Drug interactions
Hydrochlorothiazide-telmisartan + Voclosporin
Severity: Major
Hydrochlorothiazide-telmisartan and Voclosporin: 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
Voclosporin, a calcineurin inhibitor, can cause hyperkalemia and nephrotoxicity, and telmisartan adds to hyperkalemia risk and can reduce glomerular filtration in the setting of reduced renal perfusion. Hydrochlorothiazide-related volume depletion can further raise the risk of kidney injury.
What this interaction means in plain words
Hydrochlorothiazide-telmisartan and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
Additive hyperkalemia and renal hemodynamic effects from calcineurin inhibition with angiotensin receptor blockade.
What to do
Monitor serum potassium, creatinine and eGFR frequently, especially at initiation and dose changes, and reduce or stop voclosporin or telmisartan if hyperkalemia or declining renal function occurs.
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 Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-telmisartan with Voclosporin?
MediHelp rates the interaction as major. Hydrochlorothiazide-telmisartan and Voclosporin 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. Voclosporin, a calcineurin inhibitor, can cause hyperkalemia and nephrotoxicity, and telmisartan adds to hyperkalemia risk and can reduce glomerular filtration in the setting of reduced renal perfusion. Hydrochlorothiazide-related volume depletion can further raise the risk of kidney injury.
How serious is the interaction between Hydrochlorothiazide-telmisartan and Voclosporin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium, creatinine and eGFR frequently, especially at initiation and dose changes, and reduce or stop voclosporin or telmisartan if hyperkalemia or declining renal function occurs.
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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