Drug interactions
Hydrochlorothiazide-telmisartan + Sacubitril / valsartan
Severity: Major
Hydrochlorothiazide-telmisartan and Sacubitril / valsartan: 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 telmisartan with sacubitril/valsartan gives dual angiotensin receptor blockade, which adds no benefit and raises the risk of hypotension, hyperkalemia and renal impairment. The thiazide further increases the risk of volume depletion and renal dysfunction.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Sacubitril / valsartan 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.
Why it happens
Duplicate angiotensin II type 1 receptor blockade with additive effects on blood pressure, potassium and renal hemodynamics.
What to do
Avoid concurrent use of two ARBs; stop telmisartan when sacubitril/valsartan is started. If combined exposure cannot be avoided, monitor blood pressure, 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
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Sacubitril / valsartan?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan and Sacubitril / valsartan 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 telmisartan with sacubitril/valsartan gives dual angiotensin receptor blockade, which adds no benefit and raises the risk of hypotension, hyperkalemia and renal impairment. The thiazide further increases the risk of volume depletion and renal dysfunction.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Sacubitril / valsartan?
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 concurrent use of two ARBs; stop telmisartan when sacubitril/valsartan is started. If combined exposure cannot be avoided, monitor blood pressure, 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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