Drug interactions
Hydrochlorothiazide-valsartan + Sacubitril / valsartan
Severity: Major
Hydrochlorothiazide-valsartan 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
This combination duplicates valsartan, giving two sources of angiotensin receptor blockade with added hypotension, hyperkalemia and renal dysfunction risk. Hydrochlorothiazide may be used with sacubitril/valsartan, but the hydrochlorothiazide-valsartan product should not be given alongside it.
What this interaction means in plain words
Hydrochlorothiazide-valsartan 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
Therapeutic duplication of angiotensin II receptor blockade, with added neprilysin inhibition increasing hypotensive and hyperkalemic effects.
What to do
Avoid the combined product with sacubitril/valsartan; if a thiazide is needed, use hydrochlorothiazide alone and monitor blood pressure, potassium and creatinine.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydrochlorothiazide-valsartan and Sacubitril / valsartan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Sacubitril / valsartan?
MediHelp rates the interaction as major. Hydrochlorothiazide-valsartan 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. This combination duplicates valsartan, giving two sources of angiotensin receptor blockade with added hypotension, hyperkalemia and renal dysfunction risk. Hydrochlorothiazide may be used with sacubitril/valsartan, but the hydrochlorothiazide-valsartan product should not be given alongside it.
How serious is the interaction between Hydrochlorothiazide-valsartan 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 the combined product with sacubitril/valsartan; if a thiazide is needed, use hydrochlorothiazide alone and monitor blood pressure, potassium and creatinine.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
