Increased antihypertensive effect w/ baclofen. May increase hypotensive effects w/ antihypertensive agents (eg, β-blockers) & vasodilatators. May further reduce BP w/ nitroglycerine & other nitrates or vasodilatators. Reduced antihypertensive effects w/ corticosteroids, tetracosactide. Increased antihypertensive effect & risk of orthostatic hypotension w/ α-blockers (eg, prazosin, alfuzosin, doxazosin, tamsulosin); TCAs/antipsychotics/anaesth. May potentiate antihypertensive effect of amlodipine w/ amifostine. Perindopril: Higher frequency of adverse events w/ angiotensin II receptor-blockers or aliskiren. Increased risk of hyperkalaemia w/ aliskiren, K salts, K-sparing diuretics, ACE inhibitors, AIIA, NSAIDs, heparins, immunosuppressant agents (eg, ciclosporine or tacrolimus), trimethoprim, co-trimoxazole. May increase blood glucose lowering-effect of antidiabetic medicines eg, insulins, oral hypoglycaemic agents. Excessive BP reduction w/ non-K-sparing diuretics. May increase risk of angioedema w/ racecadotril; mTOR inhibitors eg, sirolimus, everolimus, temsirolimus. Antihypertensive effect may be attenuated w/ NSAIDs (eg, aspirin ≥3 g daily, COX-2 inhibitors & non-selective NSAIDs) & may be reduced w/ sympathomimetics. Increased risk of angiooedema w/ gliptines eg, linagliptine, saxagliptine, sitagliptine, vildagliptine. Nitritoid reactions w/ injectable gold (Na aurothiomalate). Contraindicated: Risk of hyperkalaemia, worsened renal function & increased CV morbidity & mortality w/ aliskiren in diabetic or impaired renal patients. Increased risk of severe anaphylactoid reactions w/ extracorporeal treatments. May increase risk of angioedema w/ sacubitril/valsartan. Not recommended: Aliskiren. Higher frequency of hypotension, syncope, hyperkalaemia, & worsened renal function w/ angiotensin receptor blocker. Risk of increased angioneurotic oedema w/ estramustine. May increase risk of hyperkalaemia w/ co-trimoxazole. Hyperkalaemia w/ K-sparing diuretics (eg, triamterene, amiloride) & K salts. Reversible increased serum conc & toxicity of lithium. Amlodipine: Plasma conc may vary w/ strong CYP3A4 inducers eg, rifampicin, Hypericum perforatum
. Exposure may be increased w/ strong or moderate CYP3A4 inhibitors eg, PIs, azole antifungals, macrolides (eg, erythromycin or clarithromycin), verapamil or diltiazem. Increased risk of hypotension w/ clarithromycin. Additive BP-lowering effect w/ other medicinal products w/ antihypertensive properties. Risk of increased tacrolimus blood levels. May increase exposure of mTOR inhibitors. Increased exposure to simvastatin. Not recommended: Lethal ventricular fibrillation & CV collapse w/ dantrolene infusion. Bioavailability may be increased w/ grapefruit or grapefruit juice.