Drug interactions
Metolazone + Tiotropium-olodaterol
Severity: Moderate
Metolazone and Tiotropium-olodaterol: 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 causes substantial urinary potassium and magnesium loss, and olodaterol can further lower serum potassium. The resulting hypokalemia may increase the risk of arrhythmias, particularly in patients with heart disease.
What this interaction means in plain words
Metolazone and Tiotropium-olodaterol 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; Tiotropium-olodaterol belongs to Respiratory.
Why it happens
Additive hypokalemia from diuretic renal potassium wasting and beta2-agonist intracellular potassium shift.
What to do
Monitor potassium and magnesium regularly and replace as needed. Take extra care in patients with cardiac disease or on digoxin or QT-prolonging drugs.
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 Tiotropium-olodaterol
Other interactions of Metolazone
Frequently asked questions
Can I take Metolazone with Tiotropium-olodaterol?
MediHelp rates the interaction as moderate. Metolazone and Tiotropium-olodaterol 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 causes substantial urinary potassium and magnesium loss, and olodaterol can further lower serum potassium. The resulting hypokalemia may increase the risk of arrhythmias, particularly in patients with heart disease.
How serious is the interaction between Metolazone and Tiotropium-olodaterol?
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 potassium and magnesium regularly and replace as needed. Take extra care in patients with cardiac disease or on digoxin or QT-prolonging drugs.
What other medicines interact with Tiotropium-olodaterol?
MediHelp also lists interactions of Tiotropium-olodaterol with, for example, Amisulpride, Arformoterol, Arsenic trioxide. The full list is on the Tiotropium-olodaterol page.
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