Drug & supplement interaction

Cod Liver Oil + Hydrochlorothiazide

Hydrochlorothiazide brand names: Esidrix, Hydro, Microzide, HydroDiuril, Hydro-D, and others.

Moderate Interaction
The bottom line Moderate

Cod Liver Oil has a moderate interaction with Hydrochlorothiazide. Theoretically, taking cod liver oil with antihypertensive drugs might increase the risk of hypotension.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cod Liver Oil and Hydrochlorothiazide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Hydrochlorothiazide

Hydrochlorothiazide falls under ANTIHYPERTENSIVE DRUGS — the group Cod Liver Oil interacts with.

Theoretically, taking cod liver oil with antihypertensive drugs might increase the risk of hypotension.
Cod liver oil can lower blood pressure and might have additive effects in patients treated with antihypertensives; use with caution.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: cod liver oil and its omega-3 fats can nudge your blood pressure down a little on their own. Since hydrochlorothiazide (your water pill) is already working to lower blood pressure and pull off extra fluid, combining the two could have an additive effect. In plain terms, your numbers might drop a bit more than expected.

If that happens, you may feel lightheaded, dizzy when you stand up, tired, or off-balance. The good news is this concern is mostly theoretical and based on limited evidence, so for most people it's not a big deal. Still, it's worth a quick chat with your pharmacist or doctor, especially if you already run low or feel dizzy. Don't change anything on your own.

References
  1. Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12.
  2. Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8.
  3. Jensen T, Stender S, Goldstein K, et al. Partial normalization by dietary cod-liver oil of increased microvascular albumin leakage in patients with insulin-dependent diabetes and albuminuria. N Engl J Med 1989;321:1572-7. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cod Liver Oil Also Interacts With Other Medications

Cod Liver Oil has 374 moderate known drug interactions in our database — the Hydrochlorothiazide one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cod Liver Oil

Covers the 2,830 medications we’ve checked against Cod Liver Oil. Pick one to open its full report.

From our Q&A

Questions About Cod Liver Oil or Hydrochlorothiazide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cod Liver Oil or Hydrochlorothiazide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Hydrochlorothiazide

This page covers Cod Liver Oil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrochlorothiazide page lists 230 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 195 moderate · 25 minor.

From our pharmacist’s overview on the Hydrochlorothiazide page

“Hydrochlorothiazide sits at the strong end of the caution scale for supplement interactions, and the small group of major-rated entries deserves a careful read before everything else on the page. Most of what appears here either adds to the pill's blood-pressure-lowering effect or piles onto its diuretic action, pushing fluid and potas…”

Reviewed by 2 · Jul 18, 2026

Open the Hydrochlorothiazide interaction page

One more smart check

Taking Cod Liver Oil as Part of a Dietary Supplement Product? Check It for Interactions

We hold 17 real supplement products containing Cod Liver Oil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cod Liver Oil. Your product may carry other ingredients that interact with Hydrochlorothiazide too, on top of Cod Liver Oil — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cod Liver Oil and Hydrochlorothiazide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cod Liver Oil
Steady interest

#946 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Hydrochlorothiazide
Top 10%

#143 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cod Liver Oil

What is Cod Liver Oil?

Cod Liver Oil
  • Source of omega-3 fatty acids
  • Vitamin A and D supplementation
  • Heart health
  • Joint and bone health
  • Reducing inflammation

Cod liver oil supplies omega-3 fatty acids (EPA and DHA) along with vitamins A and D, and is popular for heart, joint, and general health support. Evidence is strongest for its nutrient content, but proof of specific disease benefits is mixed. Because it contains vitamin A, taking too much can be harmful, so check with your pharmacist or doctor before using it.

Read the full Cod Liver Oil monograph & all interactions
Medication

About Hydrochlorothiazide

What Is Hydrochlorothiazide Used For?

Brand names: Esidrix, Hydro, Microzide, HydroDiuril, Hydro-D, Oretic, Aquazide H, Aquazide, HCTZ

Hydrochlorothiazide treats high blood pressure (hypertension) in adults and children, either alone or combined with other blood pressure medicines. Lowering blood pressure reduces the risk of strokes and heart attacks.

It also treats edema (fluid buildup) linked to congestive heart failure, hepatic cirrhosis (liver scarring), and kidney conditions including nephrotic syndrome. Hydrochlorothiazide tablets are additionally indicated for edema caused by corticosteroid or estrogen therapy, and edema from acute glomerulonephritis or chronic renal failure. Inzirqo (the oral suspension) is specifically approved for both hypertension and edema in adult and pediatric patients.

See full Hydrochlorothiazide drug information
Keep checking

Other Drugs & Cod Liver Oil

Browse every other medication we’ve checked against Cod Liver Oil — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
374Moderate
0Minor
2,455No known interaction
Moderate

374 interactions

Showing 60 of 374 moderate interactions — see all 374 on the Cod Liver Oil page.

No interaction 2,455 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Cod Liver Oil and Hydrochlorothiazide Together: Common Questions

Can you take Cod Liver Oil with Hydrochlorothiazide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Cod Liver Oil and Hydrochlorothiazide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Hydrochlorothiazide and Cod Liver Oil?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.