Amlodipine-hydrochlorothiazide-valsartan + Canagliflozin

MediHelp rates the interaction as moderate. Amlodipine-hydrochlorothiazide-valsartan and Canagliflozin 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. Canagliflozin causes osmotic diuresis and a modest fall in blood pressure, and the triple combination already contains a thiazide and an angiotensin receptor blocker. Together they raise the risk of volume depletion, hypotension and acute kidney injury, especially in older or renally impaired patients. The legacy concern about potassium is not the main issue.

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess volume status and blood pressure before starting canagliflozin and consider reducing the diuretic dose if the patient is volume depleted. Monitor renal function, electrolytes and orthostatic symptoms after initiation.

MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.