Higher frequency of adverse events through combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren. Increased serum lithium conc & toxicity. Increased effects of other antihypertensives (eg, ACE inhibitors, β-blockers, Ca channel blockers). Possible decreased response to pressor amines. Attenuated antihypertensive effect, worsening of renal function & increased serum K w/ NSAIDs. Valsartan: Increased K plasma levels w/ K-sparing diuretics, K supplements, salt substitutes containing K & other substances that may increase K levels. Hydrochlorothiazide: Decreased K levels w/ medicinal products associated w/ K loss & hypokalaemia (eg, kaliuretic diuretics, corticosteroids, laxatives, ACTH, amphotericin, carbenoxolone, penicillin G, salicylic acid & derivatives). Risk of hypokalemia w/ medicinal products that could induce torsades de pointes. Digitalis-induced cardiac arrhythmias w/ thiazide-induced hypokalaemia or hypomagnesaemia. Increased serum Ca w/ vit D or Ca salts. Dose adjustment of antidiabetics may be necessary. Risk of lactic acidosis w/ metformin. Increased risk of hyperglycaemia w/ β blockers. Enhanced hyperglycaemic effect of diazoxide. Increased dosage of probenecid or sulfinpyrazone may be necessary. Increased hypersensitivity reactions to allopurinol. Increased bioavailability w/ anticholinergic agents. Increased risk of adverse effects of amantadine. Impaired absorption w/ anionic exchange resins. Reduced renal excretion of cytotoxic agents, potentiating their myelosuppressive effects. Potentiated action of curare derivatives. Increased risk of hyperuricaemia & gout-type complications w/ ciclosporin. Potentiated orthostatic hypotension w/ alcohol, anaesth & sedatives. Reports of haemolytic anaemia w/ methyldopa. Possible hyponatremia w/ carbamazepine. Increased risk of acute renal failure w/ high doses of iodine product.
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