Compatibility «Indapamide+Perindopril» and «Hydrochlorothiazide»
Between «Indapamide+Perindopril» and «Hydrochlorothiazide» found 12 dangerous and 24 negative interactions, joint admission is not recommended without consulting a doctor.
Interaction tableCompare |
Hydrochlorothiazide |
✘Indapamide+Perindopril [Indapamide and more 1Perindopril] Analogs | |
✘Hydrochlorothiazide [Indapamide and more 1Perindopril] Analogs |
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Interactions Indapamide+Perindopril with Hydrochlorothiazide
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Dangerous interactions
Functional renal insufficiency, which can occur against the background of taking diuretics, especially 'loop' ones, with the combined use of metformin increases the risk of lactic acidosis. Dehydration of the body while taking diuretic drugs increases the risk of acute renal failure, especially when using high doses of iodine-containing contrast agents. In patients receiving diuretics, especially in patients with hypovolemia and/or reduced salt concentrations, at the beginning of perindopril therapy, there may be an excessive decrease in blood pressure, the risk of development, which can be reduced by discontinuing the diuretic, replenishing the loss of fluid or salts before starting perindopril therapy, as well as prescribing perindopril at a low dose with a further gradual increase. When using diuretics in the case of congestive heart failure, an ACE inhibitor should be prescribed at a very low dose, possibly after reducing the dose of a potassium-sparing diuretic used simultaneously. Indapamide (C03BA11) + Thiazide diuretics (C03A) => Increases the likelihood of hypokalemia. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown)The likelihood of hypokalemia increases. The effect of thiazide diuretics is enhanced. (Dangerous combinations, careful correction of the K+ content in the blood is shown). 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. Hypokalemia and hypomagnesemia caused by the action of thiazide diuretics increase the toxicity of cardiac glycosides. Patients taking diuretics, especially those who have recently started treatment, may sometimes experience an excessive decrease in blood pressure after starting therapy with perindopril erbumin. The use of a diuretic may further increase the risk of lithium toxicity. In the elderly, patients with insufficient BCC (in pm receiving diuretic therapy) or with impaired renal function, the combined use of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including perindopril, may lead to deterioration of renal function, including possible acute renal failure. In patients receiving diuretics, especially with excessive excretion of fluid and / or electrolytes, at the beginning of perindopril therapy, an excessive decrease in blood pressure may be observed, the risk of which can be reduced by discontinuing the diuretic, replenishing fluid loss (intravenous infusion of 0.9% sodium chloride solution), as well as using perindopril in lower doses. When using diuretics in the case of CHF, an ACE inhibitor should be prescribed at a low dose, possibly after reducing the dose of a potassium-sparing diuretic used simultaneously. -
Negative interactions
In hypertension in patients with hypovolemia or reduced salt concentrations during diuretic therapy, diuretics should either be discontinued before the use of an ACE inhibitor (while a potassium-sparing diuretic may later be re-prescribed), or an ACE inhibitor should be prescribed at a low dose with a further gradual increase. The use of indapamide can sum up or potentiate the effect of other antihypertensive drugs. In limited controlled studies comparing the effects of indapamide in combination with other antihypertensive drugs with the effects of other antihypertensive drugs used as monotherapy, there were no noticeable changes in the nature or frequency of adverse reactions associated with combination therapy. Indapamide and Hydrochlorothiazide belong to the same pharmaceutical group: Thiazide diuretics. Thiazides can reduce plasma levels of iodine bound to proteins. Thiazides should be discontinued before parathyroid function tests are performed. Other antihypertensive drugs. It may be necessary to adjust the dose of simultaneously prescribed antihypertensive drugs. Thiazide diuretics affect glucose tolerance (hyperglycemia may develop) and reduce the effectiveness of hypoglycemic agents (dose adjustment of hypoglycemic agents may be required). Concomitant use of thiazide diuretics (including hydrochlorothiazide), with beta‑blockers or diazoxide may increase the risk of hyperglycemia. It may be necessary to adjust the dose of uricosuric drugs, since hydrochlorothiazide increases the concentration of uric acid in the blood serum. Thiazide diuretics may increase the frequency of hypersensitivity reactions to allopurinol. Thiazide diuretics (including hydrochlorothiazide) can reduce the clearance of amantadine, lead to an increase in the concentration of amantadine in blood plasma and increase the risk of its undesirable effects. Anticholinergic drugs (for example, atropine, biperiden) increase the bioavailability of thiazide diuretics by reducing the motility of the gastrointestinal tract and the rate of gastric emptying. Thiazide diuretics reduce the renal excretion of cytotoxic drugs (e.g. cyclophosphamide and methotrexate) and potentiate their myelosuppressive effect. With the simultaneous use of thiazide diuretics and cyclosporine, the risk of hyperuricemia and exacerbation of gout increases. Thiazide diuretics may reduce the effect of oral anticoagulants. Dehydration of the body while taking thiazide diuretics increases the risk. The possibility of hypotensive effects can be minimized by reducing the dose or canceling the diuretic, or increasing salt intake before starting treatment with perindopril. However, the bioavailability of perindoprilate was reduced by diuretics, which was associated with a decrease in ACE inhibition in plasma. In patients receiving diuretics that remove fluid and / or salts, at the beginning of Perindopril therapy, there may be a marked decrease in blood pressure, the risk of which can be reduced by discontinuing diuretics, replenishing the loss of fluid or salts before starting Perindopril therapy, as well as using Perindopril at a low dose with a further gradual increase. In hypertension in patients receiving diuretics, especially those that remove fluid and/or salts, diuretics should either be discontinued before the use of an ACE inhibitor (while a potassium-sparing diuretic may be prescribed again later), or an ACE inhibitor should be prescribed at a low dose with a further gradual increase. The additional use of thiazide diuretics against the background of the combined use of lithium preparations and ACE inhibitors increases the already existing risk of lithium intoxication. Antihypertensive and vasodilating agents. It enhances the antihypertensive effect of ACE inhibitors, blood pressure monitoring is required and, if necessary, dose adjustment of antihypertensive drugs. -
No interactions
Concomitant diuretics do not affect the rate and degree of absorption and excretion of perindopril. -
Positive interactions
When used concomitantly with thiazide diuretics, hyponatremia may be potentiated. The antihypertensive effect of perindopril may be enhanced when combined with other antihypertensive drugs, vasodilators, nitrates of short and prolonged action. -
Unclear interactions
Potassium-sparing diuretics. Diuretics. Potassium-containing diuretics (eplerenone, spironolactone). If this is not possible, then the initial dose of ACE inhibitors should be reduced.
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Dangerous interactions
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. |
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Additional information
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- Why do I need to
- Avoid dangerous prescriptions for your patients.
- Check the contraindications.
- Evaluate the safety of therapy in the treatment of children.
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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: 169,974,420 possible combinations of drugs and their components were found 412,510 interacting combinations.
- Medicine section: Standard evidence-based medicine
- The date of the last update of the interaction database: 2024-05-02
Category - medicine