Dapril Drug Interactions

Clinical trial data has shown that dual blockade of the renin-angiotensin-aldosterone system (RAAS) through the combined use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers or aliskiren is associated with a higher frequency of adverse events eg, hypotension, hyperkalaemia and decreased renal function (including acute renal failure) compared to the use of a single RAAS-acting agent (see Contraindications and Precautions).
Diuretics: When a diuretic is added to the therapy of a patient receiving Dapril, the antihypertensive effect is usually potentiated.
Patients already on diuretics and especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure when Dapril is added. The possibility of symptomatic hypotension with Dapril can be minimized by discontinuing the diuretic prior to initiation of treatment with Dapril (see Dosage & Administration and Precautions).
Other Agents: Indomethacin may diminish the antihypertensive efficacy of concomitantly administered Dapril.
Dapril has been used concomitantly with nitrates without evidence of clinically significant adverse interactions.
Serum Potassium: In clinical trials, serum potassium usually remained within normal limits. If Dapril is given with a potassium-losing diuretic, diuretic-induced hypokalaemia may be ameliorated.
Risk factors for the development of hyperkalaemia include renal insufficiency, diabetes mellitus and concomitant use of potassium-sparing diuretics (eg, spironolactone, triamterene or amiloride) or potassium supplements.
The use of potassium supplements or potassium-sparing diuretics particularly in patients with impaired renal function may lead to a significant increase in serum potassium.
If concomitant use of Dapril and any of the previously mentioned agents is deemed appropriate, they should be used with caution and with frequent monitoring of serum potassium.