Drug interactions
Amiloride + Sacubitril / valsartan
Severity: Major
Amiloride and Sacubitril / valsartan: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both amiloride and valsartan reduce potassium excretion, so combining them can cause clinically significant hyperkalemia. The risk is greater in patients with renal impairment, diabetes or heart failure, and with higher doses.
What this interaction means in plain words
Amiloride and Sacubitril / valsartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Amiloride blocks the epithelial sodium channel in the collecting duct while valsartan blocks angiotensin II type 1 receptors and so lowers aldosterone-mediated potassium excretion, giving additive potassium retention.
What to do
Check serum potassium and renal function before starting and again within the first week or so, then at regular intervals. Reduce or stop amiloride if potassium rises above the normal range.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amiloride
- Amiloride + Eplerenone Contraindicated
- Amiloride + Spironolactone Contraindicated
- Amiloride + Triamterene Contraindicated
- Aceclofenac + Amiloride Major
- Acemetacin + Amiloride Major
- Amiloride + Amlodipine-benazepril Major
Frequently asked questions
Can I take Amiloride with Sacubitril / valsartan?
MediHelp rates the interaction as major. Amiloride and Sacubitril / valsartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both amiloride and valsartan reduce potassium excretion, so combining them can cause clinically significant hyperkalemia. The risk is greater in patients with renal impairment, diabetes or heart failure, and with higher doses.
How serious is the interaction between Amiloride and Sacubitril / valsartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and renal function before starting and again within the first week or so, then at regular intervals. Reduce or stop amiloride if potassium rises above the normal range.
What other medicines interact with Amiloride?
MediHelp also lists interactions of Amiloride with, for example, Eplerenone, Spironolactone, Triamterene. The full list is on the Amiloride page.
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