ACE Inhibitors; ARBs; Aliskiren/Potassium Preparations Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process potassium properly.

What might happen:

Your blood levels of potassium may increase and cause toxic effects.

What you should do about this interaction:

If you experience breathing difficulties, chest pain, irregular heartbeat, confusion, or muscle weakness, contact your doctor. If your doctor prescribes these two medicines together, you may need to check your blood level of potassium. The dose of your medicines may need adjusting. This interaction may be worse if you have kidney disease or diabetes.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Cleary JD, Taylor JW. Enalapril: a new angiotensin converting enzyme inhibitor. Drug Intell Clin Pharm 1986 Mar;20(3):177-86.
  • 2.Grossman A, Eckland D, Price P, Edwards CR. Captopril: reversible renal failure with severe hyperkalaemia. Lancet 1980 Mar 29;1(8170):712.
  • 3.Warren SE, O'Connor DT. Hyperkalemia resulting from captopril administration. JAMA 1980 Dec 5;244(22):2551-2.
  • 4.Maslowski AH, Ikram H, Nicholls MG, Espiner EA. Haemodynamic, hormonal, and electrolyte responses to captopril in resistant heart failure. Lancet 1981 Jan 10;1(8211):71-4.
  • 5.Textor SC, Bravo EL, Fouad FM, Tarazi RC. Hyperkalemia in azotemic patients during angiotensin-converting enzyme inhibition and aldosterone reduction with captopril. Am J Med 1982 Nov;73(5):719-25.
  • 6.Burnakis TG, Mioduch HJ. Combined therapy with captopril and potassium supplementation. A potential for hyperkalemia. Arch Intern Med 1984 Dec; 144(12):2371-2.
  • 7.Atlas SA, Case DB, Sealey JE, Laragh JH, McKinstry DN. Interruption of the renin-angiotensin system in hypertensive patients by captopril induces sustained reduction in aldosterone secretion, potassium retention and natruiresis. Hypertension 1979 May-Jun;1(3):274-80.
  • 8.Papadimitriou M, Zamboulis C, Alexopoulos E, Liamos H, Sakellariou G, Memmos D, Metaxas P, Thessaloniki G. Alarming hyperkalemia during captopril administration in patients on regular hemodialysis. Dialysis Transplant 1985 Aug;14:473-5.
  • 9.Schuna AA, Schmidt GR, Pitterle ME. Serum potassium concentrations after initiation of captopril therapy. Clin Pharm 1986 Nov;5(11):920-3.
  • 10.Cozaar (losartan potassium) US prescribing information. Merck & Co., Inc. December 11, 2015.
  • 11.Diovan (valsartan) US prescribing information. Novartis Pharmaceuticals Corporation July, 2015.
  • 12.Tekturna (aliskiren) US prescribing information. Novartis Pharmaceuticals Corporation November 4, 2016.