Hydrochlorothiazide and Aliskiren Interaction

Drug interaction information between Hydrochlorothiazide and Aliskiren.

Hydrochlorothiazide and Aliskiren have a documented major interaction in FDA labeling.

FDA drug labeling documents a major-severity interaction between Hydrochlorothiazide and Aliskiren. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.

Drug A

Hydrochlorothiazide

Thiazide Diuretic

Drug B

Aliskiren

Direct Renin Inhibitor

How They Interact

Using these drugs together blocks the body's blood pressure control system too much, which can hurt the kidneys or cause high potassium levels.

FDA Label Information

Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or direct renin inhibitors (such as aliskiren) is associated with increased risk of hypotension, syncope, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Do not coadminister aliskiren with lisinopril and hydrochlorothiazide tablets in patients with diabetes. Avoid use of aliskiren with PRINZIDE in patients with renal impairment (GFR <60 ml/min).

Frequently Asked Questions

What SPL severity band is on file for Hydrochlorothiazide + Aliskiren?

Compiled FDA labeling labels this pair major. That is a source-record field, not an individual medication-combination decision.

Which drug in this pair has the larger labeled-interaction portfolio?

Hydrochlorothiazide has 31 labeled pairs on file vs Aliskiren's 28. In the major band specifically: Hydrochlorothiazide has 3 (also Hydrochlorothiazide, Lisinopril); Aliskiren has 22 (also Amlodipine/Benazepril, Amlodipine/Valsartan, Azilsartan, Benazepril).

What mechanism field is on file for Hydrochlorothiazide and Aliskiren?

Using these drugs together blocks the body's blood pressure control system too much, which can hurt the kidneys or cause high potassium levels.

Aliskiren carries more major-labeled pairs than Hydrochlorothiazide

SPL source-record counts only. This page's band is major · classes on file: Hydrochlorothiazide (Thiazide Diuretic); Aliskiren (Direct Renin Inhibitor).

Aliskiren has 22 major-labeled pairs vs Hydrochlorothiazide's 3.

Hydrochlorothiazide

3 major · 1 moderate · 27 minor · 31 total

Aliskiren

22 major · 3 moderate · 3 minor · 28 total

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.