Drug interactions
Hydrochlorothiazide-valsartan + Sotalol
Severity: Major
Hydrochlorothiazide-valsartan and Sotalol: 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
Hydrochlorothiazide can cause hypokalemia and hypomagnesemia, which markedly increase the risk of QT prolongation and torsades de pointes with sotalol. Additive blood pressure lowering and bradycardia may also occur with the beta-blocker and valsartan.
What this interaction means in plain words
Hydrochlorothiazide-valsartan and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Thiazide-induced electrolyte depletion potentiates sotalol's class III QT prolongation, with additive antihypertensive effects.
What to do
Check and correct potassium and magnesium before and during therapy, and monitor ECG for QT interval. Consider an alternative diuretic or antihypertensive if QT prolongs.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Sotalol?
MediHelp rates the interaction as major. Hydrochlorothiazide-valsartan and Sotalol 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 can cause hypokalemia and hypomagnesemia, which markedly increase the risk of QT prolongation and torsades de pointes with sotalol. Additive blood pressure lowering and bradycardia may also occur with the beta-blocker and valsartan.
How serious is the interaction between Hydrochlorothiazide-valsartan and Sotalol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check and correct potassium and magnesium before and during therapy, and monitor ECG for QT interval. Consider an alternative diuretic or antihypertensive if QT prolongs.
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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