Amlife Drug Interactions

Losartan potassium: Lithium: Increases in serum lithium concentrations and lithium toxicity have been reported during concomitant administration of lithium with angiotensin II receptor antagonists. Monitor carefully serum lithium levels during concomitant use.
Potassium-sparing Diuretics/Supplements/Salt Substitutes: As with other medicines that block angiotensin II or its effect, concomitant use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may increase serum potassium.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) including Selective Cyclooxygenase-2 (COX-2) Inhibitors: The antihypertensive effect of angiotensin II receptor antagonists may be reduced when coadministered with NSAIDs such as selective COX-2 inhibitors and nonselective NSAIDs.
Concurrent administration of angiotensin II receptor antagonists with NSAIDs may result in an increased risk of worsening of renal function (including possible acute renal failure) and an increase in serum potassium, particularly in patients with poor pre-existing renal function. The combination should be administered with caution, especially in the elderly. Regularly monitor renal function after initiation of concomitant therapy and adequately hydrate patients.
Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors or aliskiren is associated with increased risk of hypotension, syncope, hyperkalemia and changes in renal function (including acute renal failure) compared with monotherapy. Closely monitor blood pressure, renal function and electrolytes in patients on losartan and other agents that affect the RAS.
Do not coadminister aliskiren with losartan in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 m²).
Tricyclic antidepressants, antipsychotics, baclofene, amifostine: Concomitant use with these drugs that may induce hypotension as an adverse effect, may increase the risk of hypotension.
Other Drugs: In studies, coadministration of losartan with other drugs such as hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole, and erythromycin showed no significant drug interactions. Rifampicin and fluconazole decreased the concentrations of losartan and its active metabolite.
Amlodipine besilate: Cimetidine, antacid (aluminum/magnesium hydroxide), or sildenafil: No significant effect on the pharmacokinetics of amlodipine.
Grapefruit Juice: Coadministration may increase the bioavailability of amlodipine resulting in increased blood pressure lowering effects. Thus, grapefruit should not be taken with amlodipine.
Digoxin: Concomitant use did not change the serum digoxin levels or digoxin renal clearance in normal volunteers.
Ethanol (alcohol): No significant effect on the pharmacokinetics of ethanol.
Warfarin: Concomitant use did not change the warfarin prothrombin response time.
Atorvastatin: No significant change in steady state pharmacokinetic parameters of atorvastatin.
Simvastatin: Concomitant use of amlodipine with simvastatin increases the systemic exposure of simvastatin. Do not exceed the dose of simvastatin to 20 mg daily in patients on amlodipine.
Cytochrome P450 3A4 (CYP3A4) Inhibitors: Concomitant use of amlodipine with strong or moderate CYP3A4 inhibitors [protease inhibitors (e.g., ritonavir), azole antifungals (e.g., ketoconazole, itraconazole), macrolides (e.g., erythromycin, clarithromycin), verapamil or diltiazem] may increase the plasma concentrations of amlodipine to a greater extent. The clinical effects of these pharmacokinetic variations may be more pronounced in the elderly. Clinical monitoring and dose adjustment may therefore be required.
CYP3A4 Inducers: There is no data available regarding the effect of CYP3A4 inducers on amlodipine. Concomitant use of CYP3A4 inducers (e.g., rifampicin, St. John's Wort) may result in lower plasma concentrations of amlodipine. Amlodipine should be used with caution when administered with CYP3A4 inducers.
Immunosuppressants (ciclosporin, tacrolimus): Coadministration may increase the systemic exposure of ciclosporin or tacrolimus. Monitor trough blood levels of ciclosporin and tacrolimus and adjust the dose as appropriate to avoid toxicity.