Compatibility «Captopril» and «Bisoprolol+Hydrochlorothiazide»

• Interactions Captopril with Bisoprolol+Hydrochlorothiazide

  • Dangerous interactions
    • ⓘ The risk of a significant decrease in blood pressure and/or acute renal failure at the beginning of treatment with ACE inhibitors or ARA II in patients with hyponatremia (especially in patients with renal artery stenosis).
    • ⓘ 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
    • ⓘ The combination of bisoprolol + hydrochlorothiazide may enhance the effect of other antihypertensive drugs used simultaneously.
    • ⓘ Other antihypertensive drugs may have an additional effect or potentiate the effect when used concomitantly with hydrochlorothiazide.
    • ⓘ Antihypertensive agents and other agents with a possible antihypertensive effect (tricyclic antidepressants, barbiturates, phenothiazine derivatives, baclofen): in combination with Lodoz may increase the risk of hypotension.
    • ⓘ ACE inhibitors (e.g. captopril, enalapril), ARA II.
    • ⓘ If the previous intake of diuretics caused hyponatremia, it is necessary either to stop taking diuretics 3 days before the start of treatment with ACE inhibitors, or to start treatment with the latter in small doses, with a gradual increase in them.
    • ⓘ 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.
    • ⓘ Antihypertensive drugs.
    • ⓘ 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).
    • ⓘ The effect of captopril is enhanced by the use of antihypertensive drugs that cause the release of renin.
    • ⓘ Other antihypertensive drugs.
    • ⓘ 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
    • ⓘ Beta-blockers enhance the antihypertensive effect of captopril, but in general the response is less than additive.
    • ⓘ In patients taking diuretics, captopril may potentiate the antihypertensive effect.
  • Unclear interactions
    • ⓘ 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.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

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• 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: 170,037,924 possible combinations of drugs and their components were found 412,574 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-05-07

Category - medicine