Drug interactions
Hydrochlorothiazide-valsartan + Metolazone
Severity: Major
Hydrochlorothiazide-valsartan and Metolazone: 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
Metolazone is a thiazide-like diuretic and combined with hydrochlorothiazide it produces profound sequential nephron blockade. This can cause marked diuresis, hypokalemia, hyponatremia, hypotension and renal impairment, which valsartan may compound by lowering glomerular pressure.
What this interaction means in plain words
Hydrochlorothiazide-valsartan and Metolazone 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-valsartan belongs to Cardiovascular; Metolazone belongs to Cardiovascular.
Why it happens
Additive diuretic and natriuretic effects from two thiazide-type agents plus RAAS blockade, leading to volume depletion and electrolyte loss.
What to do
Avoid duplicating thiazide-type diuretics unless deliberately intended for resistant edema. If combined, monitor electrolytes, creatinine, weight and blood pressure 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-valsartan
- Aliskiren + Hydrochlorothiazide-valsartan Contraindicated
- Dofetilide + Hydrochlorothiazide-valsartan Contraindicated
- Hydrochlorothiazide-valsartan + Sparsentan Contraindicated
- Aldesleukin + Hydrochlorothiazide-valsartan Major
- Amifostine + Hydrochlorothiazide-valsartan Major
- Amiloride + Hydrochlorothiazide-valsartan Major
Other interactions of Metolazone
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Metolazone?
MediHelp rates the interaction as major. Hydrochlorothiazide-valsartan and Metolazone 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. Metolazone is a thiazide-like diuretic and combined with hydrochlorothiazide it produces profound sequential nephron blockade. This can cause marked diuresis, hypokalemia, hyponatremia, hypotension and renal impairment, which valsartan may compound by lowering glomerular pressure.
How serious is the interaction between Hydrochlorothiazide-valsartan and Metolazone?
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 duplicating thiazide-type diuretics unless deliberately intended for resistant edema. If combined, monitor electrolytes, creatinine, weight and blood pressure closely.
What other medicines interact with Hydrochlorothiazide-valsartan?
MediHelp also lists interactions of Hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Hydrochlorothiazide-valsartan page.
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