Compatibility «Captopril» and «Valsartan+Hydrochlorothiazide»

• Interactions Captopril with Valsartan+Hydrochlorothiazide

  • Dangerous interactions
    • ⓘ Concomitant use of ARA II with ACE inhibitors is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.
    • ⓘ Double blockade of the RAAS with the combined use of ARA II, ACE inhibitors or aliskiren is associated with an increased risk of hypotension, hyperkalemia and changes in renal function (including acute renal failure) compared to monotherapy.
    • ⓘ Double blockade of the RAAS with the use of ARA II, ACE inhibitors or aliskiren (renin inhibitor) is associated with an increased risk of hypotension, syncope, hyperkalemia and impaired renal function (including acute renal failure).
    • ⓘ ACE inhibitors (C09A) + angiotensin ii receptor antagonists => Are associated with an increased risk of arterial hypotension, syncope, hyperkalemia and impaired renal function (in pm acute renal failure) compared with monotherapy.
    • ⓘ Double blockade of RAAS ARA II, ACE inhibitors or aliskiren is associated with an increased risk of hypotension, hyperkalemia and changes in renal function (including acute renal failure) compared to monotherapy.
    • ⓘ In the elderly, patients with hypovolemia (in pm receiving diuretics) or impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including captopril, may lead to deterioration of renal function, including the possible development of acute renal failure.
    • ⓘ With simultaneous use of a diuretic, the risk of developing side effects of lithium may increase.
    • ⓘ With the simultaneous use of ACE inhibitors (especially in combination with diuretics) and lithium preparations, an increase in the lithium content in the blood serum is possible, and therefore an increase in the cardiotoxic and neurotoxic effects of lithium preparations.
    • ⓘ In patients with risk factors (elderly age, hypovolemia, concomitant use of diuretics, impaired renal function), concomitant use of nonsteroidal anti-inflammatory drugs (including cyclooxygenase inhibitors‑2) and ACE inhibitors (including captopril), can lead to deterioration of renal function, up to acute renal failure.
    • ⓘ It should be used with caution with hypotensive drugs (their effect is potentiated, dose adjustment may be necessary), cardiac glycosides (hypokalemia and hypomagnesemia associated with the action of thiazide diuretics may increase the toxicity of digitalis), amiodarone (its use simultaneously with thiazide diuretics may lead to an increased risk of arrhythmias associated with hypokalemia), hypoglycemic oral medications (their effectiveness decreases, hyperglycemia may develop), corticosteroids, calcitonin (increase potassium excretion), NSAIDs (may weaken the diuretic and hypotensive effects of thiazides), non-depolarizing muscle relaxants (their effect may be enhanced), amantadine (clearance of amantadine may decrease with hydrochlorothiazide, which leads to an increase in plasma concentration of amantadine and possible toxicity), colestyramine (reduces absorption of hydrochlorothiazide), ethanol, barbiturates and narcotic analgesics, which enhance the effect of orthostatic hypotension.
  • Negative interactions
    • ⓘ With the simultaneous use of lithium preparations with ACE and ARA II inhibitors or thiazide diuretics, a reversible increase in the concentration of lithium in blood plasma and an associated increase in toxic manifestations were noted.
    • ⓘ Antihypertensive drugs.
    • ⓘ It is possible to enhance the antihypertensive effect when combined with other drugs that reduce blood pressure (ACE inhibitors, beta-blockers, BMCC, guanethidine, methyldopa, vasodilators, direct renin inhibitors, ARA II).
    • ⓘ Caution is required when combining ARA II, including valsartan, with other drugs that block RAAS, such as ACE inhibitors or aliskiren.
    • ⓘ When used concomitantly with ACE inhibitors and diuretics, cases of reversible increases in the plasma concentration of lithium and its toxic effects have been reported.
    • ⓘ Other antihypertensive drugs.
    • ⓘ The effect of captopril is enhanced by the use of antihypertensive drugs that cause the release of renin.
    • ⓘ Concomitant use of ACE inhibitors with angiotensin II receptor antagonists.
    • ⓘ (ARA II) is contraindicated in patients with diabetic nephropathy and is not recommended in other patients.
    • ⓘ Simultaneous use of captopril with potassium-sparing diuretics (such as spironolactone, eplerenone, triamterene, amiloride), potassium preparations, potassium-containing salt substitutes and other drugs capable of increasing the potassium content in blood serum (including angiotensin II receptor antagonists, heparin, tacrolimus, cyclosporine; drugs containing cotrimoxazole [trimethoprim + sulfamethoxazole]) may lead to a significant increase in the potassium content in blood plasma.
    • ⓘ NSAIDs, including selective cyclooxygenase‑2 (COX‑2) inhibitors and acetylsalicylic acid in doses of 3 g/day and above, can reduce the antihypertensive effect of diuretics and other antihypertensive agents.
    • ⓘ Patients receiving diuretics, especially with their recent appointment, as well as patients on a diet with strict salt restriction or dialysis, may sometimes experience a sharp decrease in blood pressure, usually within the first hour after taking the initial dose of captopril.
    • ⓘ The antihypertensive effect can be minimized by discontinuing the diuretic, or by increasing salt intake about a week before the start of captopril or starting therapy with small doses of captopril (6.25 or 12.5 mg).
    • ⓘ Caution should be exercised when co‑prescribing captopril (without or with a diuretic) and drugs that affect the sympathetic nervous system (for example, ganglioblockers, alpha-blockers).
    • ⓘ It may be necessary to adjust the dose of simultaneously prescribed antihypertensive drugs.
  • No interactions
    • ⓘ Captopril can be safely used in combination with other antihypertensive drugs (such as beta‑blockers or long-acting 'slow' calcium channel blockers).
    • ⓘ The sympathetic nervous system may be particularly important in maintaining blood pressure in patients receiving captopril in monotherapy or in combination with diuretics.
  • Positive interactions
    • ⓘ Thiazide diuretics enhance the antihypertensive effect of other antihypertensive drugs (including guanethidine, methyldopa, beta-blockers, vasodilators, BMCC, ACE inhibitors, ARA II, renin inhibitors).
    • ⓘ In patients taking diuretics, captopril may potentiate the antihypertensive effect.
  • Unclear interactions
    • ⓘ In patients who had suffered a myocardial infarction, a doubling of serum creatinine was observed in 4.2% of patients treated with valsartan and in 3.4% of patients treated with captopril.
    • ⓘ Hypotension (patients receiving diuretics).
    • ⓘ Diuretics (e.g. thiazide) can activate the RAAS.
    • ⓘ Potassium-sparing (thiazide and 'loop') diuretics.
    • ⓘ Captopril + Hydrochlorothiazide analgin and citramon are used together in Capozid, Hydrochlorothiazide+Captopril.
    • ⓘ If this is not possible, then the initial dose of ACE inhibitors should be reduced.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

Video instruction

▶

Look at ▶Youtube

Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
• Why do I need to
  • Avoid dangerous prescriptions for your patients.
  • Check the contraindications.
  • Evaluate the safety of therapy in the treatment of children.
  • See the compatibility of drugs with alcohol (enter it as a drug).
  • Point the doctor to the found interaction - you may need to adjust the therapy.
  • Do you need an API for interactions/drug analogues for your project? Write to us.
• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine