Losartan: Reduced active metabolite levels w/ rifampin & fluconazole. Increased serum K w/ K-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements, K containing salt substitutes or other drugs that may increase serum K (eg, trimethoprim-containing products). Reduced lithium excretion. Reduced effect w/ NSAIDs including selective COX-2 inhibitors. May result in a further deterioration of renal function including possible acute renal failure w/ NSAIDs in patients w/ compromised renal function (eg, elderly, vol-depleted patients including those on diuretic therapy). Increased risk of hypotension, syncope, hyperkalemia & changes in renal function w/ drugs that affect RAAS eg, angiotensin receptor blockers, ACE inhibitors or aliskiren. Reduced therapeutic effect w/ grapefruit juice. Amlodipine: May increase plasma conc w/ strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir).
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