Zestoretic

See Contraindications. May cause hypotension or increased BUN with diuretics. May cause hyperkalemia with K⁺ sparing diuretics, K⁺ supplements, or K⁺ -containing salt substitutes. May be antagonized by, and renal toxicity potentiated by NSAIDs (including COX-2 inhibitors): monitor renal function in elderly and/or volume-depleted. 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 diabetics or renal impairment (GFR <60mL/min): not recommended. May increase lithium levels; monitor frequently. Increased risk of angioedema with concomitant mTOR inhibitors (eg, temsirolimus, sirolimus, everolimus) or neprilysin inhibitors. Orthostatic hypotension may be increased by alcohol, CNS depressants. Risk of hypoglycemia with concomitant antidiabetic agents; adjust doses. Hypokalemia with ACTH, corticosteroids. May antagonize pressor amines (eg, norepinephrine). May potentiate tubocurarine, neuromuscular blocking agents. Reduced absorption with bile acid resins (eg, cholestyramine, colestipol). May interfere with parathyroid test. Nitritoid reactions with concomitant injectable gold (eg, sodium aurothiomalate); rare.