lisinopril

Monitor blood pressure, renal function, and electrolytes in patients on lisinopril and hydrochlorothiazide tablets and other agents that affect the RAS. Do not coadminister aliskiren with lisinopril and hydrochlorothiazide tablets in patients with diabetes. No meaningful clinically important pharmacokinetic interactions occurred when lisinopril was used concomitantly with propranolol, digoxin, or hydrochlorothiazide.

Mechanism: These drugs work in different ways to lower blood pressure and do not interfere with how the body breaks each other down.

What to do: Your healthcare provider should regularly check your blood pressure, kidney function, and salt levels while you are on both medications.

Dual Blockade of the Renin-Angiotensin System (RAS): Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or direct renin inhibitors (such as aliskiren) is associated with increased risk of hypotension, syncope, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Do not coadminister aliskiren with lisinopril and hydrochlorothiazide tablets in patients with diabetes. Avoid use of aliskiren with PRINZIDE in patients with renal impairment (GFR <60 ml/min).

Mechanism: Both medicines target the same body system to lower blood pressure, which can lead to dangerously low blood pressure or kidney damage.

What to do: This combination should be avoided, especially if you have diabetes or kidney issues, to prevent serious health risks.

The VA NEPHRON trial enrolled 1448 patients with type 2 diabetes, elevated urinary-albumin-to-creatinine ratio, and decreased estimated glomerular filtration rate (GFR 30 to 89.9 ml/min), randomized them to lisinopril or placebo on a background of losartan therapy and followed them for a median of 2.2 years. Patients receiving the combination of losartan and lisinopril did not obtain any additional benefit compared to monotherapy for the combined endpoint of decline in GFR, end state renal disease, or death, but experienced an increased incidence of hyperkalemia and acute kidney injury comp...

Mechanism: Using these two blood pressure drugs together can overwork the kidneys and cause potassium to build up to unsafe levels.

What to do: This combination is usually avoided because it increases the risk of kidney injury without providing extra health benefits.

Use of lisinopril with potassium-sparing diuretics (e.g., spironolactone, eplerenone, triamterene, or amiloride), potassium supplements, or potassium-containing salt substitutes may lead to significant increases in serum potassium.

Mechanism: Both drugs prevent the kidneys from removing potassium, which can cause this mineral to build up in your blood.

What to do: Your healthcare provider should regularly check your potassium levels to ensure they stay within a safe range.

No meaningful clinically important pharmacokinetic interactions occurred when lisinopril was used concomitantly with propranolol, digoxin, or hydrochlorothiazide.

Mechanism: These drugs do not change how the body absorbs or breaks down one another.

What to do: No special changes are usually needed when these two medicines are used at the same time.

Product Mix Up: This product is being recalled because of a complaint received that a sealed bottle of lisinopril and hydrochlorothiazide tablets 20mg/12.5 mg had a foreign tablet identified as atazanavir and ritonavir tablet 300mg/100mg.

Lupin Pharmaceuticals Inc.