterol: 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
Pirbuterol, a beta-2 agonist, can lower serum potassium by shifting it into cells, and hydrochlorothiazide causes potassium loss through the kidney. Together they can produce clinically relevant hypokalemia, which raises arrhythmia risk, particularly with high doses of the bronchodilator. Telmisartan partly offsets potassium loss but not reliably.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Pirbuterol 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
Additive hypokalemia from beta-2 mediated intracellular potassium shift and thiazide-induced renal potassium wasting.
What to do
Check serum potassium in patients using frequent or high-dose pirbuterol with the thiazide combination, and replace potassium if low. Use the lowest effective bronchodilator dose.
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 Pirbuterol?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Pirbuterol 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. Pirbuterol, a beta-2 agonist, can lower serum potassium by shifting it into cells, and hydrochlorothiazide causes potassium loss through the kidney. Together they can produce clinically relevant hypokalemia, which raises arrhythmia risk, particularly with high doses of the bronchodilator. Telmisartan partly offsets potassium loss but not reliably.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Pirbuterol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium in patients using frequent or high-dose pirbuterol with the thiazide combination, and replace potassium if low. Use the lowest effective bronchodilator dose.
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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