Renal disease or transplant, renal artery stenosis, cardiac disorder, raised aldosterone levels, hypotension, elevated serum K, diabetes. Dual blockade of the renin-angiotensin-aldosterone system (RAAS) through the combined use of ACE inhibitors, angiotensin II receptor blockers or aliskiren is not recommended. ACE inhibitors & angiotensin II receptor blockers should not be used concomitantly in patients w/ diabetic nephropathy. Black patients. Lactose intolerance. May affect ability to drive or operate machinery. Lactation. Childn & adolescent ≤18 yr.
Lithium, K-containing salt substitutes, K-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, heparin, ciclosporin, tacrolimus, trimethoprim. Diuretics. Reduced efficacy w/ NSAIDs or corticosteroids. Higher frequency of adverse events w/ combined use of ACE inhibitors, angiotensin II receptor blockers, or aliskiren.
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