Blopress Plus Drug Interactions

Dual blockade of the RAAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to the use of a single RAAS acting agent.
Candesartan Cilexetil: No significant drug interactions have been reported in studies of candesartan cilexetil given with other drugs such as glyburide, nifedipine, digoxin, warfarin, hydrochlorothiazide, and oral contraceptives in healthy volunteers. Because candesartan is not significantly metabolized by the cytochrome P450/system, and at therapeutic concentrations has no effects on P450 enzymes, interactions with drugs that inhibit, or rarely metabolized by those enzymes would not be expected.
Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: alcohol, barbiturates or narcotics: Potentiation of orthostatic hypotension may occur.
Antidiabetic drugs (oral agents and insulin): Dosage adjustment of the antidiabetic drug may be required other antihypertensive drugs: Additive effect or potentiation.
Cholestyramine and colestipol resins: Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85% and 43%, respectively.
Corticosteroids: ACTH-intensified electrolyte depletion, particularly hypokalemia.
Pressor Amines (e.g, norepinephrine): Possible decreased response to pressor amines but not sufficient to preclude their use.
Skeletal muscle relaxants, nondepolarizing (e.g. tubocurarine): Possible increased responsiveness to the muscle relaxant.
Lithium: Generally should not be given with diuretic agents because the renal clearance of lithium and add high risk of lithium toxicity. Refer to the package insert for lithium preparation before use of such preparations with Blopress plus.
Non-steroidal anti-inflammatory drugs: In some patients the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.
Therefore, when Blopress plus and nonsteroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of diuretic is obtained.