Increased peak plasma & trough conc of digoxin. May increase serum K w/ K-sparing diuretics (eg, spironolactone, eplerenone, triamterene or amiloride), K supplements or K-containing salt substitutes. Reversible increases in serum lithium conc & toxicity. Antihypertensive effect may be reduced w/ NSAIDs (ie, aspirin at anti-inflammatory dose, COX-2 inhibitors & non-selective NSAIDs). May result in vol depletion & risk of hypotension w/ prior diuretics (thiazide or loop diuretics). Increased BP-lowering effect w/ other antihypertensive medicinal products. Higher frequency of adverse events in dual blockade of the RAAS through combination w/ ACE inhibitors or aliskiren. May potentiate hypotensive effects of baclofen, amifostine. Orthostatic hypotension may be aggravated w/ alcohol, barbiturates, narcotics or antidepressants. Reduced antihypertensive effect w/ systemic corticosteroids.
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