Indications for: AVALIDE
Take once daily. Not controlled on monotherapy: initially 150/12.5mg, titrate to 300/12.5mg then 300/25mg if needed. Initial therapy: start at 150/12.5mg for 1–2 weeks, then titrate as needed up to max 300mg/25mg. May be substituted for titrated components. Severe renal impairment (CrCl ≤30mL/min): not recommended.
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Intravascular volume- or sodium-depletion. Correct hypovolemia before starting therapy. Hepatic impairment. Severe CHF. Severe renal disease. Renal artery stenosis. Asthma. Postsympathectomy. SLE. Gout. Acute angle-closure glaucoma. Elevated IOP. Acute myopia. Choroidal effusions. Monitor renal function and electrolytes periodically. Elderly. Neonates. Pregnancy: avoid. Nursing mothers: not recommended.
Angiotensin II receptor blocker (ARB) + thiazide diuretic.
See Contraindications. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Concomitant aliskiren in renal impairment (CrCl <60mL/min): not recommended. Hyperkalemia with K+ supplements, K+ sparing diuretics, K+ containing salt substitutes. Orthostatic hypotension with alcohol, other CNS depressants. Hypokalemia with corticosteroids, ACTH. Potentiates other antihypertensives. May potentiate muscle relaxants (eg, curare derivatives). May be antagonized by, and renal toxicity potentiated by NSAIDs, including COX-2 inhibitors; monitor. Antagonizes norepinephrine. Adjust antihyperglycemics. Separate dosing by ≥4hrs before or 4–6hrs after cholestyramine or colestipol resins. May increase lithium toxicity. Risk of hyponatremia with carbamazepine (monitor). May interfere with parathyroid tests.
Dizziness, fatigue, musculoskeletal pain, GI upset; renal dysfunction, electrolyte and metabolic disturbances; HCTZ: increased risk for non-melanoma skin cancer.
Generic Drug Availability: