Drug interactions
Hydrochlorothiazide-telmisartan + Tizanidine
Severity: Moderate
Hydrochlorothiazide-telmisartan and Tizanidine: 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
Tizanidine is a centrally acting alpha-2 agonist that lowers blood pressure and can cause hypotension and bradycardia. With telmisartan and hydrochlorothiazide, additive hypotension and dizziness are likely.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Tizanidine 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.
Hydrochlorothiazide-telmisartan belongs to Cardiovascular; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive hypotensive effects from central alpha-2 agonism, angiotensin receptor blockade and diuresis.
What to do
Start tizanidine at a low dose and titrate slowly while monitoring blood pressure and orthostatic symptoms. Reduce the antihypertensive or tizanidine dose if hypotension develops.
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
Other interactions of Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Tizanidine?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-telmisartan and Tizanidine 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. Tizanidine is a centrally acting alpha-2 agonist that lowers blood pressure and can cause hypotension and bradycardia. With telmisartan and hydrochlorothiazide, additive hypotension and dizziness are likely.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Tizanidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start tizanidine at a low dose and titrate slowly while monitoring blood pressure and orthostatic symptoms. Reduce the antihypertensive or tizanidine dose if hypotension develops.
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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