Drug interactions
Hydrochlorothiazide-valsartan + Tolvaptan
Severity: Moderate
Hydrochlorothiazide-valsartan and Tolvaptan: 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
Tolvaptan causes aquaresis and is combined with thiazides that also deplete sodium and volume, raising the risk of dehydration, hypotension and rapid sodium shifts. Tolvaptan may modestly raise potassium, which may be additive with valsartan.
What this interaction means in plain words
Hydrochlorothiazide-valsartan and Tolvaptan 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-valsartan belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive fluid and electrolyte loss from aquaresis and thiazide natriuresis, with possible potassium elevation from ARB plus V2 antagonism.
What to do
Monitor serum sodium, potassium, volume status and renal function closely, especially at initiation. Avoid excessively rapid sodium correction.
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-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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Hydrochlorothiazide-valsartan with Tolvaptan?
MediHelp rates the interaction as moderate. Hydrochlorothiazide-valsartan and Tolvaptan 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. Tolvaptan causes aquaresis and is combined with thiazides that also deplete sodium and volume, raising the risk of dehydration, hypotension and rapid sodium shifts. Tolvaptan may modestly raise potassium, which may be additive with valsartan.
How serious is the interaction between Hydrochlorothiazide-valsartan and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum sodium, potassium, volume status and renal function closely, especially at initiation. Avoid excessively rapid sodium correction.
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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