Drug interactions
Metolazone + Sacubitril-valsartan
Severity: Moderate
Metolazone and Sacubitril-valsartan: 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
Metolazone is a potent thiazide-like diuretic that can cause volume depletion, hypotension and electrolyte disturbances. With sacubitril-valsartan this may lead to hypotension and renal function decline, while potassium effects partly offset each other and are unpredictable.
What this interaction means in plain words
Metolazone and Sacubitril-valsartan 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.
Metolazone belongs to Cardiovascular; Sacubitril-valsartan belongs to Cardiovascular.
Why it happens
Additive hypotensive and volume-depleting effects; opposing effects on potassium (valsartan retains, metolazone wastes).
What to do
Monitor blood pressure, renal function, sodium and potassium after initiation and dose changes. Reduce the diuretic dose if hypotension or renal impairment occurs.
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 Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
Other interactions of Metolazone
Frequently asked questions
Can I take Metolazone with Sacubitril-valsartan?
MediHelp rates the interaction as moderate. Metolazone and Sacubitril-valsartan 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. Metolazone is a potent thiazide-like diuretic that can cause volume depletion, hypotension and electrolyte disturbances. With sacubitril-valsartan this may lead to hypotension and renal function decline, while potassium effects partly offset each other and are unpredictable.
How serious is the interaction between Metolazone and Sacubitril-valsartan?
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 blood pressure, renal function, sodium and potassium after initiation and dose changes. Reduce the diuretic dose if hypotension or renal impairment occurs.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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