Prestalia

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Hyperkalemia with K⁺ supplements, K⁺ sparing diuretics, K⁺ containing salt substitutes, others (eg, cyclosporine, indomethacin, heparin). Potentiated by diuretics. May increase lithium levels; monitor. May be antagonized by, and renal toxicity potentiated by, NSAIDs, including selective COX-2 inhibitors (monitor renal function periodically in elderly and/or volume depleted). Potentiates simvastatin; limit simvastatin dose to 20mg daily. Monitor cyclosporine levels. May be potentiated by moderate or strong CYP3A inhibitors (eg, diltiazem, itraconazole); monitor and may need dose adjustments. Monitor BP if coadministered with CYP3A4 inducers. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare.