Losartan: Reduced active metabolite levels w/ rifampin & fluconazole. May lead to increased serum K w/ K-sparing diuretics (eg, spironolactone, triamterene, amiloride), K supplements, K-containing salt substitutes or other drugs that may increase serum K (eg, trimethoprim-containing products). May reduce excretion of lithium. Antihypertensive effect may be attenuated w/ NSAIDs including selective COX-2 inhibitors. May result in a further deterioration of renal function including possible acute renal failure w/ NSAIDs (including selective COX-2 inhibitors) in patients w/ compromised renal function eg, elderly or patients who are vol-depleted, including those on diuretics. Increased risks of hypotension, syncope, hyperkalemia, & changes in renal function (including acute renal failure) associated w/ dual blockade of the renin-angiotensin-aldosterone system w/ ACE inhibitors, or aliskiren. Active metabolite conc may be lowered w/ grapefruit juice. Amlodipine: Plasma conc may be increased w/ strong CYP3A4 inhibitors eg, ketoconazole, itraconazole, ritonavir.
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