Drug interactions
Hydrochlorothiazide-telmisartan + Procainamide
Severity: Moderate
Hydrochlorothiazide-telmisartan and Procainamide: 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
Procainamide and its active metabolite NAPA are cleared partly by renal tubular cationic secretion, and thiazide-type diuretics may compete or alter renal handling, which could raise levels. Hydrochlorothiazide can also lower potassium and magnesium, which increases the proarrhythmic potential of procainamide.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Procainamide 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
Possible competition for renal tubular secretion plus diuretic-induced electrolyte disturbances that potentiate proarrhythmia.
What to do
Monitor ECG, procainamide and NAPA levels where available, and check potassium and magnesium. Correct electrolyte abnormalities and adjust the procainamide dose if levels or QRS or QT intervals increase.
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 Procainamide?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Procainamide 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. Procainamide and its active metabolite NAPA are cleared partly by renal tubular cationic secretion, and thiazide-type diuretics may compete or alter renal handling, which could raise levels. Hydrochlorothiazide can also lower potassium and magnesium, which increases the proarrhythmic potential of procainamide.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Procainamide?
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 ECG, procainamide and NAPA levels where available, and check potassium and magnesium. Correct electrolyte abnormalities and adjust the procainamide dose if levels or QRS or QT intervals increase.
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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