Interaction Details

Hydrochlorothiazide is classified as belonging to the following category: Diuretic Drugs

Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. There is some concern that people taking apple cider vinegar along with potassium depleting diuretics might have an increased risk for hypokalemia.

Interaction Rating


Likelihood of Occurrence


Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Pharmacist Analysis

Using apple cider vinegar with diuretic drugs might be dangerous and could lead to low potassium levels in the blood, which is called hypokalemia. This is because both apple cider vinegar and diuretic drugs can cause your body to lose potassium.

However, it's important to note that the evidence for this potential interaction between apple cider vinegar and diuretic drugs only goes as far as case studies. This means that there have only been a few reported cases of hypokalemia related to the use of these two substances together, and more research is needed to fully understand the extent of this risk.

It's unlikely that the short-term use of ACV has a significant risk of hypokalemia, even if you are taking a diuretic that depletes potassium. Nevertheless, if you are, be sure to talk to your doctor before taking ACV as a dietary supplement.



  • Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3.

Apple Cider Vinegar Overview

Apple Cider Vinegar Apple cider vinegar, or ACV, is the fermented juice from crushed apples. ACV is typically made by crushing apples and adding yeast and bacteria to the mixture, which ferments the sugars in the apples and turns them into alcohol. This alcohol is then converted into vinegar through a second fermentation process. ACV contains pectin, vitamins, minerals, and acid in the form of acetic acid or citric acid. While it is most popularly used in salad dressings and cooking, apple cider vinegar has been used medicinally as it is thought to have antioxidant, anti-inflammatory, and antimicrobial properties, and may help to boost the immune system.
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Hydrochlorothiazide Overview

  • Hydrochlorothiazide is used alone or in combination with other medications to treat high blood pressure. Hydrochlorothiazide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, and liver disease and to treat edema caused by using certain medications including estrogen and corticosteroids. Hydrochlorothiazide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

  • High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

See More Information Regarding Hydrochlorothiazide

Apple Cider Vinegar - More Interactions

Apple Cider Vinegar interacts with 160 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.

Major The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur.
Moderate Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur.
Minor Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction.
Unknown No interactions have been reported or no interaction data is currently available.

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Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Drug descriptions are provided by MedlinePlus.

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