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Dual Blockade of the Renin-Angiotensin-Aldosterone System (RAAS): Dual blockade of the RAAS by combining CoAprovel with an angiotensin converting enzyme inhibitor (ACEI) or with aliskiren is not recommended since there are increased risks of hypotension, hyperkalemia, and changes in renal function.
The use of CoAprovel in combination with aliskiren is contraindicated in patients with diabetes mellitus or with renal impairment (GFR <60 ml/ min/1.73 m2) (see Contraindications and Interactions).
The use of CoAprovel in combination with an ACEI is contraindicated in patients with diabetic nephropathy (see Contraindications and Interactions).
The use of CoAprovel in patients with psoriasis or a history of psoriasis should be carefully weighed as it may exacerbate psoriasis.
General: As a consequence of inhibiting the renin-angiotensin-aldosterone system, changes in renal function during therapy with CoAprovel may be anticipated in susceptible individuals. In patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system (eg, hypertensive patients with renal artery stenosis in one or both kidneys, or patients with severe congestive heart failure), treatment with drugs that affect this system has been associated with oliguria and/or progressive azotemia and (rarely) with acute renal failure and/or death. The possibility of a similar effect occurring with the use of an angiotensin II receptor antagonist, including CoAprovel, cannot be excluded.
The antihypertensive effects of thiazide diuretics may be increased in the postsympathectomy patient.
Driving a Vehicle or Performing Other Hazardous Tasks: The effects of CoAprovel on the ability to drive motor vehicles or operate machinery have not been specifically studied, but based on its pharmacodynamic properties, CoAprovel is unlikely to affect this ability. When driving vehicles or operating machinery, it should be taken into account that occasionally dizziness may occur during treatment of hypertension.
