Captopril and Rosiglitazone: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Captopril
Rosiglitazone
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of hypoglycemia
Interaction Deep Dive
Coadministration of ACE inhibitors with antidiabetic agents may increase the risk of hypoglycemia123. If concomitant use is required, conduct more frequent glucose monitoring, both during treatment and after withdrawal of an ACE inhibitor 4. Insulin dose adjustments may also be needed 12. Data from a self-controlled case series suggest the concomitant use of ACE inhibitors and insulin secretagogues is not associated with increased rates of serious hypoglycemia, with the possible exception of glimepiride 5.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) In a self-controlled case series, Medicare claims data from 5 states from 1999 to 2011 were analyzed for concomitant use of ACE inhibitors with insulin secretagogues (glimepiride, glipizide, glyburide, nateglinide, and repaglinide) or metformin (negative control). The outcome measured was hospital presentation for serious hypoglycemia. The number of serious hypoglycemic events during the observation period was 8159, 14,353, 11,129, 1595, 2901, and 32,639 for glimepiride, glipizide, glyburide, nateglinide, repaglinide, and metformin, respectively. Confounder-adjusted rate ratio (RR) was not significantly elevated with glipizide, glyburide, repaglinide, or metformin but was slightly elevated with glimepiride (RR, 1.23; 95% CI, 1.11 to 1.37) and slightly reduced with nateglinide (RR, 0.73; 95% CI, 0.56 to 0.96). With the exception of glimepiride, these data suggest concomitant use of ACE inhibitor and insulin secretagogues was not associated with increased risk of serious hypoglycemia 5.
Common questions
Can I take Captopril and Rosiglitazone together?
An increased risk of hypoglycemia Always confirm with your pharmacist or prescriber before making any change.
How serious is the Captopril and Rosiglitazone interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Captopril or Rosiglitazone need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (5)
- Product Information: TOUJEO(R) subcutaneous injection, insulin glargine subcutaneous injection. sanofi-aventis (per manufacturer), Bridgewater, NJ, 2015. DailyMed
- Product Information: AFREZZA(R) oral inhalation powder, insulin human oral inhalation powder. MannKind Corporation(TM) (per manufacturer), Danbury, CT, 2014. DailyMed
- Product Information: Zestril(R) oral tablets, lisinopril oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2014. DailyMed
- Product Information: AMARYL(R) oral tablets, glimepiride oral tablets. Sanofi-Aventis U.S. LLC (per FDA), Bridgewater, NJ, 2013. DailyMed
- Hee Nam Y, Brensinger CM, Bilker WB, et al: Angiotensin-converting enzyme inhibitors used concomitantly with insulin secretagogues and the risk of serious hypoglycemia. Clin Pharmacol Ther 2022; 111(1):218-226. PubMed
Keep reading about Captopril
Keep reading about Rosiglitazone
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